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Medicare Drug Plans

Find 2014 Aetna Medicare Plans with Prescription Drug Coverage

Each of the entries below expands to show useful tools for Medicare plans with prescription drug coverage. These tools will help you understand the unique features of each plan.

To access the plan tools, follow these easy instructions:

  • Find the plan you want.
  • Click the "+" to expand the section.
  • Click the link at the top of the section to learn more about 2014 changes.
    • Your 2014 Annual Notice of Change (ANOC) document also shows these changes. We mailed this to you in September in a purple, polywrap bag.
  • You can also select a link to see drug list changes that may affect you. Or, use an online tool to see if your drug is covered. Refer to the complete drug list to see the coverage tier for each drug you take.
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Aetna CVS/Pharmacy Prescription Drug Plan (PDP)

Aetna Medicare Rx Essentials Plan (PDP)

Aetna Medicare Rx Premier Plan (PDP)

Aetna Medicare Advantage Plan with Prescription Drug Coverage (MAPD)

For 2014, our MAPD plans use one of two preferred drug lists. You can use the Enhanced formulary for most plans. However, the areas and plans listed in the table below use a different formulary called “Saver Plus.” If you live in one of these areas and are interested in one of these plans, review the Saver Plus prescription drug coverage.

Enhanced prescription drug coverage

Saver Plus prescription drug coverage

State County Plans that use the Saver Plus formulary
CA Orange Aetna Medicare Value Plan (HMO)
CO Adams, Boulder, Broomfield, Denver, Douglas Aetna Medicare Value Plan (HMO)
FL Hillsborough, Pinellas Aetna Medicare Premier Plan (HMO)
GA Cherokee, DeKalb, Forsyth, Fulton, Gwinett Aetna Medicare Select Plan (HMO)
NC Cabarrus, Gaston, Iredell, Mecklenburg, Rowan, Union Aetna Medicare Value Plan (HMO)
NC Durham, Orange, Person, Wake Aetna Medicare Value Plan (HMO)
NY New York, Queens Aetna Medicare Value Plan (HMO)
OH Clark, Greene, Miami, Montgomery Aetna Medicare Select Plan (HMO)
OH Delaware, Franklin Aetna Medicare Select Plan (HMO)
PA Montgomery Aetna Medicare Standard Plan (HMO)
Aetna Medicare Premier Plan (HMO)
TX Atascosa, Guadalupe, Kendall, Medina, Wilson Aetna Medicare Select Plan (HMO)
TX Brazoria, Chambers, Fort Bend, Galveston, Jefferson, Liberty, San Jacinto, Waller Aetna Medicare Select Plan (HMO)
TX Ellis, Johnson, Montague, Parker, Rains, Rockwall Aetna Medicare Select Plan (HMO)
TX Tarrant Aetna Medicare Select Plan (HMO)
VA Chesterfield, Hanover, Henrico, Richmond City Aetna Medicare Value Plan (HMO)

During the Initial Coverage Stage, the plan pays its share of the cost of your covered prescription drugs, and you pay your share (your copayment or coinsurance amount). Your share of the cost will vary depending on the drug and where you fill your prescription.

Cost Sharing Tiers

Every drug on the plan’s Drug List is in one of five cost-sharing tiers. Your plan, in some instances, combines higher cost generic drugs on brand tiers. Refer to the comprehensive drug list to determine the tier of coverage for each drug you take. Generally, the higher the tier number, the higher your cost for the drug:

Tier 1 Generic Drugs includes many Part D generic drugs available on the market
Tier 2 Preferred Brand Drugs includes many common cost-effective brand name drugs and some generic drugs that cost as much as brand name drugs
Tier 3 Non-Preferred Brand Drugs includes more expensive brand name drugs, and generic drugs for which a cheaper alternative is typically available
Tier 4 Specialty Drugs includes both brand and generic drugs that meet Medicare’s definition of a specialty drug
Tier 5 Select Care Drugs includes lower cost commonly used generic drugs used in the treatment of high blood pressure, high cholesterol and diabetes

Public notice of transition process

To avoid disruption of therapy, the Centers for Medicare and Medicaid Services (CMS) has a transition program that helps Medicare Part D members receive temporary supplies of their medications.

Our program gives new and existing members up to a maximum 30-day supply of each prescribed medication that is not in our formulary. The same applies to medications that require prior authorization, quantity limits or step therapy.

This program also covers qualified members living in long-term care facilities. In addition to a 31-day maximum supply, we also provide refills up to a maximum of a 93-day supply and may be up to a 98-day, consistent with the dispensing increment, during a transition period.

What is the formulary?

The Aetna Medicare Preferred Drug List, also known as our formulary, includes both brand-name and generic prescription drugs.

Manufacturers market prescription drugs with brand or trade names until the patents expire. When they expire, generic versions of the same drugs may become available.

Save money by using generic drugs

Sometimes you can save money by asking your doctor to prescribe the generic version of a brand-name medication. Generic versions of brand-name drug:

  • Have the same active ingredients in the same amounts
  • Cost less
  • Are rated by the FDA to be as just as safe and effective

FDA approval

The U.S. Food and Drug Administration (FDA) monitors and approves all of the drugs on our formulary lists to make certain they are safe, effective and fresh.

We’ll remove a drug from our formulary and immediately alert members taking the drug if the FDA decides it is no longer safe or the manufacturer removes it from the market.

Regular updates keep the formulary current

We update our formulary from time to time. When it changes, we’ll let you know at least 60 days before a drug is:

  • Removed from coverage
  • Moved to a higher cost sharing level
  • Subject to precertification, quantity limits or step-therapy restrictions

Quality assurance policies and medication therapy management

Aetna members should refer to their Evidence of Coverage to learn more about quality assurance for the following policies and procedures:

  • Utilization management
  • Drug utilization reviews
  • Medication therapy management programs

You can find our Medicare Rx Evidence of Coverage PDF in the “Help and Resources” Download Documents section of this website under Evidence of Coverage. Just find your plan, open the PDF and go to the "Drug Management Programs" section.

Medication Therapy Management (MTM) programs

MTM programs help you safely and effectively take your medications as prescribed by your doctors. You’ll be offered a Comprehensive Medication Review (CMR) if you’re eligible for the program.

Learn more about Medication Therapy Management

Need more information? Contact Member Services at 1-800-282-5366 (TTY: 711). Hours of operation: 8 a.m. to 8 p.m., 7 days per week

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