Pharmacy Services

Prescriptions

Aetna Better Health covers prescription medications. You can get your prescriptions at no cost to you when:

• > You get your prescriptions filled at a network pharmacy
  
• > Your prescriptions are on our preferred drug list (also called a formulary)

It is important that you tell your provider or dentist about prescriptions you are already taking. Also, tell them about non-prescription medicine or vitamin or herbal supplements you may be taking.

Preferred Drug List

You can find out if your medicines are on the preferred drug list in one of two ways.

• > Call Member Services toll free at 1-866-212-2851. Have a list of your prescriptions ready when you call. Ask the representative to look up your medicines to see if they are on the list.
  
• > Illinois Formulary

Over-the-Counter Drugs

Aetna Better Health also covers certain over-the-counter drugs if they are on our list. Some of these may have rules about whether they will be covered. If the rules for that drug are met, Aetna Better Health will cover the drug. Like other drugs, over-the-counter drugs must have a prescription from a provider for them to be covered at no cost to you.

You can find out if your over-the-counter medicines are on the preferred drug list in one of two ways.

• > Call Member Services toll free at 1-866-212-2851. Have a list of your over-the-counter medicines ready when you call. Ask the representative to look up your medicines to see if they are on the list.
  
• > Click here for a list of Over-the-Counter Drugs.

CuraScript Specialty Medications

CuraScript is a specialty pharmacy that provides oral and injectable drugs that are not often available at local retail pharmacies. View the list of drugs that are available through CuraScript.

How to get your prescriptions

Here is how to get your prescriptions as an Aetna Better Health member.

• > If you need medicine, your provider will choose a drug from our list of preferred drugs.
  
• > Your provider will write you a prescription. Ask your provider to make sure that the medicine is on the list.
  
• > Take the prescription to a network pharmacy to have it filled.
  
• > Show your Aetna Better Health member ID card at the pharmacy. As long as you show your member ID card and use medicines from the preferred drug list, you will not have to pay for your prescriptions.

How to find a network pharmacy

You can find a network pharmacy in one of two ways.

• > Call Member Services toll free at 1-866-212-2851. Ask the representative to help you find a network pharmacy in your area.
  
• > Click here to search for a pharmacy in your area.

All prescriptions must be filled at a network pharmacy. Prescriptions filled at other pharmacies will not be covered.

Mail Order Prescriptions

If you take medicine for an ongoing health condition, you can have your medicines mailed to your home. Aetna Better Health works with a company called Express Scripts, Inc. (ESI), to give you this service, which you can get at no cost to you.

If you choose this option, your medicine comes right to your door. You can schedule your refills and reach pharmacists if you have questions. Here are some other features of home delivery.

• > Pharmacists check each order for safety.
  
• > You can order refills by mail, by phone, online, or you can sign up for automatic refills.
  
• > You can talk with pharmacists by phone at any time - 24 hours a day, 7 days a week.

You can sign up for this service in one of three ways.

• > Call ESI toll free at 1-866-698-1325 Monday to Friday between 8 a.m. and 5 p.m., Central time. They will help you sign up for home delivery. If you say it's OK, they will call your provider to get a prescription. If you have trouble hearing, call ESI's TTY line toll free at 1-800-899-2114.
  
• > Go to StartHomeDelivery.com. Then log in and sign up for Home Delivery. If you say it's OK, ESI will call your provider to get a prescription.
  
• > Ask your provider to write a prescription for a 90-day supply with up to one year of refills. Call ESI and ask them to mail you a Home Delivery order form. When you receive the form, fill it out and then mail ESI the prescription and the order form. Mail the form to:
  
  Express Scripts
  Home Delivery Service
  PO Box 52101
  Phoenix, AZ 85072-2101

Mail Order FAQ English

Mail Order FAQ Spanish

If Your Medicines Are Not on the Preferred Drug List

If your medicine is not on the preferred drug list, there are some things you can do.

• > Ask your provider for a similar drug that is on the list.
  
• > Ask your provider to ask Aetna Better Health to cover your drug through the prior authorization process. Your provider will know how to do this.

Refills

Your medicine bottle label says how many refills you can have. If your provider or dentist has not ordered refills and you think you may need a refill, you must call him or her at least five days before your medicine runs out. When you call, ask your provider or dentist about getting a refill. They may want to see you before giving you a refill.

Questions to Ask About Your Medicines

Aetna Better Health wants you to be as healthy as possible. This includes being informed about the different medicines you may need to take. To help you, we have included a list of questions you should always ask your provider when he or she gives you a prescription.

• > Why am I taking this medicine? What is it supposed to do for me?
  
• > How should the medicine be taken? When? For how many days?
  
• > Are there any side effects or possible allergic reactions to this medicine?
  
• > What should I do if I have a side effect or allergic reaction?
  
• > What will happen if I don't take this medicine?

Carefully read the drug information the pharmacy gives you with your medicine. It will tell you what you should and should not do while taking the medicine. If you still have questions after you get your medicine, ask to speak with the pharmacist or call your provider.