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Our dual-eligible Special Needs Plans (DSNPs) are available in Florida and Pennsylvania to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details.
You can reach First Health Part D customer service at 1-844-233-1938 (TTY: 711) or Coventry Health Care customer service for Medicare Advantage plans at 1-844-741-8423 (TTY: 711), 8 a.m. to 8 p.m., local time, seven days, from October 1 - February 14; 8 a.m. to 8 p.m., local time, Monday - Friday, from February 15 - September 30.
Aetna Medicare covers both brand name and generic prescription drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Pharmacy clinical programs such as prior authorization, step therapy, and quantity limits may apply to your prescription drug coverage.
This is not a complete list of all formulary alternatives covered by the Part D sponsor for the drug you have selected. Our Medicare plans may not cover all of the drugs listed in this search tool. Also, the tool doesn’t include every drug that may be covered by Medicare.
Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year.
See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.
Aetna Medicare's pharmacy network offers limited access to pharmacies with preferred cost sharing in: Rural Missouri, Urban Alabama and Urban Tennessee. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at https://www.aetnamedicare.com/pharmacyhelp.
Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual members where DSNP plans are available.
For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. Please call us if you do not receive your mail-order drugs within this timeframe.
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Last Updated: 10/01/2017