Aetna Medicare Choices

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 coverage issues, 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 (10 pages, 160.6kb).

You can find Summary of Benefits information and Medicare Contact Information referred to in this document within the Help and Resources section of this website. Additional Exceptions, Appeals and Grievances Forms are also found in that section, under Other Forms and Documents.