Coverage Determination
Coverage Determination Form
Fill out the Coverage Determination Form online. Alternatively, you can download or request a paper copy of this form and send it us by mail or fax.
For questions or to request a paper copy, call 1-866-600-2139 (TTY: 711). We are available 24 hours a day, 7 days a week.
Aetna Better Health Premier Plan MMAI
Part D Coverage Determination
Pharmacy Department
PO Box 818001
Cleveland, OH 44181-8001
Fax
Aetna Better Health Premier Plan MMAI
Part D Coverage Determination
Pharmacy Department
1-855-365-8109
Who may make a request: Your prescriber may ask us for a coverage determination on your behalf. Your prescriber can call 1-866-600-2139 (TTY: 711), 24 hours a day, 7 days a week. If you want another individual (such as a family member or friend) to make a request for you, that individual must be your representative. Contact us to learn how to name a representative.