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Have Medicare coverage from an Employer or Group Sponsor?

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Get the most value from your plan

The following tools and references can help you manage your employer or group sponsored Medicare Plan. Since retiree plans vary, it’s important to review the information from your former employer, group sponsor or us.

Manage your prescription

Our prescription drug list (formulary) shows:
 

  • The drugs we cover
  • The tier a drug is on
  • Any limits or requirements before we cover the drug
  • Mail order availability

Refer to your plan documents to find out which formulary your prescription drug plan uses. You'll need to know the formulary name and the number of tiers. You have two options to find this information:
 

  • Already an Aetna member? Look in your Schedule of Cost Sharing.
  • Haven’t enrolled yet? Review the Plan Benefit Summary.

Choose a 2020 formulary (drug list) name to see documents

Choose your 2019 formulary (drug list) name to see documents

Important information


There’s a lot more information on changes to our drug list (formulary), prior authorization, step therapy, quantity limits, exceptions and transition rules.

 

Learn about drug list changes, special rules and more

 

Find a doctor, pharmacy or other provider

 

Some members may have access to an Extended Service Area (ESA), giving them the freedom to use providers in and out-of-network. If a provider is not part of the ${company} Medicare network, ESA members can continue to see them as long as they are licensed, eligible to receive Medicare payment and agree to accept the ESA plan. If ESA members do not live in ${anCompany} network service area, they can view general provider information for their area by visiting www.medicare.gov.

Find Medicare Star Ratings for your plan

 

Each year, Medicare rates health and prescription drug plans on a Five–Star Quality Rating System. The Star Ratings measure Medicare Advantage plans based on five areas:

 

  • Staying healthy
  • Managing chronic (long-term) conditions
  • Member experience with the health plan
  • Member complaints
  • Health plan customer service

Select state, year and plan to see your Star Ratings

 

 

Every year, Medicare evaluates plans based on a 5-star rating system.