Medicare Resources: Covered Drugs
Open Formulary

Preferred drug list for the Aetna Medicare Rx Premier Plan (and certain Medicare Advantage Plans)

Are your medications covered by the Aetna Medicare RxSM Plan? A preferred drug list, or formulary, is a list of brand-name and generic drugs that are covered by our prescription drug plans. It is developed with help from pharmacists and physicians from both within and outside the company.

Download The Aetna Medicare Rx Premier Plan preferred drug list now. (You must have Adobe Reader to view this document. If you do not have Adobe Reader, click here to download it.)
You can then search this document for any term or medication simply by:

  1. Opening the Adobe Reader application and opening the document.
  2. Under the Edit menu, select “Search.”
  3. Enter the name of the medication, or the word or phrase you wish to find.
  4. Click the “Search” button.
The preferred drug list (or formulary) has been approved by the Federal government. It provides you and your doctor with a choice of quality, cost-effective generic and brand name medications approved by the U.S. Food and Drug Administration (FDA). When a doctor prescribes medications on the preferred drug list, it helps you reduce costs.

To be considered for the preferred drug list, a medication first must be approved by the U.S. Food and Drug Administration (FDA). The FDA is a federal agency charged with promoting and protecting public health by making sure drugs and other products are safe and effective and reach the market in a timely way. Once drugs and other products have entered the market, the FDA monitors them for continued safety. To determine whether an FDA-approved medication belongs on Aetna's preferred drug list, Aetna evaluates its safety, effectiveness and value in comparison with similar drugs. Most drugs listed on the preferred drug list are subject to manufacturer volume discount arrangements under which Aetna receives financial consideration. Keep in mind that our plan provides coverage for hundreds of other prescription drugs that are not listed on our preferred drug list. Also, our formulary is subject to change.

Aetna Medicare prescription drug plans cover both brand-name drugs and generic 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 safe and effective as brand-name drugs.

The Aetna Medicare preferred drug list is current as of this publication. The information is updated on a monthly basis. Once enrolled, you can call the toll-free Member Services number on your ID card to obtain additional information on any changes to the Aetna Medicare preferred drug list. If a medication is removed from the list, you will be notified at least 60 days before it is removed from the drug list or if precertification, quantity limit or step-therapy restrictions have been placed on a medication. We will also update this information, along with any drugs added to the formulary, on this website. (If the FDA deems a drug on the list is unsafe or the drug's manufacturer removes the drug from the market, we will immediately eliminate it from our list.)

Exceptions
You can ask Aetna to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make, they include:


  • You can ask us to cover your medication even if it is not covered on our Aetna Medicare preferred drug list.
  		• You can ask us to waive coverage restrictions or limits on your medication. For example, for certain medications Aetna limits the amount of the medication that we will cover. If your medication has a quantity limit, you can ask us to waive the limit and cover a higher quantity.
  		•  If you are in a three-tier open formulary plan, you can ask us to provide a more favorable level of coverage for your medication. For example, if your brand name medication is usually considered a non-preferred 3rd tier copay medication, you can ask us to cover it as a preferred 2nd tier copay instead. This would lower the amount you must pay for your medication.
  		• To request an exception to our coverage rules, you should submit a statement from your physician supporting your request. Most decisions will be made within 72 hours of your request.


    Public Notice of Transition Process
    As a general matter, we believe plan sponsors must make transition processes available to beneficiaries in a manner similar to information provided on formularies and benefit design. It is likely that individuals will base their decisions on which prescription drug best meets their needs on a variety of factors. Matching their current medication list with a Part D plan's formulary may only be one factor in the decision-making process. Other factors, such as cost issues and inclusion of the retail pharmacy that they are most familiar with in the plan's network, may bear more weight in the final decision-making process. Having information about a plan's transition process may reassure beneficiaries that there will be plan procedures in place to assist them switching to therapeutic alternative medications where appropriate. It will also serve a dual purpose in educating advocates and other interested third parties about plan transition process; for example, state Medicaid agencies with regard to full-benefit dual eligibles auto-enrolled into prescription drug plans.

    Contact Us
    Questions? Call us at 1-800-529-5586 (TDD 1-800-628-3323) Monday - Friday, 8:00 a.m. - 6:00 p.m. Click here for general Medicare information contacts.