Find A Medication - 2020 Small Group ACA Plans
2020 - Other plan information
Preventive drugs and products
- Under health care reform, you can get some drugs and products with no member cost share. This means they are covered 100 percent by your plan. This list shows some common examples.
Medical exceptions for non-covered drugs
Expedited medical exceptions
In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025, or fax a request to 1-855-330-1716. You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081. We will make a coverage determination within 24 hours of receiving the request, and notify you or your prescriber of our decision.
*These circumstances exist when you are suffering from a health condition that may seriously jeopardize your life, health, or ability to regain maximum function, or undergoing a current course of treatment using a non-covered drug.
This material is for information only. CVS Specialty® and Aetna are part of the CVS Health family of companies. Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The drugs on the Preferred Drug List Formulary Exclusions, Precertification, and Quantity Limit Lists are subject to change. The precertification and quantity limits drug coverage review programs are not available in all service areas. For example, precertification programs do not apply to fully insured members in Indiana. However, these programs are available to self-insured plans.
Information is believed to be accurate as of the production date; however, it is subject to change.
