Find A Medication - 2018 Standard Plan

2018 Drug Coverage

View 2019 Aetna Standard Plan 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 home delivery
- For chronic conditions like 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.

Aetna Standard Plan drug guide

Aetna Standard Plan - Preferred specialty drugs and formulary excluded specialty drugs

Aetna Standard Plan - Excluded drugs, with covered alternatives
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.

2018 - Other drug lists: These drugs appear in the main list, but have been grouped into categories to make them easier to find.

Preventive and Chronic drug lists

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.

Aetna Standard Plan - Preventive Medicine List
Pay only the copay or coinsurance for these drugs, even if you haven’t met your deductible. May not apply to all plans.

Chronic Medicine List
Pay only the copay or coinsurance for these drugs, even if you haven’t met your deductible. May not apply to all plans.

Specialty Drug lists

Aetna Standard Plan – Specialty drugs requiring precertification

Aetna Standard Plan - Specialty drugs that must be ordered from an in-network pharmacy

Step Therapy Drug list

Aetna Standard Plan – Drugs that require step therapy
Check your plan documents to see if step therapy applies. These brand-name drugs require step therapy. If you fill a prescription for one of these drugs first, without trying a generic or preferred brand, your prescription may not be covered.
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.

What's New

Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy^® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health^® family of companies.

98point6^® is a registered trademark of 98point6 Inc. Access to 98point6^® is not included in all plans. 98point6 is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan.

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.