Page 17 - Work Life and Benefits Booklet 2020 SW
P. 17

The Aetna medical plans include prescription drug coverage for you and your covered dependents. The drug plan is Advanced Control Formulary.

       Retail Pharmacy
       Present your medical plan ID card at a participating                               SAVE MONEY ON YOUR MEDICATIONS!
       pharmacy. You will receive up to a 30-day supply for
       your prescription. You will pay a copay based on the                Ask for Generic Drugs
       type of prescription you receive.                                   You can save money by asking for generic drugs. The FDA requires that generic drugs
                                                                           have the same high quality, strength, purity, and stability as brand-name drugs. The

       Mail Order – Maintenance Medication                                 next time you need a prescription, ask your doctor to prescribe a generic drug when
                                                                           it is available and appropriate.
       If you take maintenance medications for conditions
       such as high blood pressure, asthma or diabetes,
       Aetna’s mail order program can save you time and                    Price your Medication with GoodRX.com
       money.                                                              Price out your medication by searching wholesale costs online at www.goodrx.com.
                                                                           This is important for HSA members who must pay the full amount up to the
       When using the mail order service, you will receive a 3-            deductible before benefits begin.
       month (90-day) supply for the cost of 2 months. So you
       pay for two and get one free! For additional information,           Prior Authorization
       call Aetna’s Customer Service at (866) 529-2517 for HMO             Some drugs require clinical notes. If the drug is being denied, be sure to have your
       | (877) 204-9186 for OAMC/PPO or go online to                       provider contact Aetna for pre-certification.
       www.aetna.com.


                                                                       AETNA                                           AETNA
                     PLAN NAME                                       HSA PPO                                        OAMC/PPO

                                                             OAMC             NON-NETWORK                   OAMC               NON-NETWORK


       Retail Copay (30-day supply)                            Copays apply after you meet
                                                                 the medical deductible.
       Preferred Generic                                    $10 Copay           Not Covered               $10 Copay             50%, $250 max
       Preferred Brand                                      $30 Copay           Not Covered               $30 Copay             50%, $250 max

       Non-Preferred Generic/Brand                          $50 Copay           Not Covered               $50 Copay             50%, $250 max
       Specialty Drugs                                     30% to $250          Not Covered              Copays apply           50%, $250 max

       Mail Order Copay (90-day supply)
       Maintenance Medications                          2 copays for 90 day     Not Covered           2 copays for 90 day        Not Covered
                                                                                                            supply
                                                             supply
   12   13   14   15   16   17   18   19   20   21   22