Formulary
The Aetna Better Health Premier Plan MMAI formulary can be found below.
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Formulary
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Formulary Updates
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Prior Authorization Criteria
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Step Therapy Criteria
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Machine Readable Formulary File
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Medicare Part B Step Therapy
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Requirements or limits on Part B drugs
Under Aetna Better Health Premier Plan MMAI, some drugs may have special requirements or coverage limits. We’ll help you find the information you need.
How step therapy works
Some medically administered Part B drugs, like injectables or biologics, may have additional requirements or coverage limits. That may include step therapy, where we require a trial of a preferred drug to treat a medical condition before covering another non-preferred drug.
Here’s an example:
If Drug A and Drug B both treat a medical condition, we may prefer Drug A and require a trial of it first. If Drug A does not work, we’ll then cover Drug B. The listed preferred products should be used first.
Note: The step therapy requirement does not apply to patients who’ve already received treatment with the non-preferred drug within the past 365 days.
Find preferred drugs
We’ve compiled the Aetna Better Health Premier Plan MMAI Part B Step Therapy Preferred Drug Lists below for your convenience. Please click below:
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Glucose Meters
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The preferred continuous glucose meters and supplies are FreeStyle Libre® and Dexcom®.
The preferred blood glucose meter, test strips and lancets are Lifescan OneTouch® products.