What if my prescribed medication is not covered by Aetna Rx?

If a prescribed medication is not covered by Aetna Rx Home Delivery, several options may be available to the member. First, it is important to review the specific plan's formulary, which is a list of medications covered under the plan. Members can check the formulary on the Aetna website to see if there are any similar medications that may be covered. In some cases, a member's healthcare provider may be able to request a prior authorization for the medication. This process involves the provider submitting documentation to Aetna's pharmacy benefit team to justify the need for the specific medication. If approved, the medication may then be covered, even if it is not typically included in the formulary. Additionally, members can inquire about the possibility of using a different pharmacy, as some medications may be covered through retail or specialty pharmacies rather than through Aetna Rx Home Delivery. Finally, it is worth considering alternatives that may be less expensive or available through patient assistance programs offered by pharmaceutical companies. Members may want to explore these options through comprehensive online resources or by looking directly on the Aetna website for further details on coverage and assistance.