Aetna Medicare Choices
Low Income Subsidy
Aetna Medicare Rx Prescription Drug Plan (PDP)
2010 Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for Their Prescription Drug Costs
If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.
If you aren’t getting extra help, you can see if you qualify by calling:
- 1-800-Medicare (TTY/TDD users call 1-877-486-2048) - 24 hours a day/7 days a week,
- Your State Medicaid Office, or
- The Social Security Administration at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.
If you have any questions, please call our representatives at 1-800-529-5586 (TTY/TDD: 1-888-760-4748), Monday to Sunday, 8 a.m. to 8 p.m.
The table below tells how much you will pay for your monthly Aetna Medicare plan premium based on the percentage of extra help you receive. (This does not include any Medicare Part B premium you may have to pay.)
| Your State | Aetna Medicare Rx (PDP) Plan Name |
Premium Without Extra Help |
Aetna Medicare Plan Premium Based on Your Level of Extra Help | |||
| 100% | 75% | 50% | 25% | |||
| Alabama | Aetna Medicare Rx Essentials | $31.30 | $0.60 | $8.30 | $15.90 | $23.60 |
| Aetna Medicare Rx Plus | $33.50 | $8.00 | $14.40 | $20.70 | $27.10 | |
| Aetna Medicare Rx Premier | $87.20 | $56.50 | $64.20 | $71.80 | $79.50 | |
| Alaska | Aetna Medicare Rx Essentials | $39.10 | $1.10 | $10.60 | $20.10 | $29.60 |
| Aetna Medicare Rx - Costco Plus | $23.80 | $10.60 | $13.90 | $17.20 | $20.50 | |
| Aetna Medicare Rx Premier | $89.40 | $51.40 | $60.90 | $70.40 | $79.90 | |
| Arizona | Aetna Medicare Rx Essentials | $38.90 | $14.10 | $20.30 | $26.50 | $32.70 |
| Aetna Medicare Rx - Costco Plus | $34.20 | $9.40 | $15.60 | $21.80 | $28.00 | |
| Aetna Medicare Rx Premier | $82.20 | $57.40 | $63.60 | $69.80 | $76.00 | |
| Arkansas | Aetna Medicare Rx Essentials | $24.80 | $0.00 | $6.20 | $12.40 | $18.60 |
| Aetna Medicare Rx Plus | $27.20 | $9.00 | $13.50 | $18.10 | $22.60 | |
| Aetna Medicare Rx Premier | $89.00 | $60.50 | $67.60 | $74.80 | $81.90 | |
| California | Aetna Medicare Rx Essentials | $47.80 | $18.80 | $26.10 | $33.30 | $40.60 |
| Aetna Medicare Rx - Costco Plus | $43.20 | $14.20 | $21.50 | $28.70 | $36.00 | |
| Aetna Medicare Rx Premier | $98.00 | $69.00 | $76.30 | $83.50 | $90.80 | |
| Colorado | Aetna Medicare Rx Essentials | $49.80 | $18.80 | $26.60 | $34.30 | $42.10 |
| Aetna Medicare Rx - Costco Plus | $37.40 | $9.00 | $16.10 | $23.20 | $30.30 | |
| Aetna Medicare Rx Premier | $95.00 | $64.00 | $71.80 | $79.50 | $87.30 | |
| Connecticut | Aetna Medicare Rx Essentials | $29.20 | $0.00 | $7.30 | $14.60 | $21.90 |
| Aetna Medicare Rx Plus | $35.70 | $8.30 | $15.10 | $22.00 | $28.80 | |
| Aetna Medicare Rx Premier | $91.90 | $57.30 | $66.00 | $74.60 | $83.30 | |
| Delaware | Aetna Medicare Rx Essentials | $31.80 | $0.00 | $7.90 | $15.90 | $23.80 |
| Aetna Medicare Rx Plus | $33.60 | $8.00 | $14.40 | $20.80 | $27.20 | |
| Aetna Medicare Rx Premier | $96.70 | $63.00 | $71.40 | $79.80 | $88.30 | |
| District of Columbia | Aetna Medicare Rx Essentials | $31.80 | $0.00 | $7.90 | $15.90 | $23.80 |
| Aetna Medicare Rx Plus | $33.60 | $8.00 | $14.40 | $20.80 | $27.20 | |
| Aetna Medicare Rx Premier | $96.70 | $63.00 | $71.40 | $79.80 | $88.30 | |
| Florida | Aetna Medicare Rx Essentials | $65.20 | $37.70 | $44.60 | $51.50 | $58.30 |
| Aetna Medicare Rx - Costco Plus | $37.90 | $10.40 | $17.30 | $24.20 | $31.00 | |
| Aetna Medicare Rx Premier | $90.90 | $63.40 | $70.30 | $77.20 | $84.00 | |
| Georgia | Aetna Medicare Rx Essentials | $25.20 | $0.00 | $6.30 | $12.60 | $18.90 |
| Aetna Medicare Rx Plus | $28.40 | $8.90 | $13.80 | $18.60 | $23.50 | |
| Aetna Medicare Rx Premier | $91.60 | $62.00 | $69.40 | $76.80 | $84.20 | |
| Hawaii | Aetna Medicare Rx Essentials | $23.60 | $0.00 | $5.90 | $11.80 | $17.70 |
| Aetna Medicare Rx - Costco Plus | $26.20 | $10.20 | $14.20 | $18.20 | $22.20 | |
| Aetna Medicare Rx Premier | $85.20 | $59.60 | $66.00 | $72.40 | $78.80 | |
| Idaho | Aetna Medicare Rx Essentials | $50.80 | $9.90 | $20.10 | $30.40 | $40.60 |
| Aetna Medicare Rx - Costco Plus | $42.50 | $8.80 | $17.20 | $25.60 | $34.10 | |
| Aetna Medicare Rx Premier | $106.20 | $65.30 | $75.50 | $85.80 | $96.00 | |
| Illinois | Aetna Medicare Rx Essentials | $28.10 | $0.00 | $7.00 | $14.00 | $21.10 |
| Aetna Medicare Rx - Costco Plus | $34.80 | $8.90 | $15.40 | $21.80 | $28.30 | |
| Aetna Medicare Rx Premier | $89.20 | $57.60 | $65.50 | $73.40 | $81.30 | |
| Indiana | Aetna Medicare Rx Essentials | $32.40 | $0.00 | $8.10 | $16.20 | $24.30 |
| Aetna Medicare Rx Plus | $32.80 | $8.20 | $14.30 | $20.50 | $26.60 | |
| Aetna Medicare Rx Premier | $85.90 | $50.10 | $59.10 | $68.00 | $77.00 | |
| Iowa | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Kansas | Aetna Medicare Rx Essentials | $33.30 | $0.00 | $8.30 | $16.60 | $25.00 |
| Aetna Medicare Rx Plus | $32.40 | $8.30 | $14.30 | $20.30 | $26.40 | |
| Aetna Medicare Rx Premier | $93.40 | $57.60 | $66.60 | $75.50 | $84.50 | |
| Kentucky | Aetna Medicare Rx Essentials | $32.40 | $0.00 | $8.10 | $16.20 | $24.30 |
| Aetna Medicare Rx Plus | $32.80 | $8.20 | $14.30 | $20.50 | $26.60 | |
| Aetna Medicare Rx Premier | $85.90 | $50.10 | $59.10 | $68.00 | $77.00 | |
| Louisiana | Aetna Medicare Rx Essentials | $41.40 | $10.10 | $17.90 | $25.70 | $33.60 |
| Aetna Medicare Rx Plus | $35.80 | $8.50 | $15.30 | $22.10 | $29.00 | |
| Aetna Medicare Rx Premier | $88.00 | $56.70 | $64.50 | $72.30 | $80.20 | |
| Maine | Aetna Medicare Rx Essentials | $47.90 | $20.90 | $27.70 | $34.40 | $41.20 |
| Aetna Medicare Rx Plus | $32.00 | $8.30 | $14.20 | $20.10 | $26.10 | |
| Aetna Medicare Rx Premier | $87.20 | $60.20 | $67.00 | $73.70 | $80.50 | |
| Maryland | Aetna Medicare Rx Essentials | $31.80 | $0.00 | $7.90 | $15.90 | $23.80 |
| Aetna Medicare Rx Plus | $33.60 | $8.00 | $14.40 | $20.80 | $27.20 | |
| Aetna Medicare Rx Premier | $96.70 | $63.00 | $71.40 | $79.80 | $88.30 | |
| Massachusetts | Aetna Medicare Rx Essentials | $29.20 | $0.00 | $7.30 | $14.60 | $21.90 |
| Aetna Medicare Rx Plus | $35.70 | $8.30 | $15.10 | $22.00 | $28.80 | |
| Aetna Medicare Rx Premier | $91.90 | $57.30 | $66.00 | $74.60 | $83.30 | |
| Michigan | Aetna Medicare Rx Essentials | $33.30 | $0.00 | $8.30 | $16.60 | $25.00 |
| Aetna Medicare Rx - Costco Plus | $33.90 | $9.10 | $15.30 | $21.50 | $27.70 | |
| Aetna Medicare Rx Premier | $85.90 | $51.00 | $59.70 | $68.40 | $77.20 | |
| Minnesota | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Mississippi | Aetna Medicare Rx Essentials | $21.20 | $0.00 | $5.30 | $10.60 | $15.90 |
| Aetna Medicare Rx Plus | $26.90 | $9.10 | $13.50 | $18.00 | $22.40 | |
| Aetna Medicare Rx Premier | $90.30 | $57.30 | $65.50 | $73.80 | $82.00 | |
| Missouri | Aetna Medicare Rx Essentials | $29.60 | $0.00 | $7.40 | $14.80 | $22.20 |
| Aetna Medicare Rx Plus | $34.10 | $8.00 | $14.50 | $21.00 | $27.60 | |
| Aetna Medicare Rx Premier | $86.50 | $46.50 | $56.50 | $66.50 | $76.50 | |
| Montana | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Nebraska | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Nevada | Aetna Medicare Rx Essentials | $43.10 | $15.80 | $22.60 | $29.40 | $36.30 |
| Aetna Medicare Rx - Costco Plus | $31.10 | $9.40 | $14.80 | $20.20 | $25.70 | |
| Aetna Medicare Rx Premier | $104.70 | $77.40 | $84.20 | $91.00 | $97.90 | |
| New Hampshire | Aetna Medicare Rx Essentials | $47.90 | $20.90 | $27.70 | $34.40 | $41.20 |
| Aetna Medicare Rx Plus | $32.00 | $8.30 | $14.20 | $20.10 | $26.10 | |
| Aetna Medicare Rx Premier | $87.20 | $60.20 | $67.00 | $73.70 | $80.50 | |
| New Jersey | Aetna Medicare Rx Essentials | $38.70 | $3.70 | $12.40 | $21.20 | $29.90 |
| Aetna Medicare Rx Plus | $40.20 | $7.90 | $16.00 | $24.00 | $32.10 | |
| Aetna Medicare Rx Premier | $98.30 | $63.30 | $72.00 | $80.80 | $89.50 | |
| New Mexico | Aetna Medicare Rx Essentials | $34.10 | $12.70 | $18.00 | $23.40 | $28.70 |
| Aetna Medicare Rx - Costco Plus | $28.80 | $9.80 | $14.50 | $19.30 | $24.00 | |
| Aetna Medicare Rx Premier | $82.70 | $61.30 | $66.60 | $72.00 | $77.30 | |
| New York | Aetna Medicare Rx Essentials | $50.00 | $16.70 | $25.00 | $33.30 | $41.70 |
| Aetna Medicare Rx - Costco Plus | $42.00 | $8.70 | $17.00 | $25.30 | $33.70 | |
| Aetna Medicare Rx Premier | $117.50 | $84.20 | $92.50 | $100.80 | $109.20 | |
| North Carolina | Aetna Medicare Rx Essentials | $30.20 | $0.00 | $7.50 | $15.10 | $22.60 |
| Aetna Medicare Rx Plus | $35.50 | $8.50 | $15.20 | $22.00 | $28.70 | |
| Aetna Medicare Rx Premier | $101.80 | $66.90 | $75.60 | $84.30 | $93.10 | |
| North Dakota | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Ohio | Aetna Medicare Rx Essentials | $25.40 | $0.00 | $6.30 | $12.70 | $19.00 |
| Aetna Medicare Rx - Costco Plus | $31.10 | $9.40 | $14.80 | $20.20 | $25.70 | |
| Aetna Medicare Rx Premier | $78.00 | $47.50 | $55.10 | $62.80 | $70.40 | |
| Oklahoma | Aetna Medicare Rx Essentials | $26.70 | $0.00 | $6.70 | $13.30 | $20.00 |
| Aetna Medicare Rx Plus | $31.70 | $8.30 | $14.10 | $20.00 | $25.80 | |
| Aetna Medicare Rx Premier | $88.90 | $56.60 | $64.70 | $72.70 | $80.80 | |
| Oregon | Aetna Medicare Rx Essentials | $26.20 | $0.00 | $6.50 | $13.10 | $19.60 |
| Aetna Medicare Rx - Costco Plus | $36.50 | $9.10 | $15.90 | $22.80 | $29.60 | |
| Aetna Medicare Rx Premier | $106.40 | $70.80 | $79.70 | $88.60 | $97.50 | |
| Pennsylvania | Aetna Medicare Rx Essentials | $49.00 | $16.90 | $24.90 | $33.00 | $41.00 |
| Aetna Medicare Rx Plus | $36.70 | $8.70 | $15.70 | $22.70 | $29.70 | |
| Aetna Medicare Rx Premier | $83.70 | $51.60 | $59.60 | $67.70 | $75.70 | |
| Rhode Island | Aetna Medicare Rx Essentials | $29.20 | $0.00 | $7.30 | $14.60 | $21.90 |
| Aetna Medicare Rx Plus | $35.70 | $8.30 | $15.10 | $22.00 | $28.80 | |
| Aetna Medicare Rx Premier | $91.90 | $57.30 | $66.00 | $74.60 | $83.30 | |
| South Carolina | Aetna Medicare Rx Essentials | $30.90 | $0.00 | $7.70 | $15.40 | $23.20 |
| Aetna Medicare Rx Plus | $30.90 | $8.50 | $14.10 | $19.70 | $25.30 | |
| Aetna Medicare Rx Premier | $95.50 | $60.50 | $69.20 | $78.00 | $86.70 | |
| South Dakota | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
| Tennessee | Aetna Medicare Rx Essentials | $31.30 | $0.60 | $8.30 | $15.90 | $23.60 |
| Aetna Medicare Rx Plus | $33.50 | $8.00 | $14.40 | $20.70 | $27.10 | |
| Aetna Medicare Rx Premier | $87.20 | $56.50 | $64.20 | $71.80 | $79.50 | |
| Texas | Aetna Medicare Rx Essentials | $21.00 | $0.00 | $5.20 | $10.50 | $15.70 |
| Aetna Medicare Rx Plus | $25.80 | $9.30 | $13.40 | $17.50 | $21.70 | |
| Aetna Medicare Rx Premier | $74.80 | $47.30 | $54.20 | $61.00 | $67.90 | |
| Utah | Aetna Medicare Rx Essentials | $50.80 | $9.90 | $20.10 | $30.40 | $40.60 |
| Aetna Medicare Rx - Costco Plus | $42.50 | $8.80 | $17.20 | $25.60 | $34.10 | |
| Aetna Medicare Rx Premier | $106.20 | $65.30 | $75.50 | $85.80 | $96.00 | |
| Vermont | Aetna Medicare Rx Essentials | $29.20 | $0.00 | $7.30 | $14.60 | $21.90 |
| Aetna Medicare Rx Plus | $35.70 | $8.30 | $15.10 | $22.00 | $28.80 | |
| Aetna Medicare Rx Premier | $91.90 | $57.30 | $66.00 | $74.60 | $83.30 | |
| Virginia | Aetna Medicare Rx Essentials | $32.80 | $0.00 | $8.20 | $16.40 | $24.60 |
| Aetna Medicare Rx - Costco Plus | $32.70 | $9.30 | $15.10 | $21.00 | $26.80 | |
| Aetna Medicare Rx Premier | $88.90 | $54.70 | $63.30 | $71.80 | $80.40 | |
| Washington | Aetna Medicare Rx Essentials | $26.20 | $0.00 | $6.50 | $13.10 | $19.60 |
| Aetna Medicare Rx - Costco Plus | $36.50 | $9.10 | $15.90 | $22.80 | $29.60 | |
| Aetna Medicare Rx Premier | $106.40 | $70.80 | $79.70 | $88.60 | $97.50 | |
| West Virginia | Aetna Medicare Rx Essentials | $49.00 | $16.90 | $24.90 | $33.00 | $41.00 |
| Aetna Medicare Rx Plus | $36.70 | $8.70 | $15.70 | $22.70 | $29.70 | |
| Aetna Medicare Rx Premier | $83.70 | $51.60 | $59.60 | $67.70 | $75.70 | |
| Wisconsin | Aetna Medicare Rx Essentials | $35.40 | $0.00 | $8.80 | $17.70 | $26.50 |
| Aetna Medicare Rx Plus | $35.40 | $8.60 | $15.30 | $22.00 | $28.70 | |
| Aetna Medicare Rx Premier | $78.40 | $40.20 | $49.70 | $59.30 | $68.80 | |
| Wyoming | Aetna Medicare Rx Essentials | $28.30 | $0.00 | $7.10 | $14.10 | $21.20 |
| Aetna Medicare Rx Plus | $33.40 | $8.00 | $14.30 | $20.70 | $27.00 | |
| Aetna Medicare Rx Premier | $82.90 | $45.30 | $54.70 | $64.10 | $73.50 | |
Coverage is provided through a Medicare Advantage organization or a Medicare prescription drug plan sponsor with a Medicare contract. Benefits, limitations, service areas and premiums are subject to change on January 1 of each year.
