| Aetna Member Resources
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Through your Aetna member account, you can:
- Review prescription drug coverage
Check whether a medication is covered
Review prescription claims
View copays and estimated out-of-pocket expenses
Access pharmacy plan documents and forms
Aetna Contact Information
Medical Member Services: 833-821-8558
Precertification, Hospital Admissions and Prior Approval: 888-632-3862
Employees should call the Pharmacy Member Services number on their ID card for questions about medication coverage and copays, participating pharmacies, prior authorization requirements, step therapy or quantity limits, mail-service prescriptions, specialty medications and prescription claims.
Benefits Team
Contact the Human Resources Benefits Team for questions about eligibility, enrollment, premium deductions or qualifying life events.
Important Information About Medication Coverage
The Pharmacy Drug Guide, also called a formulary, identifies medications covered by the plan. Some medications may be subject to additional requirements, including:
- Prior authorization: Approval is required before the medication will be covered.
- Step therapy: Certain medications must generally be tried before another medication will be covered.
- Quantity limits: Coverage may be limited to a certain amount within a specified period.
- Formulary exclusions: Certain medications may not be covered when other clinically appropriate options are available.
Employees should review their coverage through the Aetna member website or contact Pharmacy Member Services before filling a new prescription. Medication coverage and requirements may change during the plan year.
Mail-Service and Specialty Medications
CVS Caremark Mail Service Pharmacy may be available for eligible maintenance medications taken on a regular basis. Employees should confirm coverage and pricing before transferring a prescription to mail service.
Certain specialty medications may need to be filled through CVS Specialty Pharmacy. Employees will be contacted or directed to CVS Specialty when specialty pharmacy services are required.