Formulary

The Aetna® D-SNP formulary can be found below.

View the 2024 formulary (English|Spanish|Vietnamese|Arabic)

View the 2025 Aetna Medicare Better Health (HMO D-SNP) formulary (English|Spanish|Vietnamese|Arabic)

View the 2025 Aetna Medicare Assure Value (HMO D‑SNP) formulary (English|Spanish|Vietnamese|Arabic)

View the 2024 Formulary Change Notice

View the 2025 Aetna Medicare Better Health (HMO D-SNP) 2025 Formulary Change Notice

View the 2025 Aetna Medicare Assure Value (HMO D‑SNP) 2025 Formulary Change Notice

View the 2024 PA Criteria

View the 2025 Aetna Medicare Better Health (HMO D-SNP) PA Criteria

View the 2025 Aetna Medicare Better Health (HMO D-SNP) Medicaid Weight Loss PA criteria

View the 2025 Aetna Medicare Assure Value (HMO D‑SNP) PA Criteria

 

View the 2024 Step Therapy criteria

View the 2025 Aetna Medicare Better Health (HMO D-SNP) Step Therapy criteria

View the 2025 Aetna Medicare Assure Value (HMO D‑SNP) Step Therapy criteria

 

Requirements or limits on Part B drugs

Under Medicare Advantage plans, 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® Part B Step Therapy Preferred Drug Lists below for your convenience. Please click below:

2024 Medicare Part B Step Therapy Preferred Drug List

2025 Medicare Part B Step Therapy Preferred Drug List (Aetna Medicare Assure Value)

2025 Medicare Part B Step Therapy Preferred Drug List (Aetna Medicare Better Health (HMO D-SNP)