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Prescription drug information and resources
Have Medicare prescription questions? You’re in the right place. Below, you’ll find Medicare prescription information, as well as details on Aetna® prescription drug coverage.
Prescription drug coverage rules:
Prescription drug coverage rules:
Some drugs have coverage rules you need to follow. These include:
- Prior authorization - You or your doctor needs approval from Aetna before we cover the drug.
- Quantity limits - For certain drugs, there’s a limit on the amount of it you can fill within a certain time frame. For example, 60 tablets per 30-day prescription.
- Step therapy - We require you to try another drug first before we cover your drug.
Two ways to request an exception to our coverage rules
Two ways to request an exception to our coverage rules
You or your doctor can request an exception to one of our coverage rules using either of the following two options:
- Request an exception online.
- Call Customer Care at the number on your Aetna member ID card.
To learn more about requesting an exception, please refer to your Evidence of Coverage.
Understanding our medication transition process
Understanding our medication transition process
There may be times when you’re taking a drug that either isn’t on our formulary (drug list) or has coverage rules. A formulary shows the drugs we cover, the tier a drug is on, any limits or coverage rules and mail-order availability.
Learn about our transition process to see if you’re eligible for a one-month supply of medication. This temporary supply allows you to work with your doctor to either transition to a new drug on our formulary or request an exception to continue your current drug.
Find the list of drugs covered by Aetna for Medicare
The Aetna drug search tool lets you check Medicare drug coverage and find the lowest Medicare drug costs available. You can also find and download the formulary for your specific Medicare plan.