How to Fill Your Medicare Prescriptions

We make it easy to fill your Medicare prescriptions

Medicare Prescription Drug Plans (PDP) have a network of pharmacies. You’re required to use a pharmacy in the network to fill your prescriptions.

Find a pharmacy in our network

Get your prescriptions by mail

If you take medications regularly, Aetna Rx Home Delivery pharmacy may be a great option for you. Your formulary (drug list) tells you if a medication is available for home delivery.

Keep in mind: Our Aetna Medicare Select Rx (PDP) doesn’t include Aetna Rx Home Delivery mail-order benefit.

Learn about Aetna Rx Home Delivery

Save money by using generics: Sometimes you can save money by asking your doctor to prescribe the generic version of a brand-name medicine. Generic versions of brand-name drugs:

Have the same active ingredients in the same amounts

Typically cost less

Are declared by the Food and Drug Administration to be just as safe and effective
When to request a refill: There are time guidelines for refilling your drugs.

At a retail pharmacy:

For a 30-day prescription

- Order a refill when you have a 7-day supply left

For eye-drop medication

- Order a refill when you have a 9-day supply left

Through a mail-order pharmacy:

For a 90-day prescription

- Order a refill when you have a 22-day supply left

For eye-drop medication

- Order a refill when you have a 27-day supply left

If you order too early, the pharmacy won’t give you the refill until the approved date.

You can get prescription drugs shipped directly to your home. Often, mail-order drugs arrive within 7 to 14 days. Call the number on your ID card if you don't get your mail-order drugs within this time. You can also sign-up for automated mail-order delivery.

Medicare only covers prescription drugs sold, filled and used in the U.S. and its territories.
Using Aetna Specialty Pharmacy (ASRx): Our network specialty pharmacy focuses on medicines that aren’t usually available at retail pharmacies. It offers:

Injection supplies, like needles, syringes, alcohol swabs, adhesive bandages and containers for needle waste at no cost to you

Fast, no-cost delivery

Package tracking

Delivery to your home, doctor’s office or place of choice

Support and education to help you use your medicines and manage your health condition

Flexible payment options

Information on drug maker programs that offer financial help
Using an out-of-network pharmacy: There may be times when you need to use an out-of-network pharmacy:

There’s no network pharmacy close or open 24 hours

You need a prescription drug that nearby network or mail-order pharmacies don’t often stock, like drugs for rare medical conditions

You get a Part D prescription drug from an out-of-network provider pharmacy from:

- An emergency room
- A provider-based clinic
- An ambulatory surgical center
- An outpatient setting

You get a prescription outside of your home or service area due to:

- A state or federal disaster declaration
- Other public health emergency

If one of the above reasons doesn't apply, we won’t reimburse you for your prescription filled out of network.

If one of the above reasons applies, you'll have to pay the full cost when filling the prescription. You may get a smaller amount of your medicine until you can get to a network pharmacy.

For reimbursement, send us a claim form and your receipt. We'll reimburse you for the amount you paid up to a 10-day supply, minus your copay or coinsurance.

Print a prescription drug claim form

Print a prescription drug claim form (Spanish)

Your plan coverage document (Evidence of Coverage) has more details about out-of-network pharmacies.

See your Evidence of Coverage

We're here to help!

Members:
Email us or call Member Services at the number on your ID card.

Don’t have your ID card handy?
Find a phone number

Not yet a Member?
Email us or call an Aetna representative at (TTY: 711), Monday to Friday, 8 a.m. to 8 p.m.

We speak your language: We have free interpreter services to answer questions you may have about our health or drug plan.
Get help from an interpreter

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Disclaimers

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays.

We receive rebates from drug manufacturers that may help in determining our Preferred Drug List. Rebates do not directly reduce the amount a member pays the pharmacy for covered prescriptions.

Participating physicians, hospitals and other health care providers are independent contractors. They're neither agents nor employees of Aetna. The availability of any particular provider can't be guaranteed. Provider network make-up is subject to change.

Our pharmacy network meets or exceeds CMS requirements for pharmacy and preferred pharmacy access in your area.

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For Members

Filling Your Prescriptions

We make it easy to fill your Medicare prescriptions

Get your prescriptions by mail

Save money by using generics

When to request a refill

Using Aetna Specialty Pharmacy (ASRx)

Using an out-of-network pharmacy

We're here to help!

We speak your language

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