Prescription Drugs
All of the medical plans include retail and mail-order prescription drug coverage through Aetna.
Paying for Prescriptions
There is no annual deductible for prescription drugs, so you begin paying copays with your first prescription purchase. The category, or tier, your drug is in determines the amount you pay. See the Medical Plan Comparison Chart for coverage amounts.
Save Money
Here are tips to help you save on your prescription drug costs:
- Ask your doctor about generics. Generic medications are generally just as effective as brand-name medications, but they cost between 30% and 75% less.
- Use mail order. If you regularly take medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — using the mail order prescription service will save you time and money. Visit Aetna’s website or call the number on the back of your insurance ID card to use this service.
Prescription Drug Coverage Comparison
Plan Details | Aetna HMO Plan | Aetna EPO Plan | Aetna PPO Plan | ||
Retail (30-day supply) | In-Network | In-Network | Out-of-Network | In-Network | Out-of-Network |
Tier 1 | $20 copay | $20 copay | 20% coinsurance | $20 copay | 20% coinsurance |
Tier 2 | $40 copay | $40 copay | 20% coinsurance | $40 copay | 20% coinsurance |
Tier 3 | $70 copay | $70 copay | $20% coinsurance | $70 copay | 20% coinsurance |
Tier 4 | 20% coinsurance; maximum $250 copay per fill | 20% coinsurance; maximum $250 copay per fill | 20% coinsurance | 20% coinsurance; maximum $250 copay per fill | 20% coinsurance |
Mail Order (90-day supply) | |||||
Tier 1 | $40 copay | $40 copay | 20% coinsurance | $40 copay | 20% coinsurance |
Tier 2 | $80 copay | $80 copay | 20% coinsurance | $80 copay | 20% coinsurance |
Tier 3 | $140 copay | $140 copay | 20% coinsurance | $140 copay | 20% coinsurance |