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We cover the medications listed on our preferred drug list (PDL) at no extra cost to members. They can download our PDL or check it out online. If their medicine isn’t listed, then they can ask a provider:
- For a similar medication that is on the list
- To get prior authorization from Aetna Better Health of Illinois to cover this medicine
Pharmacy prior authorization
Pharmacy prior authorization
If a member needs prior authorization for a medication, then you can fill out a pharmacy prior authorization form on their behalf. Or you can call Provider Services at 1-866-329-4701 (TTY: 711). You can learn more about getting pharmacy prior authorization with the links below.
If a member takes a maintenance medicine for an ongoing health condition, they can have it mailed to their home. We work with CVS Caremark® to give members this service at no extra cost. Members can expect each order to be checked for safety. And they can speak with a pharmacist anytime on the phone.
They’ll need the following information to get started:
Plan member ID card
Mailing address, including ZIP code
Doctor’s first and last name and phone number
A list of their allergies and other health conditions
Their original prescription from their doctor (if they have it)
Members can call the CVS Caremark toll-free number at 1-855-271-6603 (TTY: 711), 24 hours a day, 7 days a week. They’ll let members know which of their medicines can be filled through the CVS Caremark Mail Service Pharmacy. They’ll also contact the member’s doctor for a prescription and mail them their medicine.
Members with prescriptions
They can sign up for our mail service:
Specialty medications are for chronic issues. They can be injected or taken orally. Our preferred specialty pharmacies provide many helpful services, including:
Free, secure delivery within 48 hours of confirming a member’s order
Delivery to the member’s home, doctor’s office or somewhere else
Training on how to self-inject their medicine
Free injection supplies, such as needles, syringes, alcohol swabs, adhesive bandages and containers for used needles
Getting started with specialty pharmacies
A doctor can fill a new prescription for a member by contacting one of our preferred specialty pharmacies below. A member or their doctor can transfer the member’s prescription by contacting a specialty pharmacy in our network.
- OptumRx Pharmacy — phone: 1-855-427-4682; fax: 1-877-342-4596
- CVS Specialty® pharmacy — phone: 1-800-237-2767; fax: 1-800-323-2445
- Orsini Specialty Pharmacy — phone: 847-734-7373; fax: 847-734-1822
- AcariaHealth — phone: 1-800-511-5144; fax: 1-877-541-1503
- Specialty Therapeutic Care — phone: 1-866-506-2626; fax: 1-800-696-0607
- Foundation Care Pharmacy — phone: 1-877-291-1122; fax: 1-877-291-1155