Tools and Resources

Get forms and documents easily. Read online or print, it’s that simple.

 Find the documents below on our 2012 Download Documents page.

• Pharmacy Directory
• Provider Directory
• Aetna Quick Charge Program for members that receive a premium notice from Aetna
• Medicare Prescription Drug Claim Form for reimbursement of covered prescription drug services.
• Aetna Medical Exception/Precertification Request Form for Prescription Medication
• CMS Medicare Part D Coverage Determination Form

Aetna Medicare Advantage: Appeals and Grievances

We understand the importance of having the coverage you need. If you have a coverage issue or problem, Member Services can help you to resolve it. If you feel that Aetna Medicare should pay for benefits and services that are not covered, you have the right to appeal any decision. You have two options:

• Appeal to have a decision made by Aetna Medicare on the benefits you feel you are entitled to receive
• File a grievance to address your complaints and problems if Member Services cannot resolve your issue.

For more complete information about the appeal and grievance processes, download this Appeals and Grievances information Y0001_M_OT_WB_10925_R1 CMS Approved 12/29/2011 (9 pages, 102kb)

Aetna Medicare Rx Plan (PDP): Exceptions, Appeals and Grievances

We understand the importance of having the coverage you need — and that includes your prescription drugs. If you're taking a medication that's not currently covered by Aetna Medicare Rx^® Plan (PDP), you have several options:

• Request an exception for nonformulary Part D drugs and for brand, tiered cost sharing.
• Appeal to have Aetna Medicare make a decision on the benefits you feel you are entitled to receive.
• File a grievance to address your complaints and problems if Member Services is unable to resolve your issue.

For more complete information about the various appeals processes, download Exceptions, Appeals, and Grievances Information Y0001_M_OT_WB_10926_R2 CMS Approved (9 pages, 106 kb) 

• CMS Appointment of Representative form CMS-1696 Y0001_M_AG_FM_10121 File & Use 02/15/2011 (2 pages, 273 kb)
• Aetna Medicare Grievance Form Y0001_M_AG_FM_11150 CMS Approved 12/14/2011 (2 pages, 166kb)
• Request for Redetermination of an Aetna Medicare Prescription Drug Denial (Appeal) Y0001_M_AG_FM_11152 CMS Approved 12/12/2011 (2 pages, 168 KB)

Look up your covered prescriptions and more.

• For a partial list of covered prescription drugs for 2012, view and/or print our 2012 Aetna Medicare Abridged Formulary (prescription drug list). 2012 Aetna Medicare Abridged Formulary (48 pages, 582 kb)

• For a complete listing of all covered prescription drugs for 2012, view and/or print our 2012 Aetna Medicare Formulary (prescription drug list).

• 2012 Aetna Medicare Standard Formulary (188 pages, 999 kb)

• 2012 Aetna Medicare Open Formulary (212 pages, 1,103 kb)

• 2012 Aetna Medicare Base Closed Formulary (144 pages, 1,002 kb)

• Pharmacy Benefits – Aetna Rx Home Delivery – If you are looking for information about Aetna Rx Home Delivery, you can learn more by visiting AetnaMedicare.com/member, or members can log on to Aetna Navigator. Select the "Coverage & Benefits" then choose "Pharmacy Benefits."
  

Get forms and documents easily. Read online or print, it’s that simple.

 Find the documents below on our 2013 Download Documents page.

• Pharmacy Directory
• Provider Directory
• Aetna Quick Charge Program for members that receive a premium notice from Aetna
• Medicare Prescription Drug Claim Form for reimbursement of covered prescription drug services.
• Aetna Medical Exception/Precertification Request Form for Prescription Medication
• CMS Medicare Part D Coverage Determination Form

Aetna Medicare Advantage: Appeals and Grievances

We understand the importance of having the coverage you need. If you have a coverage issue or problem, Member Services can help you to resolve it. If you feel that Aetna Medicare should pay for benefits and services that are not covered, you have the right to appeal any decision. You have two options:

• Appeal to have a decision made by Aetna Medicare on the benefits you feel you are entitled to receive
• File a grievance to address your complaints and problems if Member Services cannot resolve your issue

For more complete information about the appeal and grievance processes, download this Appeals and Grievances information (5 pages, 139kb).

Aetna Medicare Rx Plan (PDP): Exceptions, Appeals and Grievances 

We understand the importance of having the coverage you need — and that includes your prescription drugs. If you're taking a medication that's not currently covered by Aetna Medicare Rx^® Plan (PDP), you have several options: 

• Request an exception for nonformulary Part D drugs and for brand, tiered cost sharing.  
• Appeal to have Aetna Medicare make a decision on the benefits you feel you are entitled to receive.  
• File a grievance to address your complaints and problems if Member Services is unable to resolve your issue.

For more complete information about the various appeals processes, download Exceptions, Appeals, and Grievances Information Y0001_M_OT_WB_10926_R2 CMS Approved (9 pages, 106 kb)

• CMS Appointment of Representative form CMS-1696 Y0001_M_AG_FM_10121 File & Use 02/15/2011 (2 pages, 273 kb)
• Aetna Medicare Grievance Form Y0001_M_AG_FM_11150 CMS Approved 12/14/2011 (2 pages, 166kb)
• Request for Redetermination of an Aetna Medicare Prescription Drug Denial (Appeal) Y0001_M_AG_FM_11152 CMS Approved 12/12/2011 (2 pages, 168 KB)

Look up your covered prescriptions and more.

• For a partial list of covered prescription drugs for 2013, view and/or print our 2013 Aetna Medicare Abridged Formulary (prescription drug list). 2013 Aetna Medicare Abridged Formulary (62 pages, 413 kb)
• For a complete listing of all covered prescription drugs for 2013, view and/or print our 2013 Aetna Medicare Formulary (prescription drug list).
• 2013 Aetna Medicare Managed Standard Formulary (183 pages, 1,522 kb)
• 2013 Aetna Medicare Open I Formulary (213 pages, 1,677 kb)
• 2013 Aetna Medicare Base Closed Formulary (149 pages, 1,456 kb)
• Pharmacy Benefits – Aetna Rx Home Delivery – Learn more about Aetna Rx Home Delivery by visiting AetnaMedicare.com/member. Select “Rx” and then “Rx by mail.” Or members can log on to Aetna Navigator. Select "Coverage & Benefits" then choose "Pharmacy Benefits."