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Request a Quote TodayAllina Health | Aetna is pleased to now offer Medicare Advantage plans.
2020 Drug Coverage
Aetna Standard Plan
- Brand and generic drugs chosen for their quality and effectiveness
- Specialty drugs and services through Aetna Specialty Pharmacy®
- With personal support and programs that help improve your health
- Maintenance drugs sent to your door through CVS Caremark® Mail Service Pharmacy
- For chronic conditions like arthritis, diabetes or asthma that require regular treatment
We list only the most common drugs covered under your plan. To check coverage and copay information for a specific medicine log in to your secure member website after your effective date.
2020 - Other drug lists
2020 - Other drug lists
These drugs appear in the main list, but have been grouped into categories to make them easier to find.
HSA-associated plans: Prescription drugs on the Preventive list below will be covered as if you have already met your deductible. You are responsible only for your copay.
HRA-associated plans: Prescription drugs on the Preventive list and/or the Chronic list below could be covered as if you already met your deductible. You would be responsible only for your copay. To find out which lists apply to you, check your plan benefits documents.
Preventive drugs and products
- Under health care reform, you can get some drugs and products with no member cost share. This means they are covered 100 percent by your plan. This list shows some common examples.
Exclusions Drug List
- The drugs on this list are not covered under your plan. There are similar products with the same active ingredients that are covered. The list shows you the non-covered drugs and the similar covered ones.
Preferred specialty drugs and formulary excluded specialty drugs
- Specialty drugs treat complex conditions that often require support by a nurse or pharmacist during treatment. These drugs may be injected, infused or taken orally and may require special handling.
Medical exceptions for non-covered drugs
Medical exceptions for non-covered drugs
Expedited medical exceptions
In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025, or fax a request to 1-855-330-1716. You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081. We will make a coverage determination within 24 hours of receiving the request, and notify you or your prescriber of our decision.
*These circumstances exist when you are suffering from a health condition that may seriously jeopardize your life, health, or ability to regain maximum function, or undergoing a current course of treatment using a non-covered drug.
About your drug list
What is a formulary?
A formulary is a list of drugs covered under your plan, with details about the type of coverage. You may hear the word "formulary" during a doctor’s visit or when you pick up a prescription.
Does the main list include every covered drug?
Your pharmacy benefits plan includes thousands of drugs – too many to list. So your main drug list contains only the most commonly prescribed drugs.
For current members, to check coverage and copay information for a specific medicine log in to your secure member website.
This material is for information only. Aetna Specialty Pharmacy refers to Aetna Specialty Pharmacy, LLC, a subsidiary of Aetna Inc., which is a licensed pharmacy that operates through specialty pharmacy prescription fulfillment. The drugs on the Preferred Drug List Formulary Exclusions, Precertification, and Quantity Limit Lists are subject to change. The precertification and quantity limits drug coverage review programs are not available in all service areas. For example, precertification programs do not apply to fully insured members in Indiana. However, these programs are available to self-insured plans.
Information is believed to be accurate as of the production date; however, it is subject to change.
Effective solutions that fit a variety of needs
Our health coverage solutions bring together local expertise with the experience of a leading national insurance brand. We provide plans that deliver the services members value with the type of cost clarity that gives peace of mind.
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Aetna is the brand name for Aetna Life Insurance Company and its affiliated companies. Allina Health and Aetna Insurance Company is an affiliate of Aetna Life Insurance Company and its affiliates (Aetna). Aetna provides certain administrative services for Allina Health and Aetna.
Legal Notices: Health benefits and health insurance plans contain exclusions and limitations.
Health benefits and health plans are offered, underwritten or administered by Allina Health and Aetna Insurance Company (Allina Health | Aetna). Allina Health l Aetna is an affiliate of Aetna Life Insurance Company and its affiliates (Aetna). Allina Health | Aetna has sole responsibility for its products and services. Aetna provides certain management services to Allina Health | Aetna. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family.
Allina Health | Aetna is the brand name used for products and services provided by Allina Health and Aetna Insurance Company.
This material is for information only and is not an offer or invitation to contract. Health benefit plans contain exclusions and limitations. Providers are independent contractors and not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability are subject to change and may vary by location. If you are in a plan that requires the selection of a primary care physician and your primary care physician is part of an integrated delivery system or physician group, your primary care physician will generally refer you to specialists and hospitals that are part of the delivery system or physician group. Information is believed to be accurate as of the production date; however, it is subject to change.
*Applies only to covered services at MinuteClinic. Members in indemnity plans are not eligible for this benefit. Such members should refer to their benefit plan documents in order to determine coverage and applicable cost share for walk-in clinic benefits and services, as applicable. Visit MinuteClinic.com for age and service restrictions. Eligible members enrolled in qualified high-deductible plans must meet their deductible. However, such services would be subject to negotiated contract rates. Once the deductible has been met, members will be able to access MinuteClinic services at no cost share. Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are both within the CVS Health family. Aetna is not responsible for services received at MinuteClinic locations. 98point6 and 98point6 physicians are independent contractors and are neither agents nor employees of Allina Health | Aetna or plans administered by Allina Health | Aetna and does not guarantee that a prescription will be written.
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