A formulary is a list of prescription medications that are covered under aetna health and life insurance companys 2020 medicare advantage plan in texas. A formulary is a list of generic and brandname drugs your health plan prefers. Specialty drugs if you need drugs to treat your illness or condition prescription drug coverage is. Aetna medicare is a pdp, hmo, ppo plan with a medicare contract. Search by typing part of the generic chemical or brand trade name. The aetna prescription prior authorization form is a document that is used to justify the prescribing of a particular medication not already on the aetna formulary. If your prescription is written for fewer than 30 days, well allow. Aetna choice pos ii medical plan plan features home host network aetna network outofnetwork calendar year. Aetna specialty pharmacy refers to aetna specialty pharmacy, llc, a subsidiary of aetna inc. Information about the cost of this plan called the premium will be provided.
Aetna choice pos ii medical plan marine corps community. Check out pages 14 20 of the 2020 postdoc benefits guide to see the new 2tier structure with aetna choice pos ii plan, you may select any physicians and hospitals in and outside the plans network. With your aetna choice pos ii plan, you are free to visit any doctor whenever you need care, but you save money when you use innetwork providers because they charge a lower, negotiated fee, and the plan pays a higher percentage of. Please see your human resources representative for details.
Below is the formulary, or drug list, for aetna medicare choice plan hmo pos from aetna health inc. The drugs on the preferred drug list formulary exclusions, precertification, and quantity limit lists are subject to change. You must continue to pay your medicare part b premium. A formulary is a list of covered drugs selected by aetna medicare rx offered by silverscript in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. We choose drugs for it that are safe and cost effective theyre the drugs your health benefits or insurance plan prefers that you use. Search by the therapeutic class of your medication. Find a preferred aetna s choice pos ii network provider online, or by asking your doctor if they are in the preferred network. Aetna pharmacy management administers, but does not offer, insure or otherwise underwrite the. The drug list also tells you if there are any special rules or restrictions on any drugs. Although you may see any provider covered by the plan, you receive higher benefits if you use ppo providersthe choice is yours, each time you use your benefits.
The aetna choice pos ii plan offers comprehensive health care both inside and outside the extensive aetna network. Check our medicare covered drug list aetna medicare. Angiotensin ii receptor antagonist calcium channel blocker combinations. After two fills at your local retail pharmacy, you will pay the full cost of the drug if you choose to continue to receive only a 30day supply. Nonpreferred brand drugs 10% coinsurance not covered not covered applicable cost as noted above for generic or brand drugs. Your guide includes a list of commonly used drugs covered on your pharmacy. Aetna choice pos ii the aetna choice pos ii plan is a network plan that gives you the freedom to select any licensed provider when you need care. So when your doctor prescribes one of these drugs, it can help you control the cost of health care. The aetna pharmacy drug guide shows you recent changes to the guide.
Aetna intouch care, informed health line, and the aetna maternity programs included at no extra cost. Beginning jan 1, 2020 aetna choice will become a 2tier network plan. Your guide includes a list of commonly used drugs covered on your pharmacy plan. This is a preferred provider organization plan that gives you the freedom to receive care from any licensed health care provider and the opportunity to save when you use preferred providers doctors and other health care providers who belong to the aetna network. Aetna standard plan preferred specialty drugs and formulary excluded specialty drugs. The drug list also tells you if there are any special rules or restrictions on any drugs covered by. The sbc shows you how you and the plan would share the cost for covered health care services. If you have an aetna plan, your pharmacy plan type is on your summary of benefits and coverage sbc. Aetna rx home delivery medicine and support services. If you mail in your own prescription, please send it with a completed patient profile form.
Choice pos ii map plus option 2 high deductible health plan hdhp with prescription drug outofarea under 65 retirees excludes medicare retirees this is an erisa plan, and you have certain rights under this plan. The sbc shows you how you and the would share the cost for covered. For specialty drug information, see the federal plan brochure if you choose the brand name drug over the generic equivalent, you will owe the corresponding copay plus the. Find a list of covered prescription drugs under your aetna plan or for the plan youre considering if not yet a member as well as medication cost estimates. Its either a flat fee how to use this guide your guide includes a list of commonly used drugs covered on your pharmacy plan. Aetna standard plan excluded drugs, with covered alternatives. Please contact your employer for additional information. Nonpreferred benefits are subject to recognized charges. Health benefits and health insurance plans contain exclusions and limitations. This plan is a network plan, which means you get the highest level of benefits when you choose doctors, hospitals and other health care providers who belong to the aetna network. Aetna choice pos carnegie human resource department.
If the necessary preauthorization is not obtained, the drug may not be covered. A formulary is a list of covered drugs selected by aetna medicare rx offered by silverscript in. To check coverage and copay information for a specific medicine log in to your secure member website after your effective date. Benefit plan what your plan covers and how prepared. Aetna maintains choice pos ii provider networks throughout the. Youll find drug tiers and any special rules, like prior authorizations. Free aetna prior prescription rx authorization form pdf. The amount you pay depends on the drug your doctor prescribes. Aetna is the brand name used for products and services provided by one or more of the aetna group of subsidiary companies, including aetna life insurance company and its affiliates aetna. Click here for the 2020 preferred drug guide formulary pdf. Drugs formulary introduction this document is called the list of covered drugs also known as the drug list. Check our drug list formulary to see which drugs are covered by your aetna medicare plan.
Aetna medicare formulary 8 drug tier copay levels 9 formulary key 10 drug list 10 index of drugs 100 enhanced drug list 122 2. Pos the summary of benefits and coverage sbc document will help you choose a health plan. Your user name stays the same, even if you change jobs or the type of insurance you have with us. Ppo the summary of benefits and coverage sbc document will help you choose a health plan. It tells you which prescription drugs and overthecounter drugs and items are covered by aetna better health premier plan.
You may search for your prescription in several ways. The patients personal insurance information, their current condition, and the previous drugs therapies attempted to. Preventive care is paid in full with your trust plan. This plan offers both innetwork and outofnetwork benefits.