Aetna International pharmacy benefits
Learn key points about prescription drug benefits for those overseas.
Aetna International pharmacy benefits
Learn key points about prescription drug benefits for those overseas.
You may be able to order up to a 12-month supply of covered medications at any participating U.S. pharmacy.
As part of your Aetna® medical plan, your prescription drugs are covered under the Aetna Standard Plan: Department of Defense formulary. The formulary is a list of medicines that are covered by your plan.
The formulary also lists which tier the drug falls into, which affects how much it costs when you’re getting a prescription filled in the U.S. This list can also help you understand which prescriptions are considered generics when you’re getting them filled overseas.
The Aetna Standard Plan for the Department of Defense offers:
- Coverage for most medicines
- Mail-order pharmacy services
- 12-month supply (fill) of covered prescriptions at any participating U.S. pharmacy
- Personal support for specialty medicine needs
- Your personal member website with tools to help you find what you need
- 24/7 pharmacy help by calling the phone number on your member ID card
Understanding the four-tier pharmacy plan
No matter where you fill a prescription, the amount you’ll pay depends on the type or tier of drug. For example, generic medicines, which are Tier One drugs in the DoD plan, usually cost less than brand-name drugs or specialty drugs (such as those that are injected or inhaled).
In your plan materials, you can see what medicines are covered by your plan and how much you’ll have to pay. Here’s how it breaks down based on what type of plan you select — a high-deductible health plan (HDHP) or non-HDHP plan.
To compare the cost of medicines filled at a network pharmacy in the U.S.: Log in to Aetna.com and go to Pharmacy, then select Check medication costs.
Prescription drug benefits with the Aetna International HDHP plan
This chart explains drug costs with an HDHP medical plan. Note: While we work hard to limit cost increases for employees from year to year, we must also manage the ever-increasing cost to our organization.
This chart lists what you’ll pay after meeting your calendar-year deductible, which includes pharmacy. The max refers to the most you’ll pay for up to a 30-day or 90-day supply of a medicine in that tier.
| Tier and drug type | At any U.S. network pharmacy for up to a 30-day supply | With CVS Mail Service Pharmacy for up to a 90-day supply |
|---|---|---|
| Tier One: Generic drugs | 0% after deductible | 0% after deductible |
| Tier Two: Preferred brand-name drugs | 35% after deductible; $75 max | 35% after deductible; $150 max |
| Tier Three: Non-preferred brand-name drugs* | 50% after deductible; $125 max | 50% after deductible; $250 max |
| Tier Four: Specialty drugs | 50% after deductible; $125 max | — |
| Fill limit for maintenance drugs | Limit 2 fills | No limit |
*Your pharmacy will automatically fill your prescription with a generic drug if one is available.
Note: 30-day supply prescription fills are only available in the United States, Puerto Rico, Guam and the U.S. Virgin Islands.
Prescription drug benefits with the Aetna International non-HDHP plan
This chart explains drug costs with a non-HDHP medical plan. Note: While we work hard to limit cost increases for employees from year to year, we must also manage the ever-increasing cost to our organization.
This chart lists what you’ll pay as a copay and/or percentage of the drug cost when filling prescriptions in the U.S. The min/max refers to the least or most you’ll pay for a 30-day supply of a medicine in that tier.
| Tier and drug type | At any U.S. network pharmacy for up to a 30-day supply | With CVS Mail Service Pharmacy for up to a 90-day supply | When filling prescriptions overseas |
|---|---|---|---|
| Tier One: Generic drugs | $10 copay | $20 copay | 0% after deductible |
| Tier Two: Preferred brand-name drugs | 25% (min $45 / max $70) | 25% (min $90 / max $140) | 80% after deductible |
| Tier Three: Non-preferred brand-name drugs* | 35% (min $75 / max $200) | 35% (min $150 / max $400) | — |
| Tier Four: Specialty drugs | 40% of negotiated price** (min $60 / max $125) | — | — |
| Fill limit for maintenance drugs | Limit 2 fills | No limit | — |
*Your pharmacy will automatically fill your prescription with a generic drug if one is available.
**Participating pharmacies agree to charge discounted prices for prescriptions filled by Aetna members. Your share of Tier Three and Tier Four drug costs is a percentage of these discounted (or “negotiated”) prices.
Note: 30-day supply prescription fills are only available in the United States, Puerto Rico, Guam and the U.S. Virgin Islands.
You have two ways to fill a 90-day supply:
- Use the CVS Caremark® Mail Service Pharmacy. This service lets you order a 90-day supply of maintenance medications to be delivered to your home or any other address you choose. Shipping is free and the packaging is confidential. Mail-order pharmacies use the same quality and accuracy checks for prescriptions as retail pharmacies. To learn more, visit Aetna.com > Pharmacy or call CVS Caremark Mail Service Pharmacy at 1-888-792-3862.
- Visit a CVS Pharmacy® retail store. Pick up your 90-day supply from a CVS Pharmacy location near you. Find a CVS Pharmacy near you. Note: Members in Hawaii only may use a Longs Drugs location.
Contact information