Aetna Part D Medicare Drug Plan


TOLL FREE: 1-844-233-1939
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Premier Option
2019 Aetna Part D Premier Option Annual Notice of Changes |
2019 Aetna Part D Premier Option Benefit Summary |
2019 Aetna Part D Premier Option Formulary

Value Option
2019 Aetna Part D Value Option Annual Notice of Changes |
2019 Aetna Part D Value Option Benefit Summary |
2019 Aetna Part D Value Option Formulary | >

Aetna Part D Rx Paper Claim Form

Aetna Part D is an optional Medicare Part D prescription drug component. This plan provides a level of benefits not available on standard Part D plans found on the private market.

This year Aetna Part D will have Premier and Value options for members to review.
NOTE: These plans have the same Network of Providers but do have separate formulary. Review the formulary (Preferred Drug List) to make sure the prescriptions you use are listed.

For questions concerning Aetna Part D coverage, members should contact Aetna Part D Customer Care representatives at 1-844-233-1939. The benefit specialists are available from 8:00 a.m. to 8:00 p.m. Monday - Friday. They can assist with drug cost estimations and answer any questions you may have.

Aetna Part D Overview
Aetna Part D will generally cover the drugs listed in their formulary as long as:

  • The drug is medically necessary
  • The prescription is filled at a Network pharmacy, and other coverage rules are followed.

Aetna Part D does not pay for drugs that are covered by Medicare Part B, such as:

  • Drugs usually supplied by and administered in your doctor’s office (such as chemotherapy drugs)
  • Drugs used with durable medical equipment (DME) that you obtained through DME services, such as respiratory drugs given through a nebulizer
  • Some immunosuppressive drugs (if you had a Medicare covered transplant) and some oral anti-cancer drugs
  • Drugs provided in Hospital Outpatient Departments and drugs such as erythropoietin (EPO) if you are undergoing dialysis

In order to participate in Medicare Part D, you must enroll in only one of the Part D plans.  Once you are enrolled in a plan (either through the State Employee Health Plan or the private market), if you enroll in another Medicare Part D plan at a later date, you will be automatically dis-enrolled in the previous plan, you will still need to contact State Employee Health Plan at 866-541-7100 if you are dropping coverage with the State. If you are enrolled in a Medicare Part D plan that is coupled with other health insurance, enrollment in a subsequent Part D plan may result in loss of your health insurance benefits.

NOTE: Premiums are billed by Aetna Part D directly to the member. These premiums are not included in the premium drafted by the State Employee Health Plan.