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Pharmacy benefits for members

At Aetna Better Health® of California, we cover a wide variety of prescription and over-the-counter medications to keep our members healthy. You can learn more by checking out our pharmacy guidelines.

 

What medications are covered?

What medications are covered?

We cover the medications listed on our formulary at no extra cost to our members. They can download our formulary. Check if their medicine is covered in our online formulary. Or check out our provider formulary and updates. If their medicine isn’t listed, then they can ask their provider:

 

  • To prescribe a similar medication that is on the list
  • To request prior authorization on their behalf to cover this medicine

Where can members fill their prescriptions?

Where can members fill their prescriptions?

We keep health care close to home. Members can fill their prescriptions at any pharmacy in our network.  

Pharmacist explains prescription to patient

Members can get their medicine in the mail

 

If members take medicine for an ongoing health condition, they can have it mailed to their home. Aetna Better Health works with CVS Caremark® to offer this service at no extra cost. Our members expect each order to be checked for safety.

 

CVS Caremark just needs the following information:

 

  • Plan member ID card
  • Mailing address, including ZIP code
  • Doctor’s first name, last name and phone number
  • A list of the member’s allergies and other health conditions
  • The original prescription from the member’s doctor (if they have it)

 

How they can get started

Members can call the CVS Caremark toll-free number at 1-855-271-6603 (TTY: 711), 24 hours a day, 7 days a week. CVS Caremark will let the member know which of their medicines can be filled through the mail service pharmacy. CVS Caremark will then contact the member’s doctor for a prescription and mail the medicine to the member.

 

Do they already have a prescription?

They can sign up online

The member can log in to the secure Member Portal. They should go to “Tasks” and then “Pharmacy services.” They should click on the “CVS” link to go to Caremark.com. Then, they should choose “Start mail service.”

They can sign up by mail

If the member already has a prescription, they can fill out a mail service order form and send it to:
CVS Caremark
PO Box 2110
Pittsburgh, PA 15230-2110

They can request to have a form mailed to them by calling Member Services at 1-855-772-9076 (TTY: 711).

Specialty medications

Specialty medications

CVS Specialty® pharmacy provides many services, including:

 

  • Delivery of specialty medications to members’ homes or doctors’ offices with CVS Caremark
  • Counseling on medications and conditions
  • Coordination of care with members and their doctors
  • Options to drop off prescriptions and pick up the medication at any CVS Pharmacy® location
  • The ability to talk to a pharmacist 24 hours a day, 7 days a week

If you have questions or need help with the services listed above, you can call CVS Specialty pharmacy at 1-800-237-2767 (TTY/TDD: 1-800-863-5488).

Contact us

 

If members have any questions or want more information about:

Our formulary

They can call Member Services at 1-855-772-9076 (TTY: 711).

Over-the-counter medications

They can call Member Services at 1-855-772-9076 (TTY: 711).

CVS Specialty pharmacy

They can call CVS Specialty pharmacy at 1-800-237-2767 (TTY/TDD: 1-800-863-5488).

Mail-order prescriptions

They can visit Caremark.com or call CVS Caremark prescription services at 1-855-271-6603 (TTY: 711).