PRESCRIPTION INFORMATION

Both the Medical HMO and POS plans offer prescription coverage. Please review the appropriate plan benefit summary listed in the Documents Library, for information on appropriate copays depending on your choice of generic formulary, brand formulary or non-formulary.

A drug formulary is a list of prescription drugs, both generic and brand name, that are preferred by Aetna. Aetna may only pay for medications that are on this preferred list. To see which prescription drugs are covered under each medical plan, please click below:

AETNA HMO 3 TIER OPEN FORMULARY

AETNA POS 4 TIER OPEN FORMULARY

MAIL ORDER PRESCRIPTIONS

You can order maintenance medications through Aetna's RX Home Delivery for chronic conditions as asthma, arthritis, diabetes, high cholesterol and heart conditions. For more information on how to order prescriptions via mail, please click below:

AETNA RX HOME DELIVERY/ORDER FORM

AETNA PRECERTIFICATION, QUANTITY LIMITS AND STEP-THERAPY LISTS UPDATE

Aetna has adopted the following procedures regarding certain drugs. This affects both HMO/POS members. Drugs on Aetna's Precertification, Quantity limits and Step-Therapy Lists are based on accepted treatment guidelines, including FDA-approved drug manufacturer labeling instructions and clinical studies.

PRECERTIFICATION - APPROVAL IS NEEDED BEFORE COVERAGE APPLIES TO DRUGS THAT:

• Are likely to be taken inappropriately
• Should only be prescribed for certain conditions
• Tend to be more expensive than other medications proven to be just as effective

QUANTITY LIMITS - RESTRICTIONS FOR MEMBER SAFETY:

• Are likely to be taken inappropriately
• Are likely to be taken in amounts greater than dosage recommendations
• Certain eye and ear drop preparations will be subject to maximum-use quantity limit. The limited drug classes include antibiotics, corticosteroids, and non-steroidal anti-inflammatory agents.

STEP-THERAPY - COVERAGE WHEN OTHER DRUGS ARE TRIED FIRST:

• To get coverage for step-therapy medication, must first try other equally effective but less costly drugs
• If medically necessary, doctors can ask for a medical exception (via request to Aetna to cover the drug)

HEALTH CARE REFORM ADDITION OF WOMEN'S CONTRACEPTIVE DRUGS AND DEVICES

Click the brochure below to learn of what contraceptives have been approved for your access at no copay due to the Patient Protection and Affordable Care Act (Health Care Reform). You may have your doctor write a prescription for those drugs and devices listed on this sheet and there will be no copay required.

WOMEN'S CONTRACEPTIVE LIST

Additional Questions

Please visit www.aetna.com/formulary or call:

• HMO Member Services: 1-877-402-8742
• POS Member Services: 1-877-204-9186
• RX Services both HMO/POS: 1-866-612-3862
• Mail RX Services: 1-800-227-5720