Get details on your prescription drug costs and coverage

Your Aetna^® prescription drug coverage comes with powerful coverage that, when used correctly, can help you save money. This video will help you better understand how to get the most coverage and savings out of your plan.

First, you’ll need to understand how your medications are priced. Each medication is placed on one of 5 different drug tiers. Tier 1 is the least-expensive option and Tier 5 is the most expensive. Generally, the lower the tier, the less you pay.

You can find what tier a drug is on by checking your formulary or drug list. You can find the formulary or drug list on your member portal. It details which drugs are covered and any plan requirements associated with these drugs.

For example, you may see acronyms like PA, ST, or QL next to a drug. Here are a few definitions so you can understand what they mean.

• Step therapy: You’ll need to try certain drugs first before we’ll cover another option. A drug like this will have “ST” in the “Requirements/Limits” column.
• Prior authorization: Your doctor needs to get approval from us before we cover the drug. A drug like this will have “PA” in the “Requirements/Limits” column.
• Quantity Limit: There’s a limit on the amount of the drug that we cover. A drug like this will have “QL” in the “Requirements/Limits” column.

Additionally, you’ll notice drug names are either in italics or UPPERCASE letters. These mean:

• Italics – generic drugs that are most often found on lower tiers
• UPPERCASE – brand-name drugs that are most often found on higher tiers

It’s also important to note that the amount you pay for your drugs may depend on your plan’s deductible and how that deductible applies to the medications on your plan. For example, the deductible might not apply to Tier 1 and Tier 2 drugs in some plans. You can double check your coverage by consulting your Evidence of Coverage.

You can also consult your Evidence of Coverage when you work with your doctor. It can help your doctor prescribe drugs covered by your plan. And it may help them prescribe a lower-cost drug to help treat your condition.

When you’re ready to choose a pharmacy and receive your drugs, you have choices:

The first option is to pick them up in person. To receive the highest savings possible, you’ll want to find a preferred pharmacy on your member portal. Make sure you use a pharmacy in our network. Your plan may offer lower cost shares at preferred pharmacies in our network.

Another option is to receive your prescription through the CVS Caremark Mail Service Pharmacy. This option is great for those who regularly take maintenance drugs, like those for diabetes or asthma.

The service allows you to have up to a 90 or 100-day supply depending on your plan. Your drugs are delivered directly to you and may be a great option if you take medications regularly. It can also help you save time and trips to the pharmacy. Visit your Aetna member website to learn more about this service.

For more details on the specifics of your drug coverage, please review your plan documents. And of course, you can always visit us at AetnaMedicare.com to learn more.