Page 16 - Work Life and Benefits Booklet 2020 SDC EDC

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
If you take maintenance medications for conditions it is available and appropriate.

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 AETNA AETNA
PLAN NAME DEDUCTIBLE HMO FULL HMO HSA PPO OAMC/PPO

DEDUCTIBLE HMO HMO
NETWORK NETWORK OAMC NON- OAMC NON-
CA EMPLOYEES ONLY CA EMPLOYEES ONLY NETWORK NETWORK
Copays apply after you meet
Retail Copay (30-day supply) the medical deductible.

Preferred Generic $10 Copay $15 Copay $10 Copay Not Covered $10 Copay 50%, $250 max
Preferred Brand $20 Copay $30 Copay $30 Copay Not Covered $30 Copay 50%, $250 max
Non-Preferred Generic/Brand $35 Copay $50 Copay $50 Copay Not Covered $50 Copay 50%, $250 max
Specialty Drugs Copays apply Copays apply 30% to $250 Not Covered Copays apply 50%, $250 max

Mail Order Copay (90-day supply)

Maintenance Medications 2 copays for 90 day 2 copays for 90 day 2 copays for 90 Not Covered 2 copays for 90 Not Covered
day supply
day supply
supply
supply