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Pharmacy benefits

At Aetna Better Health® of Maryland, we cover a wide range of prescription and over-the-counter (OTC) medications to keep members healthy.

Covered medications

Covered medications

Prescription medications

 

We cover prescription medications listed on our formulary (drug list) at no extra cost to members. If your patient needs medication, you’ll want to check the list for covered medications, step therapy requirements, quantity limits and updates. You can download the list or check it online. 

 

If a medication isn’t listed on the formulary (drug list), you can: 

 

  • Prescribe a similar one that is on the list
  • Get prior authorization (PA) for coverage

Ask members to check with you for refills. And let them know you may need to see them first.

OTC medications

 

Members can get coverage for OTC medications on the formulary (drug list) when they:

 

  • Meet any added requirements (for some medications)

  • Get a prescription from their provider

  • Fill their OTC prescription at a pharmacy in our network

Members can also check with Member Services at 1-866-827-2710 (TTY: 711). When calling, they’ll want to have a list of their OTC medications ready. They can ask to see if their medications are on the list.

Pharmacy PA

Pharmacy PA

If a member needs PA for a medication, you can fill out a pharmacy PA form on their behalf. Or you can call Provider Relations at 1-866-827-2710 (TTY: 711). 

Filling prescriptions

 

 

In person

 

Members can fill their prescriptions at any pharmacy in our network.

 

Find a pharmacy nearby

By mail

 

When members take maintenance medications for an ongoing health condition, they can get it by mail. We work with CVS Caremark® to give members this service at no extra cost. Each order is checked for safety. And members can speak with a pharmacist anytime on the phone.

 

To get started, they’ll need their:

 

  • Plan member ID card

  • Mailing address, including ZIP code

  • Doctor’s first and last name and phone number 

  • List of allergies and other health conditions

  • Original prescription from their doctor (if they have it)

Mail service makes it easy

Members can call CVS Caremark at 1-855-271-6603 (TTY: 711), 24 hours a day, 7 days a week. They’ll let the member know which medications can be filled with CVS Caremark Mail Service Pharmacy. They’ll also contact the member’s provider for a prescription and mail the member’s medication. 

 

Members with prescriptions

 

They can sign up for mail service:

Online

Members can log in to the secure Member Portal. Go to “Tasks” and then “pharmacy services.” Choose the “CVS” link to go to the CVS Caremark website. Then, choose “start mail service.” 

With an order form

If members already have a prescription, they can fill out a mail service order form (PDF) and send it to:

CVS Caremark 
PO Box 2110  
Pittsburgh, PA 15230-2110  
 

Or we can mail them a form. They just need to call Member Services at 1-866-827-2710 (TTY: 711).

Specialty medications

Specialty medications

CVS Specialty® pharmacy provides many services, like:

 

  • Delivery of specialty medications to the member’s home or doctor's office 

  • Counseling on medications and conditions

  • Coordination of care with members and providers

  • Option to drop off a prescription and pick up the medication at any CVS Pharmacy® location

  • Ability to talk to a pharmacist 24 hours a day, 7 days a week

 

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

SimpleDose™ 


Pharmacists at CVS Pharmacy locations can help organize medications for members at no extra cost. They'll put maintenance medications in 30-day packs. And clearly label the time and date when the member should take it. Then, they’ll send it to the member’s home or local CVS Pharmacy.  

 

Members can sign up: 

By phone

Members can call CVS Pharmacy at 1-800-753-0596 (TTY: 711), Monday through Friday, 8 AM to 6 PM.  

In person

Members can sign up with a pharmacist at their local CVS Pharmacy. 

Online

Members can fill out an enrollment form online to sign up. 

SimpleDose 

Call Provider Relations

Contact us

Questions? Just call Provider Relations 
at 1-866-827-2710 (TTY: 711).

Call Provider Relations