What is the difference between Tier 1 Tier 2 drugs?
Feb 24, 2022 · Check our drug list. Search our formulary for covered drugs and get the information you need. It shows the drugs we cover, the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Your Summary of Benefits tells you the drug costs for tiers.
What is the Aetna Medicare Formulary for drugs?
Oct 01, 2021 · Formularies are set up in tiers. A drug in a lower tier usually costs less than a drug in a higher tier. Use a plan’s formulary to tell you which drugs are covered and which tier they are in. The tiers are numbered and include: Tier 1, Preferred Generic: These are commonly prescribed generic drugs. Tier 2, Generic: These drugs are generic but ...
How many tablets does Aetna prescribe per month?
Jan 06, 2022 · Tier 1 / Tier 2. *As low as $0 if you receive Extra Help. **For SmartRx Tier 2-5 drugs, and Choice Tier 3-5 drugs, the deductible is $480. † For 30-day supply, at preferred pharmacies in the initial coverage stage. †† Copays may vary by state.
Does Aetna Medicare Rx value plus have a deductible?
To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling. 1-877-890-1409. 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. A licensed insurance agent can use Aetna Medicare plan formularies to help you find Aetna Medicare prescription drug ...
What is a Tier 2 prescription?
What are drug formulary tiers?
What is a drug tier exception?
What is a Tier 3 drug list?
How are prescription drug tiers determined?
How many tiers are there in Medicare Part D?
What are the 4 phases of Medicare Part D coverage?
What is Tier 3 in Medicare Part D?
What is quantity limit exception?
Use this form to request coverage of a quantity in excess of plan quantity limits. Quantity limits are in place on certain classes of agents based on manufacturer's safety and dosing guidelines.
What is a Tier 4 medication?
What is a Tier 6 drug?
Is Synthroid a Tier 2 drug?
What drugs are covered by Aetna Medicare plans?
An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It also lists them in alphabet...
What are the drug tier copay levels in a formulary?
The copay amount you pay will vary from one Aetna Medicare plan to another. So be sure to check your plan’s Summary of Benefits or Evidence of Cove...
Does Aetna offer mail order prescription drug coverage?
Some drugs on an Aetna Medicare plan formulary may be eligible for home delivery through CVS Caremark® Mail Service Pharmacy. You can typically get...
What are the tiers of a drug plan?
What are drug tiers? Formularies are set up in tiers. A drug in a lower tier usually costs less than a drug in a higher tier. Use a plan’s formulary to tell you which drugs are covered and which tier they are in. The tiers are numbered and include: Tier 1, Preferred Generic: These are commonly prescribed generic drugs.
What is Tier 2 generic?
Tier 2, Generic: These drugs are generic but usually cost more than the drugs in Tier 1.
What is Tier 4 drug?
Tier 4, Non-Preferred Drug: These are higher-priced brand-name and generic drugs, less commonly prescribed than drugs in the preferred tiers. Tier 5, Specialty: These are the most expensive drugs on the list. They may require special handling and/or close monitoring. Check our formulary.
What is Tier 4 non preferred?
Tier 4, Non-Preferred Drug: These are higher-priced brand-name and generic drugs, less commonly prescribed than drugs in the preferred tiers.
Who provides Medicare Part D?
Because Medicare Part D is provided by private insurance companies such as Aetna and SilverScript, each company can decide which drugs to cover. However, a formulary must meet the minimum standards and requirements of Medicare Part D coverage.
Does Aetna use InstaMed?
Aetna handles premium payments through InstaMed, a trusted payment service. Your InstaMed log-in may be different from your Caremark.com secure member site log-in.
Who is Caremark for Aetna?
Aetna has selected Caremark as the prescription management and mail delivery service for our members. If you do not intend to leave our site, close this message.
Does Aetna use InstaMed?
Aetna handles premium payments through InstaMed, a trusted payment service. Your InstaMed log-in may be different from your Caremark.com secure member site log-in.
Does Aetna use Payer Express?
Aetna handles premium payments through Payer Express, a trusted payment service. Your Payer Express log-in may be different from your Aetna secure member site log-in.
How to find out what Aetna plans are covered by?
An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It also lists them in alphabetical order. To find out which drugs are covered by Aetna Medicare plans in your area, you can speak with a licensed insurance agent. You can reach one by calling. 1-877-890-1409.
What are the copay tiers for Medicare?
In them you’ll find the copay or coinsurance amounts you can expect for the plan year. The formulary copay tiers are as follows: Tier 1: Preferred Generic. Tier 2: Generic. Tier 3: Preferred Brand. Tier 4: Non-Preferred Drug.
How do I get Aetna Medicare?
How can I get Aetna Medicare prescription drug coverage? You can receive Aetna Medicare prescription drug coverage by enrolling in an Aetna Medicare Advantage plan that include prescription drug coverage (MAPD). Each plan offers low copay amounts at preferred retail pharmacies and through home delivery.
How does Medicare formulary work?
A Medicare formulary organizes prescription drugs into tiers. Your copay for each drug may differ based on the tier in which the drug fits.
How to contact Aetna by phone?
You can reach one by calling. 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week.
How long does it take for Aetna to deliver?
You can typically get up to a 90-day supply for most medications through this home delivery service. Prescriptions usually arrive within 7 to 10 days.
What is the number for Aetna?
1-877-890-1409. 1-877-890-1409 TTY Users: 711 24 hours a day, 7 days a week. A licensed insurance agent can use Aetna Medicare plan formularies to help you find Aetna Medicare prescription drug coverage that fits your needs.
How many tiers are there in a drug plan?
Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
Where to find Aetna pharmacy plan name?
Not sure of the plan name? If you’re an Aetna member, you can find this information in your Summary of Benefits and Coverage (SBC). If your employer is offering an Aetna pharmacy plan and you’re considering one, ask your HR department for the plan name.
What is Aetna insurance?
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions and limitations. See all legal notices.
Is Aetna a part of CVS?
and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Aetna is proud to be part of the CV S Health family . You are now being directed to the CVS Health site.
Is Aetna liable for the content of linked sites?
Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Please log in to your secure account to get what you need. You are now leaving the Aetna Medicare website.
Is Aetna Inc. responsible for the content of its websites?
Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Links to various non-Aetna sites are provided for your convenience only.
Medicare Part D FAQs
Find the answers to common questions about prescription drug coverage.
Policies & Procedures
Standalone Prescription Drug Plans are offered by SilverScript, a CVS Health company.
More coverage details
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 (TTY: 711), 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.
Already a member?
Find coverage and formulary details, check copays and estimate drug costs for your plan on your member website.
Looking for Medicare plans?
Use our helpful resources to find plans by ZIP code, see if your doctor or medicine is covered and more.
Legal notices
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Which is better, Aetna or RX Saver?
For typically higher premiums than the Rx Select plan, the Aetna Medicare Rx Saver plan offers the best coverage for Tier 3 (preferred brand) drugs out of all three plans—in our sample, that is; your mileage may vary. It also gives slightly better coverage than the Rx Select plan for Tier 5 (specialty) drugs.
Which Medicare plan has the highest monthly deductible?
Aetna Medicare Rx® Value Plus (PDP) Although Aetna's Medicare Rx Value Plus plan typically has the highest monthly deductible, it provides the best coverage of all three plans for a wider range of drugs.
Does CVS have Aetna?
CVS customers: Every CVS pharmacy in the country is in Aetna’s preferred network. Home delivery fans: Aetna offers home delivery in some of its plans, so you may not have to go to a physical pharmacy to get your medications.
Does Aetna sell Part D?
NOTE: As a contingency for the Aetna/CVS merger to continue, Aetna was required to sell its Part D program, which WellCare purchased. For 2019, Aetna has promised not to change its Part D “benefits, networks, formularies, or premiums.” 2 But starting in 2020, all of Aetna’s plans will officially be under WellCare—be sure to check WellCare’s Part D ...
Does Aetna deductible work for generic drugs?
This plan could work for people who need generic drugs, but also a few brand name drugs that are on the preferred tier on Aetna’s formulary —although you must meet the deductible before coverage kicks in for anything Tier 3 (preferred brand drugs) and below.
Is eligibility.com a DBA?
Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.
Does Aetna have Tier 1 or Tier 2?
This plan could be a viable option for any beneficiary who wants drug coverage but doesn’t take a lot of brand-name prescriptions, as it offers adequate Tier 1 and 2 coverage with no deductible. If you rely more on brand-name preferred (Tier 3) or non-preferred (Tier 4) drugs, however, you may save more money if you go with one of Aetna's other two plans.
How to request medical exception for Aetna?
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 CVS Health , ATTN: Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081. If the request is expedited a coverage determination will be made within 24 hours of receiving the request, and notify you or your prescriber of our decision. All medically necessary outpatient prescription drugs will be covered. If a medical exception is approved the member is responsible for the highest applicable copay after deductible depending upon the members pharmacy plan design.
How to contact Aetna Pharmacy?
You or your doctor can call the Aetna Pharmacy Precertification Unit at 1-800-414-2386 . You can log in to your secure member website and submit a request through the Contact Us feature. You or your doctor can fill out a request form and send it to us: By fax. The fax number is on the form.
How to receive prescription refill notices?
When you enroll a prescription in the service, you will need to select a preferred method of communication (either automated phone call, email or text message) to receive notices about upcoming automatic refill orders . If you select automated phone calls or text messages, please note that you may also receive notices by email or the U.S. postal mail.
What is coinsurance on a prescription?
Copayment, co-pay or coinsurance is the amount a plan member is required to pay for a prescription in accordance with a plan.
What happens if you don't have Aetna?
If you have out-of-network benefits, and you use a pharmacy that is not in the Aetna network, you pay the full amount at the time of purchase. Then you can submit a claim and get reimbursed. You are still responsible for any copay or coinsurance. If you don't have out-of-network benefits, you will not be reimbursed.
How to see if a drug is covered by a pharmacy plan?
To see if a drug is covered by your plan, log in to your secure member website. You can search by the drug name to see coverage information. Log in to see drug coverage information. If you prefer not to log in, and you know the name of your pharmacy plan and tier, you can view your formulary (drug list) online.
How to find my pharmacy plan?
If you have a plan through your job - or your spouse's/partner's job - and don't know the name of your plan or tier, contact the Human Resources department of the employer that offers your coverage. Find your formulary.