Form validation functions

Aetna Medicare Rx Plans (PDP) FAQ

Frequently Asked Questions

About Aetna Medicare Rx® Plans (PDP)

Below are frequently asked questions about Medicare and Aetna Medicare Rx® Plans (PDP). To view an answer, simply click on that question. The questions are listed in six categories:  

General

  1. When did the Medicare prescription drug coverage begin?
  2. Is it really necessary to have Medicare prescription coverage?
  3. What does a Medicare prescription drug plan cover?  

Costs

  1. Can Aetna Medicare Rx® Plans (PDP) help me save on the costs of medications?
  2. How much will Medicare prescription drug coverage cost?
  3. Does this program benefit someone who takes only a few prescription medications each month?
  4. How do I pay plan premiums?
  5. Which Aetna Medicare Rx® Plan (PDP) allows me to pay the least out of my pocket to get a prescription filled?
  6. What if I need help paying for prescription drugs?
  7. Who qualifies for help? How can I find out more and apply for help?
  8. Medicaid helped pay for my prescription drug coverage in the past. Do I have to join a Medicare prescription drug plan?
  9. Will my Medicare Advantage plan premium go down if the government is helping pay for part of the Medicare prescription drug plan cost?

Coverage

  1. What is a “coverage gap?”
  2. Do all Medicare prescription drug plans have a coverage gap?
  3. What happens after the coverage gap?
  4. What about a plan with continuous coverage — no coverage gap (or donut hole)?
  5. Are both brand and generic prescription drugs covered?
  6. How can I find out which prescription drugs are covered?
  7. What is the Aetna Medicare Preferred Drug List, or formulary?
  8. Can the Aetna Medicare Preferred Drug List change?
  9. What if a medication I'm already taking is not included on the Aetna Medicare Preferred Drug List?
  10. How do I request an exception to the Aetna Medicare Preferred Drug List?
  11. What are generic medications?
  12. Do Aetna Medicare Rx® Plans (PDP) cover wheelchairs and durable medical equipment (DME)?
  13. Do the Aetna Medicare Rx® Plans (PDP) cover insulin and diabetic supplies?
  14. What if I already receive prescription drug coverage as part of my employer's retiree benefits?
  15. What is “creditable coverage?”
  16. I have coverage through the Veteran’s Administration (VA). Will my prescriptions continue to be covered?
  17. What drugs are not covered under Medicare prescription drug plans?

Filling Prescriptions

  1. Which pharmacies can I use to get covered prescriptions filled?
  2. Can I get prescriptions by mail order?
  3. How will a prescription mail-order service help me save money?
  4. What if I'm traveling and need to fill a covered prescription?
  5. Are prescriptions filled in Canada covered?

Enrolling

  1. Do I need to sign up for Medicare prescription drug coverage?
  2. Is it better to enroll in a plan that provides both medical and prescription coverage?
  3. Who is eligible to join a Medicare prescription drug plan?
  4. How do I enroll?
  5. What if I didn't select a Medicare prescription drug plan by May 2006?
  6. Is there a standard time period for people to change their coverage?
  7. I just have Original Medicare (Parts A and B). Can I enroll in the Aetna Medicare Rx® Plan?
  8. I have a Medicare Supplement (Medigap) plan. Can I enroll in a Medicare Rx plan?
  9. Can a child or guardian enroll a parent in a prescription drug plan?
  10. What happens to my Medicare card if I enroll in a prescription drug plan?
  11. What happens to my Medicare card if I enroll in a Medicare Advantage plan that has a prescription drug plan?

Member ID Cards

  1. When will my Medicare prescription drug coverage begin if I enroll in an Aetna Medicare Rx® Plan (PDP)?
  2. When should I expect to receive my Aetna Medicare member ID card?
  3. How can I get my covered prescriptions filled if I have NOT received my new member ID card for the Aetna Medicare Rx® Plan (PDP)?

General

  1. When did the Medicare prescription drug coverage begin?

    The legislation passed by Congress and signed by President George W. Bush in 2003 created the Medicare Part D prescription drug benefit, giving everyone with Medicare access to prescription drug coverage effective January 1, 2006. Medicare beneficiaries may purchase prescription drug coverage from private insurance companies, such as Aetna. In addition, extra help is available for people with low incomes.

    back to top

  2. Is it really necessary to have Medicare prescription coverage?

    The costs for prescriptions go up each year. People often face even greater medical and prescription drug costs as they age. To get Medicare prescription drug coverage, you'll need to join a Medicare prescription drug plan, such as an Aetna Medicare Rx® Plan (PDP).

    If you were eligible to join a Medicare prescription drug plan before January 1, 2006, but did not, you may pay a penalty to join now. Medicare sets the penalty, and it increases your plan premium by 1% of the national base beneficiary premium for every month you were eligible but did not join (unless you have creditable coverage).

    If you don’t join a Medicare drug plan when you are first eligible for Medicare Part A and/or B and you go without creditable prescription drug coverage for 63 continuous days or more, you may have to pay a late-enrollment penalty to join a plan later.

    back to top

  3. What does a Medicare prescription drug plan cover?

    Medicare prescription drug plans cover preferred generic and brand-name drugs. Plans may have rules about what drugs are covered in different drug categories to be sure people with different medical conditions can get the treatment they need. Most plans will have a formulary, which is a list of drugs covered by the plan. This list must meet Medicare’s requirements.

    back to top

Costs

  1. Can Aetna Medicare Rx® Plans (PDP) help me save on the costs of medications?

    Yes. Aetna negotiates discounts for medications with participating network pharmacies. The plans include ways to help you save — such as the prescription drug mail-order service and coverage for generic drugs.

    back to top

  2. How much will Medicare prescription drug coverage cost?

    It depends on the plan you select and where you live. Go to Find Plans to estimate the cost of an Aetna Medicare Rx® Plan (PDP). Some people may qualify for financial help with prescription drug coverage, often referred to as “special help.” This depends on factors the federal government has outlined.

    back to top

  3. Does this program benefit someone who takes only a few prescription medications each month?

    Yes. Even if you’re healthy now and take only a few medications, your prescription drug costs could increase in the future from an unexpected illness. Also, if you are eligible for Medicare but do not participate in a Medicare prescription drug plan, you may have to pay a late enrollment penalty if you decide to join a plan later.

    back to top

  4. How do I pay plan premiums?

    You can pay the Medicare prescription drug plan premium directly to Aetna Medicare, have plan premiums deducted from your Social Security checks, or your employer can pay plan premiums for Medicare-eligible retirees.

    back to top

  5. Which Aetna Medicare Rx® Plan (PDP) allows me to pay the least out of my pocket to get a prescription filled?

    Compare expected costs for Aetna Medicare Rx® Plans (PDP) available where you live by using the cost estimation tools to Find Plans. We will ask you questions about your eligibility and coverage requirements, including what medications you take, to give you a comparison of the available Aetna Medicare Rx® Plans (PDP).

    back to top

  6. What if I need help paying for prescription drugs?

    Medicare helps those who qualify for extra help in paying for prescription drugs. The help depends on income and other resources.

    To see if you qualify for getting extra help, call:

    • 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7days a week;
    • The Social Security Administration at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
    • Your state Medicaid office.
    back to top

  7. Who qualifies for help? How can I find out more and apply for help?

    Eligibility for help is based on guidelines set by the federal government. You can apply for extra help through the Social Security Administration or a State Medical Assistance Office. Remember, the amount of help received depends on income and resources, and is determined by the federal government.

    To see if you qualify for getting extra help, call:

    • 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7days a week;
    • The Social Security Administration at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
    • Your state Medicaid office.
    back to top

  8. Medicaid helped pay for my prescription drug coverage in the past. Do I have to join a Medicare prescription drug plan?

    Yes. After December 31, 2005, the Medicaid program stopped providing prescription coverage for people eligible for Medicare. (However, certain drugs that are not covered by Medicare may still be covered by your state Medicaid program.) In January 2006, Medicare began helping individuals cover their prescription drug costs. If you have full Medicaid benefits including prescription coverage, you will be assigned to a Medicare prescription drug plan if you do not select one on your own or choose to decline Medicare prescription drug coverage completely.

    back to top

  9. Will my Medicare Advantage plan premium go down if the government is helping pay for part of the Medicare prescription drug plan cost?

    If you have a Medicare Advantage plan without Medicare prescription drug coverage, the government financial help may not have an impact on your plan. If you have a Medicare Advantage plan with Medicare prescription drug coverage, the government financial help may affect your premiums, copayments or both.

    If you know how much coverage you receive, check Aetna’s Medicare Rx® Plan (PDP) subsidy table on the Low Income Subsidy page to see what your premium might be.

    back to top

Coverage

  1. What is a “coverage gap?”

    Also known as the “donut hole,” it is a phase in the benefit design of a Medicare prescription drug plan. This phase occurs when a member has reached the initial coverage limit and ends once the member has reached the true out-of-pocket threshold. A member may be responsible for 100% of medication costs during this portion of the plan, although some plans may include full or partial coverage during this phase.

    back to top

  2. Do all Medicare prescription drug plans have a coverage gap?

    No. Some plans offer broader coverage and have continuous protection, even in the coverage gap period. The Aetna Medicare Rx® Premier Plan (PDP) provides coverage for preferred generic drugs through this period. If you would like to protect yourself against out-of-pocket expenses — and you do not want to pay the full price for prescriptions as part of your plan — you may want to choose a plan with extended coverage.

    back to top

  3. What happens after the coverage gap?

    After you pay a specified amount of true out-of-pocket expenses (for 2010 the amount is $4,550) for your covered Part D medications, most of your costs for prescriptions included in the Aetna Medicare Rx® Plans (PDP) will be covered, subject to modest cost sharing.

    • For 2010 the cost sharing will be the greater of 5% or $2.50 minimum for covered generic prescription drugs or drugs treated like generics and $6.30 minimum for covered brand-name prescription drugs.
    back to top

  4. What about a plan with continuous coverage — no coverage gap (or donut hole)?

    We have a plan with coverage in the coverage gap. Take a look at the Aetna Medicare Rx® Premier Plan (PDP), which covers preferred generic prescription drugs during the coverage gap phase.

    back to top

  5. Are both brand and generic prescription drugs covered?

    Yes. Aetna Medicare Rx® Plans (PDP) cover both brand-name and generic prescription drugs. See the Find Prescriptions section of our website for more information.

    back to top

  6. How can I find out which prescription drugs are covered?

    Go to the Find Prescriptions section of our website for more information or use our comparison tool to find your medication and compare costs.

    back to top

  7. What is the Aetna Medicare Preferred Drug List, or formulary?

    The Aetna Medicare Preferred Drug List (also known as a formulary) is a list of medications chosen by Aetna, in consultation with a team of health care professionals, including geriatric specialists. Prescription drugs on the Aetna Medicare Preferred Drug List have been chosen on the basis of sound medical data, safety and cost. Additionally:

    • The Aetna Medicare Preferred Drug list has been approved by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees the Medicare program.
    • The medications on the Aetna Medicare Preferred Drug List have been approved by the Food and Drug Administration (FDA) as safe and effective.
    • Both brand-name and generic medications are on the Aetna Medicare Preferred Drug List.

    For a complete list of all prescription medications covered by Aetna Medicare prescription drug plans, please call the Member Services number listed on your Aetna Medicare member ID card between 8 a.m. and 8 p.m., 7 days a week. TTY/TDD users for the hearing or speech impaired should call: 1-888-760-4748. You can also go to the Find Prescriptions section of the website.

    back to top

  8. Can the Aetna Medicare Preferred Drug List change?

    The Aetna Medicare Preferred Drug List is updated on an ongoing basis and may change during the year. We will let affected members know at least 60 days before a medication is removed from coverage, moved to a higher cost-sharing level, or if precertification, quantity limit or step-therapy restrictions have been placed on a medication.

    • From time to time, Aetna reviews the Aetna Medicare Preferred Drug List to make sure it meets the criteria for safety, effectiveness and overall value. Medications may be covered at a higher copayment and/or removed from the Preferred Drug List with advance notice of the change.
    • As brand-name medications lose their patents and generic versions become available, the brand-name medication may be covered at a higher copayment.
    • The Aetna Medicare Preferred Drug List may also change if a medication is taken off the market or becomes available without a prescription.
    • If the Food and Drug Administration judges a drug on the Aetna Medicare Preferred Drug List to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove it from the Aetna Medicare Preferred Drug List.

    For updated information about the medications covered by your plan, please go to Find Prescriptions or call the Member Services number listed on your Aetna Medicare Member ID card. TTY/TDD users for the hearing or speech impaired should call: 1-888-760-4748.

    back to top

  9. What if a medication I’m already taking is not included on the Aetna Medicare Preferred Drug List?

    You can find details regarding the transition process and exceptions for medications not covered under the plan in the Aetna Medicare Rx Exceptions, Appeals and Grievances section of this website.

    back to top

  10. How do I request an exception to the Aetna Medicare Preferred Drug List?

    You can ask Aetna to make a medical exception to our coverage rules. There are several types of exceptions that you can ask us to make:

    • If you are enrolled in a Medicare closed formulary plan, you can ask us to cover your medication even if it is not designated as covered on the 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.

    When you are requesting an exception, you should submit a statement from your doctor supporting your request. Most decisions will be made within 72 hours of your request. Refer to the Aetna Medicare Rx — Exceptions, Appeals and Grievances section for more information.

    back to top

  11. What are generic medications?

    • A generic medication has the same active-ingredient formula as the brand-name medication.
    • Generic medications usually cost less than brand-name medications and are approved by the Food and Drug Administration (FDA).
    • On the Aetna Medicare Preferred Drug List, generic medications are listed in lowercase italicized letters (for example: ranitidine), and brand-name medications are listed in all capitalized letters (for example: ZANTAC).

    For updated information about the medications covered by your plan, please go to Aetna Medicare Rx® — Find Prescriptions or call the Member Services number listed on your Aetna Medicare Member ID card. TTY/TDD users for the hearing or speech impaired should call: 1-888-760-4748.

    back to top

  12. Do Aetna Medicare Rx® Plans (PDP) cover wheelchairs and durable medical equipment (DME)?

    Wheelchairs and durable medical equipment are not included in the Medicare prescription drug coverage. They may be covered under Medicare Part A and/or B.

    back to top

  13. Do the Aetna Medicare Rx® Plans (PDP) cover insulin and diabetic supplies?

    Yes. Insulin and some diabetic supplies are covered. Testing supplies such as lancets and test strips are covered under Medicare Part B.

    back to top

  14. What if I already receive prescription drug coverage as part of my employer's retiree benefits?

    It’s up to you to decide what works best for you. If an employer or union offers prescription drug benefits, you should compare the plan and costs with those offered under the Aetna Medicare prescription drug plans. It is an employer’s responsibility to inform their Medicare eligible retirees/employees if the prescription drug plan offered is on average, at least as good as the standard Medicare Part D benefit — that is, if it is creditable coverage.

    Note: If your retiree plan is not considered “creditable coverage” and you choose not to purchase a Medicare prescription drug plan, you may have to pay more each month (penalty) if you want to join a Medicare prescription plan later.

    back to top

  15. What is “creditable coverage?”

    This is coverage that is, on average, at least as good as the standard Medicare prescription drug coverage the government has outlined. This is important if you decide not to select a Medicare prescription drug plan during your initial enrollment period — because you can join a Medicare Part D plan after the initial enrollment period without a penalty if you have coverage that is at least as good as basic Medicare prescription drug coverage.

    back to top

  16. I have coverage through the Veteran’s Administration (VA). Will my prescriptions continue to be covered?

    VA benefits will not be affected. Medicare beneficiaries who currently have prescription drug benefits through the VA will be able to continue to obtain their prescriptions through the VA coverage.

    back to top

  17. What prescription drugs are not covered under Medicare prescription drug plans?


    1. Drugs that are covered under Medicare Part A or Part B
    2. Drugs purchased outside the U.S.
    3. Drugs used for anorexia, weight loss, or weight gain
    4. Drugs used to promote fertility
    5. Drugs used for cosmetic purposes or hair growth
    6. Drugs used for SYMPTOMATIC relief of cough and colds
    7. Prescription vitamins and mineral products, EXCEPT prenatal vitamins and fluoride preparations
    8. Non-prescription drugs (over the counter or OTC)
    9. Covered outpatient drugs for which the manufacturer seeks to require associated tests or monitoring services purchased exclusively from the manufacturer or its designee as a condition of sale
    10. Barbiturates (such as phenobarbital) and benzodiazepines (such as Valium, Xanax, Restoril), unless included as an enhanced benefit
    11. Drugs used for the treatment of sexual or erectile dysfunction
    back to top

Filling Prescriptions

  1. Which pharmacies can I use to get covered prescriptions filled?

    More than 60,000 retail pharmacies participate in the Aetna Medicare Rx® Plan (PDP) network. This includes pharmacies like Costco, CVS, H-E-B and Rite Aid. Find participating pharmacies using Doc Find. Enter your location, make a selection under “Pharmacies,” then choose “Aetna Medicare Rx®“ Plan (PDP) and Search Criteria.

    back to top

  2. Can I get prescriptions by mail order?

    Yes. If you take medications on an ongoing basis, you might be able to save money getting them by mail order. Covered prescription drugs are delivered right to your front door. If you depend on prescription medications to treat chronic conditions and diseases — such as arthritis, diabetes, heart conditions, asthma, high blood pressure and high cholesterol — you can order covered medications through the easy-to-use, convenient Aetna Rx Home Delivery® service, Aetna’s preferred mail-order service.

    back to top

  3. How will a prescription mail-order service help me save money?

    Aetna Rx Home Delivery® is our preferred mail-order service designed to help you manage your health while watching your budget. Ordering medications to help with problems like arthritis, diabetes, heart conditions, asthma, high blood pressure, and high cholesterol is easy and convenient. Among its advantages are:

    • Cost savings. Depending on the plan and the medication you use, you may be able to get a three-month supply of covered medications for the price that is typically paid for a two-month supply at a retail pharmacy. Standard shipping is always free.
    • Simplicity. Aetna’s easy, two-step process makes ordering maintenance medications a snap.
    • Quality service. Registered pharmacists check your orders for accuracy and are available 24 hours a day, 7 days a week, in case of emergencies.

    Also, the Aetna Pharmacy website can help you stay informed about your prescription drugs and learn how to use your prescription drug benefits wisely. You can get information about hundreds of prescription drugs, possible side effects, generic substitutions and more.

    back to top

  4. What if I'm traveling and need to fill a covered prescription?

    You can fill a prescription at any of the pharmacies participating in the Aetna Medicare network, no matter where they are in the United States. Also, you can use the Aetna Rx Home Delivery® prescription mail-order service.

    back to top

  5. Are prescriptions filled in Canada covered?

    Only drugs sold within the United States may be covered under the Medicare prescription drug plan.

    back to top

Enrolling

  1. Do I need to sign up for Medicare prescription drug coverage?

    The Medicare prescription drug program is completely voluntary. If you want Medicare prescription drug coverage, you can choose to enroll in a plan that meets your needs. If you have Medicare, you can either enroll in a Medicare prescription drug plan (PDP) or in a Medicare Advantage plan with Medicare prescription drug coverage (MA-PD). Aetna has prescription drug plans throughout the country and Medicare Advantage plans in some areas.

    Also, if you have Medicare, you can continue to receive prescription coverage through a group plan — one that an employer/former employer/union offers. You will need to contact the group’s benefits administrator to find out more about the coverage.

    back to top

  2. Is it better to enroll in a plan that provides both medical and prescription coverage?

    It’s up to you. Aetna Medicare has a full range of products for retirees. Medicare prescription drug coverage can be included in a Medicare Advantage plan (an HMO, a PPO or a PFFS). A Medicare prescription drug plan can also be combined with a Medicare Supplement plan. Aetna Medicare can give you information that can help you choose a plan that works for your individual needs. Learn more by visiting our Aetna Medicare Choices section of the site.

    back to top

  3. Who is eligible to join a Medicare prescription drug plan?

    Anyone eligible for Medicare Part A and/or B can join a Medicare prescription drug plan, such as one of the plans Aetna Medicare offers. Anyone who is eligible will be accepted, regardless of current health condition. You must also live in the service area of the plan you are choosing in order to be enrolled.

    back to top

  4. How do I enroll?

    Enrolling is easy! Follow these simple steps:

    1. Enroll online: Use our safe and secure enrollment tool.
    2. Enroll by phone: Call an Aetna Medicare representative at 1-800-529-5586 (TTY/TDD 1-888-760-4748), Monday through Sunday, 8 a.m. to 8 p.m. local time.
    3. Enroll by mail: Complete and sign your enrollment form, then mail it to:
    • Aetna Medicare
    • P.O. Box 14088
    • Lexington, KY 40512-4088

    If you need help, call an Aetna Medicare representative at 1-800-529-5586 (TTY/TDD 1-888-760-4748), Monday through Sunday, 8 a.m. to 8 p.m. local time. We'll be happy to help you.

    back to top

  5. What if I didn’t select a Medicare prescription drug plan by May 2006?

    There could be a penalty if you did not join during the initial enrollment period, which was November 15, 2005, to May 15, 2006. The penalty is 1% for every month you did not enroll, but were eligible. The exception is if you have creditable coverage, meaning you have a plan that is on average at least as good as the standard Medicare Part D coverage.

    back to top

  6. Is there a standard time period for people to change their coverage?

    Yes, the federal government has established periods when a person can join and change his or her Medicare prescription drug coverage. See the website section Important Dates to Remember for more information.

    back to top

  7. I just have Original Medicare (Parts A and B). Can I enroll in the Aetna Medicare Rx® Plan (PDP)?

    Yes, if it is during a valid enrollment period. See the website section Important Dates to Remember for more information. You may also Enroll Online.

    back to top

  8. I have a Medicare Supplement (Medigap) plan. Can I enroll in a Medicare Rx plan?

    Yes. If your Medicare Supplement plan has drug coverage and you enroll in a Medicare prescription drug plan, you must contact your Medicare Supplement issuer to let them know you have joined a Medicare prescription drug plan. Your prescription coverage will be removed from your Medicare Supplement policy if you enroll in a Medicare prescription drug plan.

    back to top

  9. Can a child or guardian enroll a parent in a prescription drug plan?

    Generally, only a Medicare beneficiary can enroll. However, another individual (such as a court-appointed guardian) could be the legal representative or appropriate party to complete an enrollment or disenrollment request. Please refer to the “Appointment of Representation” section of Aetna Medicare Rx® — Exceptions, Appeals, and Grievances.

    back to top

  10. What happens to my Medicare card if I enroll in a prescription drug plan?

    Keep it. The prescription drug plan card will not replace your Medicare card. An Aetna Medicare Rx® Plan (PDP) card will be sent to individuals who join Aetna and can be used when purchasing prescription drugs.

    back to top

  11. What happens to my Medicare card if I enroll in a Medicare Advantage plan that has a prescription drug plan?

    Keep it, but only use it for discounts and general identification purposes. You must use your Aetna Medicare member ID card when you require medical services or to obtain covered prescription drugs.

    back to top

Member ID Cards

  1. When will my Medicare prescription drug coverage begin if I enroll in an Aetna Medicare Rx® Plan (PDP)?

    Your Aetna Medicare Rx® Plan (PDP) coverage begins on January 1 if you enroll in a plan between November 15 and December 31. If you enroll during your initial enrollment period, your coverage begins the first day of the month after the month you enrolled and became eligible for Medicare. For example, if you enroll in Aetna Medicare on January 23 and you are already Medicare eligible, your Medicare plan will begin on February 1.

    back to top

  2. When should I expect to receive my Aetna Medicare member ID card?

    Our goal is to send you an Aetna Medicare member ID card as soon as possible. Please contact Aetna Medicare Member Services if you have questions.

    Call:

    Aetna Medicare Rx® Plans (PDP) (individuals) 1-877-238-6211
    Aetna Medicare Plan (HMO), Aetna Medicare Plan (PPO), and Aetna Medicare Open Plan (PFFS) (individuals) 1-800-282-5366
    Aetna Medicare Rx® Plans (PDP) (members of group plans) 1-877-238-6211
    Aetna Medicare Plan (HMO), Aetna Medicare Plan (PPO), and Aetna Medicare Open Plan (PFFS) (members of group plans) 1-800-282-5366
    Aetna Medicare Plans (Aetna retirees) 1-800-282-5366
    back to top

  3. How can I get my covered prescriptions filled if I have NOT received my new member ID card for the Aetna Medicare Rx® Plan (PDP)?

    Aetna Medicare members can get covered prescriptions filled at participating pharmacies if they have not received an Aetna Medicare member ID Card. To get your covered medications, you can:

    1. Ask your pharmacist to call Aetna. If you're eligible for prescription drug coverage and Aetna has processed your application in our system and submitted it to CMS, we will allow the covered prescription to process.
    2. Print a temporary Aetna Medicare member ID card from Aetna Navigator®, the member part of our website. If a member has been processed in our system, he/she can print a temporary Aetna Medicare member ID card online through Aetna Navigator®.
    3. Submit a claim for prescriptions that you have filled at a participating pharmacy. If your application has not been processed, you can pay for your covered medications and submit a claim to Aetna once your enrollment is complete. NOTE: This is a temporary process. Get a claim form here.

    If CMS says you're not eligible for Medicare prescription drug coverage (Part D), you will not be reimbursed for your medications.

    back to top

 

Get Adobe ReaderYou will need Adobe Acrobat Reader to view some of the materials. You can download the latest Acrobat Reader software free by clicking this link. Download Adobe Reader


Questions? Call our representatives at 1-800-529-5586
(TTY/TDD: 1-888-760-4748), Monday through Sunday, 8 a.m. to 8 p.m.

Want us to contact you?
Enter your phone number here


Copyright © 2001-2010 Aetna Inc.

Easy Answers

Click here to find: Easy Answers Box Bottom
M0001_M_OT_WB_90620_R1 (1/2010)
S5810_M_OT_WB_90620_R1 (1/2010)

Page Last Updated: January 4, 2010