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Pharmacy benefits
At Aetna Better Health® of Maryland, we cover a wide range of prescription and over-the-counter (OTC) medications to keep members healthy.
Covered medications
Covered medications
Prescription medications
We cover prescription medications listed on our formulary (drug list) at no extra cost to members. If your patient needs medication, you’ll want to check the list for covered medications, step therapy requirements, quantity limits and updates. You can download the list or check it online.
If a medication isn’t listed on the formulary (drug list), you can:
- Prescribe a similar one that is on the list
- Get prior authorization (PA) for coverage
Ask members to check with you for refills. And let them know you may need to see them first.
OTC medications
Members can get coverage for OTC medications on the formulary (drug list) when they:
Meet any added requirements (for some medications)
Get a prescription from their provider
Fill their OTC prescription at a pharmacy in our network
Members can also check with Member Services at 1-866-827-2710 (TTY: 711). When calling, they’ll want to have a list of their OTC medications ready. They can ask to see if their medications are on the list.
Pharmacy PA
Pharmacy PA
If a member needs PA for a medication, you can fill out a pharmacy PA form on their behalf. Or you can call Provider Relations at 1-866-827-2710 (TTY: 711).
Filling prescriptions
In person
Members can fill their prescriptions at any pharmacy in our network.
By mail
When members take maintenance medications for an ongoing health condition, they can get it by mail. We work with CVS Caremark® to give members this service at no extra cost. Each order is checked for safety. And members can speak with a pharmacist anytime on the phone.
To get started, they’ll need their:
Plan member ID card
Mailing address, including ZIP code
Doctor’s first and last name and phone number
List of allergies and other health conditions
Original prescription from their doctor (if they have it)
Mail service makes it easy
Members can call CVS Caremark at 1-855-271-6603 (TTY: 711), 24 hours a day, 7 days a week. They’ll let the member know which medications can be filled with CVS Caremark Mail Service Pharmacy. They’ll also contact the member’s provider for a prescription and mail the member’s medication.
Members with prescriptions
They can sign up for mail service:
Online
Members can log in to the secure Member Portal. Go to “Tasks” and then “pharmacy services.” Choose the “CVS” link to go to the CVS Caremark website. Then, choose “start mail service.”
With an order form
If members already have a prescription, they can fill out a mail service order form (PDF) and send it to:
CVS Caremark
PO Box 2110
Pittsburgh, PA 15230-2110
Or we can mail them a form. They just need to call Member Services at 1-866-827-2710 (TTY: 711).
Specialty medications
Specialty medications
CVS Specialty® pharmacy provides many services, like:
Delivery of specialty medications to the member’s home or doctor's office
Counseling on medications and conditions
Coordination of care with members and providers
Option to drop off a prescription and pick up the medication at any CVS Pharmacy® location
Ability to talk to a pharmacist 24 hours a day, 7 days a week
Members can call CVS Specialty pharmacy at 1-800-237-2767 (TTY/TDD: 1-800-863-5488) with questions.
SimpleDose™
Pharmacists at CVS Pharmacy locations can help organize medications for members at no extra cost. They'll put maintenance medications in 30-day packs. And clearly label the time and date when the member should take it. Then, they’ll send it to the member’s home or local CVS Pharmacy.
Members can sign up:
By phone
Members can call CVS Pharmacy at 1-800-753-0596 (TTY: 711), Monday through Friday, 8 AM to 6 PM.
In person
Members can sign up with a pharmacist at their local CVS Pharmacy.