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Aetna Medicare Rx prescription drug plans (PDP) FAQ

Frequently asked questions 

Learn more about Aetna Medicare prescription drug plans We know you have a lot of questions about Medicare and prescription drug plans. Below, we've answered some of the questions you ask most often. To see an answer, simply click on the question below. We've put the questions in eight groups:

 

General

  1. When did Medicare prescription drug coverage begin?
  2. Do I need a Medicare prescription drug plan?
  3. What does a Medicare prescription drug plan cover?
  4. Do you have a quality improvement program?

Costs

  1. Can your Medicare prescription drug plan save me money?
  2. How much will I pay for your Medicare prescription drug plan?
  3. I only take a few prescription drugs. Will a Medicare prescription drug plan still save me money?
  4. How can I pay for my Medicare prescription drug plan?
  5. Under which of your Medicare prescription drug plans will I pay the least out of my pocket?
  6. Can I get Extra Help paying for my Medicare prescription drug plans?
  7. Who qualifies for Extra Help? How can I find out more and apply?
  8. Medicaid helped pay for my prescriptions in the past. Do I have to enroll in a Medicare prescription drug plan?
  9. I have Extra Help paying for my Medicare prescription drug plan. Will that make my Medicare Advantage plan premium go down?

Coverage

  1. What is the "coverage gap" or "donut hole"?
  2. Do all Medicare prescription drug plans have a coverage gap?
  3. What comes after the coverage gap?
  4. Do your Medicare prescription drug plans cover both brand-name and generic drugs?
  5. How can I find out which prescription drugs are covered?
  6. What is a preferred drug list or formulary?
  7. Can your preferred drug list change?
  8. What if a medication I'm already taking is not on your preferred drug list?  
  9. How do I ask for an exception to your preferred drug list?
  10. What is a generic drug?
  11. Do your Medicare prescription drug plans cover wheelchairs and durable medical equipment?
  12. Do your Medicare prescription drug plans cover insulin and diabetic supplies?
  13. I already have prescription drug coverage through my employer’s retiree plan. Should I enroll in a Medicare prescription drug plan?
  14. What is "creditable coverage"?
  15. Veterans Affairs (VA ) covers my prescription drugs. Will I lose my VA coverage if I have Medicare?
  16. What drugs aren't covered under Medicare prescription drug plans?

Filling Prescriptions

  1. Which pharmacies can I use to fill my prescriptions?
  2. Can I get my prescription by mail?
  3. Will mail-order prescriptions help save me money?
  4. What if I'm traveling and need to fill my covered prescription?
  5. Do your plans cover prescriptions filled in Canada?

Preferred Pharmacies

  1. Why should I fill my prescriptions at a preferred pharmacy?
  2. Do you have preferred pharmacy plans?
  3. Is there an advantage to enrolling in the Aetna CVS/pharmacy Prescription Drug Plan (PDP)?

Enrolling 

  1. Do I have to sign up for Medicare prescription drug coverage?
  2. Should I enroll in a plan that provides both medical and prescription drug coverage?
  3. Am I eligible to enroll in a Medicare prescription drug plan?
  4. How do I enroll?
  5. Why would I have to pay a late enrollment penalty?
  6. When can I enroll or change my prescription drug plan?
  7. I just have Original Medicare (Parts A and B). Can I enroll in one of your Madicare prescription drug plans?
  8. I have a Medicare supplement insurance (Medigap) plan with drug coverage. Can I enroll in your Medicare prescription drug plan?
  9. Can a child or guardian enroll a parent in a Medicare prescription drug plan?
  10. What should I do with my Medicare card if I enroll in one of your prescription drug plans?
  11. What should I do with my Medicare card if I enroll in a Medicare Advantage plan that covers my prescription drugs?

Coverage Start Date

  1. When will my coverage start if I enroll in one of your Medicare prescription drug plans?

Member ID Cards

  1. When will I get my member ID card?
  2. How can I get my prescriptions filled if I haven't gotten my new member ID card?

 

General

  1. When did Medicare prescription drug coverage begin?

    A 2003 federal law created the Medicare Part D prescription drug benefit. It went into effect January 1, 2006. If you have Medicare, the law gives you access to prescription drug coverage. You can buy a plan with this coverage from a private insurance company like Aetna. And if your income’s limited, you may be able to get Extra Help paying for your plan.*

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  2. Do I need a Medicare prescription drug plan?

    Your prescriptions cost more each year. And you may pay more as you get older. A Medicare prescription drug plan helps pay the cost of your prescriptions.

    And it's better if you enroll in a plan when you're first eligible for Medicare or turn 65. If you don't, or you go without creditable coverage for 63 days or more, you may pay more for your plan if you enroll later.

    You may already have prescription drug coverage through a union or your employer's retiree plan. If you do, check with your employer or the plan issuer to see if the plan offers creditable coverage — coverage that on average pays at least as much as Medicare’s standard prescription drug coverage.

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  3. What does a Medicare prescription drug plan cover?

    Medicare prescription drug plans cover generic and brand-name drugs that Medicare says are Part D eligible. A Plan may have rules about what drugs it covers in different drug groups. That's to make sure people with different medical conditions get the treatment they need. Most plans have a formulary, or list of drugs covered by the plan. Our preferred drug list has been approved by the Centers for Medicare and Medicaid Services (CMS). CMS is the federal agency that oversees the Medicare program. 

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  4. Do you have a quality improvement program?

    Yes. We design our programs to improve the quality of the care you receive. The health care information we give you is supported by clinical data and industry-accepted, evidence-based guidelines. And we offer credible clinical information and tools to help you and your doctors make informed decisions about your care.

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Costs

  1. Can your Medicare prescription drug plans save me money?

    Yes, in a number of ways:

    • Medicare pays a portion of your Part D costs
    • We negotiate discounts with the pharmacies in our network. This lowers the cost of your medications, even during the coverage gap.
    • We negotiate discounts – or rebates – with drug makers to help lower the cost of your plan
    • Medicare negotiated a discount with drug makers so that you pay 50 percent less for brand-name drugs during the coverage gap
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  2. How much will I pay for your Medicare prescription drug plan?

    It depends on what plan you choose and where you live. Go to Find Plans to estimate what you'll pay for our plans. If your income's limited, you may be able to get Extra Help paying for your plan. *See questions 6 and 7 for more info.

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  3. I only take a few prescription drugs. Will a Medicare prescription drug plan still save me money?

    Even if you're healthy now, your drug costs could increase in the future due to an unexpected illness. Also, if you're eligible for Medicare but don't have a Medicare prescription drug plan or other creditable coverage now, you may pay more if you sign up later.

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  4. How do I pay for my Medicare prescription drug plan?

    You can pay us directly or have your plan premium taken out of your monthly Social Security check. Your employer may pay your premium if you have a retiree benefit plan.

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  5. Under which of your Medicare prescription drug plans will I pay the least out of my pocket?

    Go to Find Plans and use our cost estimate tools to find out what you'll pay for our different Medicare prescription drug plans. We'll ask you questions about your eligibility, coverage needs, and medications to help you compare the plans available in your area.

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  6. Can I get Extra Help paying for prescription drugs?

    If your income's limited, you may be able to get Extra Help paying for your prescription drug plan. If you're eligible, Medicare could pay up to 100 percent of your plan costs, including your monthly premiums, annual deductibles and co-insurance. You also won't be subject to the coverage gap or have to pay a late enrollment penalty.

    You may qualify for Extra Help and not know it. To find out more or see if you're eligible, call:

    • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday - Friday. TTY users should call 1-800-325-0778. You may also apply online at http://www.ssa.gov.
    • Your state Medicaid office
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  7. Who qualifies for Extra Help? How can I find out more and apply?

    Rules set up by the federal government will determine if you qualify for Extra Help. You can apply for Extra Help through the Social Security Administration or your state Medicaid office.

    To see if you qualify for getting Extra Help, call:

    • The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday - Friday. TTY users should call 1-800-325-0778. You may also apply online at http://www.ssa.gov.
    • Your state Medicaid office
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  8. Medicaid helped pay for my prescription drug coverage in the past. Do I have to enroll in a Medicare prescription drug plan?

    Yes. Medicaid won't help pay for your prescriptions if you're eligible for Medicare. (However, if Medicare doesn't cover your medication, Medicaid may still cover it.) If you have full Medicaid benefits, the federal government will assign you to a Medicare prescription drug plan if you don't select one on your own or decline Medicare prescription drug coverage completely.

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  9. I have Extra Help paying for my Medicare prescription drug plan. Will that make my Medicare Advantage plan premium go down?

    If you have a Medicare Advantage plan with prescription drug coverage, Extra Help may affect your premium and copayments.

    If you know how much Extra Help you get, go to Low Income Subsidy. Then look at the premium subsidy table for your plan type to see what your new premium might be.

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Coverage

  1. What is the "coverage gap" or "donut hole"?

    It's a coverage phase in a Medicare prescription drug plan. It starts when you reach the initial coverage limit of your Medicare prescription drug plan. It ends when you reach the true out-of-pocket threshold. During this phase, you have to pay up to 72 percent of covered generic drugs and 47.5 percent of your covered brand-name drugs. But some plans may offer full or partial supplemental gap coverage during this phase.

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  2. Do all Medicare prescription drug plans have a coverage gap?


    Yes. But all plans also provide some level of coverage that continues during the gap. Our Medicare prescription drug plans and our Medicare Advantage plans with prescription drug coverage offer different levels of coverage during the gap. See our Summary of Benefits for more info on the coverage available in your area. During the coverage gap, Medicare minimum gap coverage offers a 28 percent benefit on generic drugs and a combined 52.5 percent benefit/discount on brand-name drugs.

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  3. What comes after the coverage gap?

    You'll move into the catastrophic phase of the plan. Then most of your costs for prescriptions included in the Medicare prescription drug plan will be covered by modest cost sharing (i.e., the greater of 5 percent or $6.35 on brand drugs and the greater of 5 percent or $2.55 on all other drugs).

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  4. Do your Medicare prescription drug plans cover both brand-name and generic drugs?

    Yes. Our plans cover both brand-name and generic prescription drugs, including many well-known brands. Go to Find Prescriptions for more info.

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  5. How can I find out which prescription drugs are covered?

    Go to Find Prescriptions for more info. Or use our Prescription Drug Search tool to see if your medication is covered.

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  6. What is a preferred drug list, or formulary?

    Our preferred drug list, or formulary, is a list of medications we've chosen with the help of doctors and pharmacists, including geriatric specialists. We've chosen these medications based on sound medical data, safety and cost.

    Our preferred drug list:

    • Has been approved by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees the Medicare program
    • Includes only medications that the Food and Drug Administration (FDA) has approved as safe and effective
    • Includes both brand-name and generic medications

    To get a complete list of the medications covered by our Medicare prescription drug plans, please call us at 1-800-282-5366 (TTY: 711). Hours of operation: 8 a.m. and 8 p.m., 7 days per week. Or, you can go to Find Prescriptions to get formularies for each of our plans that offer Part D coverage.

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  7. Can your preferred drug list change?

    Generally, during the year we won’t take a medication you’re taking off our preferred drug list or change how we cover it. But if a new, less expensive generic drug becomes available or if we find concerns about the safety or effectiveness of your drug, we’ll update our formulary and let you know about the change. Other types of formulary changes, such as removing a drug from our formulary, will not affect members who are currently taking the drug. It will remain available at the same cost-sharing for those members taking it for the remainder of the coverage year.

    We’ll let you know 60 days ahead of time or when you get your prescription filled if we take your medication off our prescription drug list or change how much you pay for it. We’ll also tell you if we add prior authorization requirements, quantity limits or step therapy restrictions. If you find out about these changes when you refill your prescription, you'll get a 60-day supply of the drug.

    We’ll let you know immediately if we have to take one of your medications off our preferred drug list because the Food and Drug Administration says it’s unsafe or the drug maker takes it off the market.

    To get a complete list of the medications covered by our Medicare prescription drug plans, please call us at 1-800-282-5366 (TTY: 711). Hours of operation: 8 a.m. and 8 p.m., 7 days per week. Or, you can go to Find Prescriptions to get formularies for each of our plans that offer Part D coverage.

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  8. What if a medication I'm already taking is not on your preferred drug list?

    You can find details regarding the transition process and exceptions for medications not covered under the plan in the Aetna Medicare Rx Exceptions, Appeals and Grievances section of this website.

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  9. How do I ask for an exception to your preferred drug list?

    You can ask us to cover your medication if it’s not shown as covered on our preferred drug list.

    Or you can ask us to waive coverage restrictions or limits on your medication. For example, we limit the amount we’ll cover of some medications. If your medication has a quantity limit, you can ask us to waive the limit and cover a higher quantity.

    When you ask for an exception, submit a statement from your doctor that supports your request. We use CMS rules to help us make our decision. CMS rules also tell us how long we have to answer your request. Go to the Request for Prescription Drug Coverage Determination Form for more info.

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  10. What is a generic drug?

    A generic drug has the same active-ingredient formula as the brand-name drug. Both generic and brand-name drugs are approved by the Food and Drug Administration, but generic drugs usually cost less.

    On our preferred drug list, we show generic drugs in lowercase italicized letters. (For example: ranitidine.) We show brand-name drugs in all caps. (For example: ZANTAC.)

    Go to Aetna Medicare Rx — Find Prescriptions for the latest info on drugs covered by your plan. To get a complete list of the medications covered by our Medicare prescription drug plans, please call us at 1-800-282-5366 (TTY: 711). Hours of operation: 8 a.m. and 8 p.m., 7 days per week.

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  11. Do your Medicare prescription drug plans cover wheelchairs and durable medical equipment?

    Wheelchairs and durable medical equipment are not included under Medicare prescription drug coverage. But they may be covered under Medicare Part A and/or B.

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  12. Do your Medicare prescription drug plans cover insulin and diabetic supplies?

    Yes. Insulin and some diabetic supplies are covered. Testing supplies such as lancets and test strips are covered under Medicare Part B.

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  13. I already have prescription drug coverage through my employer’s retiree plan. Should I enroll in a Medicare prescription drug plan?

    It’s up to you. If your union or former employer offers prescription drug benefits, compare the plan and costs with those of our prescription drug plans.

    Also find out if your employer’s plan has any limitations. For example, if you leave your employer’s retiree plan, you may not have an opportunity to re-enroll later on.

    Your employer has to let you know if its prescription drug plan is considered creditable coverage — coverage as good as that offered by Medicare. If it’s not and you don’t enroll in a Medicare prescription drug when you first become eligible for Medicare or turn 65, you may have to pay more for your plan if you enroll later on.

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  14. What is "creditable coverage"?

    It means that on average a plan will pay at least as much as Medicare’s standard prescription drug coverage. This is important to remember if you don’t enroll in a Medicare prescription drug plan during your initial election period. You won’t pay more for your plan when you enroll if you already have creditable coverage.

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  15. Veteran's Affairs (VA) covers my prescription drugs. Will I lose my VA coverage if I have Medicare?

    No. If you have Medicare, you can continue getting your prescriptions under your VA coverage.

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  16. What drugs aren’t covered under Medicare prescription drug plans?

    • Drugs covered under Medicare Part A or Part B
    • Drugs purchased outside the U.S.
    • Drugs used for anorexia, weight loss, or weight gain
    • Drugs used to promote fertility
    • Drugs used for cosmetic purposes or hair growth
    • Drugs used for relief of cough and cold symptoms
    • Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations
    • Non-prescription, over-the-counter drugs
    • Covered outpatient drugs for which the manufacturer seeks to require associated tests or monitoring services purchased exclusively from the manufacturer or its designee as a condition of sale
    • Drugs used for the treatment of sexual or erectile dysfunction
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Filling Prescriptions

  1. Which pharmacies can I use to fill my prescriptions?

    You can get your prescription filled at one of the more than 65,000 pharmacies in our network. This includes national chains like CVS, Walgreens and Walmart, as well as regional chains and independent pharmacies. To find a network pharmacy, go to DocFind. Then select the type of pharmacy, your plan and and how you’d like to search. Remember to enter your zip and the distance you’ll travel or your city and state before you click "Search."

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  2. Can I get my prescription drugs by mail?

    If you take certain medications on an ongoing basis, you might be able to save money getting them by mail order. Covered prescription drugs are delivered right to your front door. If you depend on prescription medications to treat chronic conditions and diseases — such as arthritis, diabetes, heart conditions, asthma, high blood pressure and high cholesterol — you can order covered medications through the easy-to-use, convenient Aetna Rx Home Delivery® service, Aetna's preferred mail-order service. See Aetna's Preferred Drug List for availability of medications through Aetna's Mail Order Drug facility.

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  3. Will mail-order prescriptions help me save money?

    Depending on the plan and the medication you use, you may be able to save money on a three-month supply of covered medications. And standard shipping through our prescription mail-order service is always free.

    Other advantages to our prescription mail-order service include:

    • Convenience. You can place your order 24-hours a day from your home and have your medication delivered to you. No waiting in line at the pharmacy or multiple trips dropping off and picking up your prescriptions.
    • Simplicity. Our easy, two-step process makes it easy to order maintenance medications such as those used for your arthritis, diabetes, heart conditions, asthma, high blood pressure or high cholesterol.
    • Quality service. Registered pharmacists check your orders for accuracy and are available 24 hours a day, 7 days a week, if you have an emergency.

    On our pharmacy website, you can get more information about your prescription drugs, including possible side effects and generic substitutions. You can also learn how to use your prescription drug benefits wisely.

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  4. What if I'm traveling and need to fill my covered prescription?

    You can fill a prescription at any of the pharmacies participating in our network. It doesn't matter where they are in the United States. You can also have your prescriptions delivered to you by our mail-order service.

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  5. Do your plans cover prescriptions filled in Canada?

    Our Medicare prescription drug plans only cover drugs sold, dispensed and consumed within the U.S.

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Preferred Pharmacies

  1. Why should I fill my prescription at a preferred pharmacy?

    You’ll save money when you get your covered prescription filled at any pharmacy in our network. But you may save more if you get it filled at one of our preferred pharmacies. Check your Evidence of Coverage to find out if you have this benefit.

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  3. Do you have preferred pharmacy plans?

    Yes. The Aetna CVS/pharmacy Prescription Drug Plan (PDP) is available in 43 states and Washington, D.C. We don't offer it in Alaska, Arkansas, Colorado, Idaho, Oregon, Utah or Washington state. In Hawaii, since CVS/pharmacy owns Longs Drugs, it also is a preferred pharmacy in our network. Additionally, Walmart and Sam's Club locations were added to the preferred pharmacy network for this plan beginning January 1, 2014.

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  5. Is there an advantage to enrolling in the Aetna CVS/pharmacy Prescription Drug Plan (PDP)?

    Yes. You may save more when you go to your neighborhood CVS/pharmacy, Walmart, or Sam's Club. At these preferred pharmacies, you may get your questions answered by an experienced pharmacist, plus:

  • You'll pay just $2 ($3 in Hawaii and New Mexico) for almost 800 generic drugs and only $1 for Select Care generics used in treating high blood pressure, high cholesterol and diabetes
  • At many locations, you can get your prescription filled 24 hours a day, or even pick up your prescription in the drive-through.
You can also fill your prescription at any of over 65,000 pharmacies in our network.

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Enrolling

  1. Do I need to sign up for Medicare prescription drug coverage?

    The Medicare prescription drug program is voluntary. If you want Medicare prescription drug coverage, you can enroll in a plan that meets your needs. But keep in mind you may have to pay more if you put off enrolling.

    If you have Medicare, you can enroll in a Medicare Advantage plan with prescription drug coverage.

    Or you can enroll in a stand-alone Medicare prescription drug plan if you have one of the following:

    • Original Medicare (Parts A and B)
    • A Medicare supplemental insurance – or Medigap – plan
    • A Medicare Private Fee-for-Service plan that doesn’t cover prescription drugs

    In addition, if you have Medicare and are receiving prescription drug coverage through a group plan offered by a former employer/union, you can continue this coverage. You will need to contact your group's benefits administrator to find out more about this coverage to ensure it is considered creditable coverage.

    We have Medicare Advantage plans in some areas and Medicare-approved prescription drug plans throughout the U.S.

    Also, you can keep the prescription drug coverage you have through your union or former employer if you have Medicare. Just call your group's benefits administrator to make sure it’s “creditable coverage.”

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  2. Should I enroll in a plan that provides both medical and prescription drug coverage?

    It’s up to you. Medicare prescription drug coverage can be part of a Medicare Advantage  HMO, PPO or a PFFS plan. Medicare supplemental insurance, or Medigap, plans can also offer drug coverage. We can help you choose a plan that works for you. Go to Aetna Medicare Plans for more info.

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  3. Am I eligible to enroll in a Medicare prescription drug plan?

    Anyone eligible for Medicare Part A and/or B can enroll in a Medicare prescription drug plan. And you'll be accepted, regardless of your current health.

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  4. How do I enroll?

    Enrolling is easy. You can enroll:

    1. Online: Use our secure enrollment tool
    2. By phone: Call us at ReferrerPhoneNumber (TTY: 711) from 8 a.m. to 8 p.m. local time, 7 days a week
    3. By mail: Complete and sign your enrollment form, then mail it to:
    • Aetna Medicare
    • P.O. Box 14088
    • Lexington, KY 40512-4088

    If you have questions, just call us at ReferrerPhoneNumber (TTY: 711). We're available to help you 8 a.m. to 8 p.m. local time, 7 days a week.

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  5. Why would I have to pay a late enrollment penalty?

    If you don’t enroll in a Medicare prescription drug plan when you’re first eligible or if you go 63 days or more without “creditable coverage,” you may have to pay a late enrollment penalty. (“Creditable coverage” means that on average the plan will pay at least as much as Medicare’s standard prescription drug coverage.)

    • The amount of your penalty depends on how long you waited before you enrolled in drug coverage or how many months you were without drug coverage after you became eligible
    • The penalty is included as part of your monthly plan premium. If you don’t pay your monthly plan premiums, we may disenroll you.
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  6. When can I enroll or change my prescription drug plan?

    You can enroll or make changes to your Medicare prescription drug plan at specific times of the year. Go to Important Dates to Remember for more info.

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  7. I just have Original Medicare (Parts A and B). Can I enroll in one of your Medicare prescription drug plans?

    Yes, if it's during a valid election period. Go to Important Dates to Remember for more info. You can even Enroll Online.

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  8. Can a child or guardian enroll a parent in a prescription drug plan?

    Generally, only the beneficiary - the person who's eligible for Medicare – can enroll in a plan. But a court-appointed guardian or legal representative may enroll or disenroll on behalf of the beneficiary.

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  9. What should I do with my Medicare card if I enroll in one of your prescription drug plans?

    Keep your Medicare card. We'll send you a member ID card when you enroll in one of our prescription drug plans. The member ID card for your plan does not replace your Medicare card. Use your plan member ID when you get your prescriptions filled.

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  10. What should I do with my Medicare card if I enroll in a Medicare PDP plan that covers my prescription drugs?

    Keep your Medicare card. But only use it for discounts and general identification. You have to use your Aetna Medicare member ID card when you go to the doctor or hospital, or when you get your covered prescriptions filled.

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Coverage Start Date

  1. When will my coverage start if I enroll in one of your Medicare prescription drug plans?

    You can enroll in a plan only at specific times of the year. Your effective date will depend on when you enroll. If you sign up during Medicare’s Open Enrollment period from October 15 to December 7, your coverage is effective January 1 of the next year.

    If you enroll when you first become eligible for Medicare or turn 65 and you apply before the first day of the month you become eligible, your coverage starts on the first day of the month. For example, if you enroll on January 23 and you're eligible for Medicare February 1, your coverage starts February 1.

    You may be able to enroll at other times of the year. Go to Important Dates to Remember or call us for more info.

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Member ID Cards

  1. When will I get my member ID card?

    Our goal is for you to receive your member ID card in 7-10 business days. If you have questions, call us at the phone number for your plan:

    Aetna Medicare Rx® Plans (PDP) (individuals) 1-877-238-6211
    Aetna Medicare Plan (HMO) and Aetna Medicare Plan (PPO) (individuals) 1-800-282-5366
    Aetna Medicare Rx® Plans (PDP) (members of group plans) 1-800-594-9390
    Aetna Medicare Plan (HMO) and Aetna Medicare Plan (PPO) (members of group plans) 1-888-267-2637
    Aetna Medicare Plans (Aetna retirees) 1-800-282-5366
    TTY Users
    711
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  2. How can I get my prescriptions filled if I haven't gotten my member ID card?

    To get your covered medication at one of our network pharmacies, you can:

    1. Ask your pharmacist to call us. If you're eligible for prescription drug coverage and we've processed your application in our system and sent it to CMS, we'll allow the covered prescription to process.
    2. Print a temporary member ID card on Aetna Navigator®, our secure member website. If we've processed you in our system, you can print a temporary member ID card after you register on the website.
    3. Pay for your covered medications and submit a prescription drug claim form to us once your enrollment is complete. NOTE: This is a temporary process. Get a claim form here.

    If CMS notifies us that you're not eligible for Medicare prescription drug coverage (Part D), we won't reimburse your for your medications.

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* It's easy and free to apply for “Extra Help.” You or a family member, trusted counselor, or caregiver can apply online at http://www.socialsecurity.gov/prescriptionhelp or call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778).

Aetna Medicare is an HMO/PPO/PDP plan with a Medicare contract. Enrollment in Aetna Medicare depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. 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.

Plans are offered by Aetna Health Inc., Aetna Health of California Inc., and/or Aetna Life Insurance Company (Aetna). Not all health services are covered. See Evidence of Coverage for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location.

You must have both Medicare Part A and Part B to enroll in a Medicare Advantage plan. You must have Medicare Part A and/or Part B to enroll in a Medicare prescription drug plan. You must continue to pay your Medicare Part B premium.

Medicare beneficiaries may enroll in a plan only during specific times of the year. To obtain additional information, please contact Aetna Medicare.

In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances. Pharmacy clinical programs such as prior authorization, step therapy, and quantity limits may apply to your prescription drug coverage.

Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services.

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