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Aetna Broker Alert

Story Content Provided by Aetna on 6/7/13

We're adding more drugs to our precertification, step-therapy lists.

On June 1, 2013 and July 1, 2013, we're adding more brand-name drugs to our Pharmacy precertification and step-therapy lists. We began sending letters to your clients in April and May about these changes.

We wanted you to be aware, in case your clients call you. Please review the pharmacy changes and the letter linked above.

Reasons we use precertification, step therapy.

We use the precertification process and step-therapy requirement to review a member's coverage for certain drugs. We add drugs to these two lists based on certain criteria, in order to:

  • Make sure these drugs are used safely
  • Help members save money, when possible

If a member has a medical need for one of these brand-name drugs, his/her prescribing doctor can ask us for a medical exception. If approved, we'll cover the drug at the copay that applies under the member's plan.

Note: The precertification, quantity limits and step-therapy lists may change. For the most current list, tell your clients to go to www.aetna.com/formulary. Or, have them call the toll-free number on their member ID card.

Contact us for more information.

Please call your Aetna sales executive with questions or for more information.