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Your pharmacy benefits

At Aetna Better Health® of New Jersey, we cover a wide range of prescription and over-the-counter (OTC) medications to keep you as healthy as you can be.

Medications my plan covers

Medications my plan covers

Prescription medications

 

We cover the prescription medications listed in our preferred drug list (formulary) at no extra cost to you. These medications need to be medically necessary. This means you need them to manage a health condition. The formulary also includes generic versions of the brand-name drugs.

 

You can download our formulary. Or check it online. If your medication isn’t listed, ask your provider:

 

  • To prescribe a similar one that’s in the formulary

  • To get prior authorization (PA) for coverage

 

Need PA? Just ask your provider to fill out a pharmacy prior authorization form. Or they can call 1-855-232-3596 (TTY: 711).

 

 

Formulary and updates   Formulary (PDF)

 

 

Still not sure if we cover your medication? Just call 1-855-232-3596 (TTY: 711). When you call, have a list of your prescription medications ready. We can check them for you. 

 

Understand your medication

 

Be sure you understand what your medication is for and how to take it. Check out these medication tips to learn more.

OTC medications

 

You can get coverage for these OTC medications in the preferred drug list (formulary) when you:

 

  • Meet any added requirements (for some medications)
  • Get a prescription from your provider
  • Fill your OTC prescription at a pharmacy in our network

 

Do you have both Medicare and Medicaid coverage? If yes, that means you’re dual eligible. In this case, you can check the OTC wrap formulary for dual-eligible members (PDF).

 

Still not sure if we cover your medication? Just call 1-855-232-3596 (TTY: 711). When you call, have a list of your OTC medications ready. We can check them for you.

Get medications and refills

Get medications and refills

If you need medication, your provider will write you a prescription for one in our preferred drug list (formulary). You’ll want to:

 

  • Ask your provider to make sure the medication is in our formulary
  • Take your prescription to a pharmacy in our network
  • Show your plan member ID card at the pharmacy

Need refills? Your medication label notes how many refills you have. Well before you run out of medication, call your pharmacy to place a refill order. If the pharmacy doesn’t have any refills left and you need more medication, check with your provider at least five days before you run out of medication. They may want to see you before prescribing refills. 

Fill your prescriptions

 

 

In person

 

You can fill your prescriptions at any pharmacy in our network. We can’t cover medications that you fill at other pharmacies.

 

Find a pharmacy near me

By mail

 

If you take maintenance medication for an ongoing health condition, you can get it by mail. We work with CVS Caremark® to give you this service at no extra cost. You can expect them to check each order for safety. And you can speak with a pharmacist anytime on the phone. 

 

You’ll just need your:

 

  • Plan member ID card
  • Mailing address, including ZIP code
  • Provider’s first and last name and phone number
  • List of allergies and other health conditions
  • Original prescription from your provider (if you have it)

Get started with mail service

You can sign up for mail service:

Online

 

Log in to the Member Portal. Go to “Tasks” and then “Pharmacy Services.” Go to Caremark.com by clicking on the “CVS” link. Then, choose “start mail service” to print the mail-order form.

With an order form

 

Ask your provider to write a prescription for a 90-day supply with up to one year of refills. Then, fill out a mail service order form (English PDF) | (Spanish PDF). Or we can mail you a form. Just call Member Services at 1-855-232-3596 (TTY: 711).

 

Send the form, along with your prescription, to:
CVS Caremark
PO Box 2110
Pittsburgh, PA 15230-2110 

By phone

 

Just call CVS Caremark at 1-855-271-6603 (TTY: 1-800-231-4403). You can call 24 hours a day, 7 days a week. If you say it’s okay, they’ll call your provider to get a prescription.

Specialty medications

Specialty medications

CVS Specialty® pharmacy offers medications for conditions like:

 

  • Cancer
  • Hemophilia
  • Immune deficiency
  • Multiple sclerosis
  • Rheumatoid arthritis

Local pharmacies may not carry these medications, which need PA. Providers can call 1-855-232-3596 (TTY: 711) to ask for PA. Or they can fill out a pharmacy prior authorization form and fax to 1-855-296-0323.

 

CVS Specialty pharmacy provides many services, such as:

 

  • Delivery of specialty medications to your home or provider’s office
  • Counseling on your medications and conditions
  • Coordination of care with you and your provider
  • The option to drop off your prescription and pick up your medication at any CVS Pharmacy® location
  • The ability to talk to a pharmacist 24 hours a day, 7 days a week

Have questions or need help with these services? Just call CVS Specialty pharmacy at 1-800-237-2767 (TTY/TDD: 1-800-863-5488). You can also find answers to your questions about CVS Specialty pharmacy (PDF)

Medication recalls

Need info about medication recalls? Just call the U.S. Food and Drug Administration (FDA) at 1‑888-463-6332. Or visit the drug recalls page on the FDA website.

SimpleDose

Need help organizing your medications? Pharmacists at your local CVS Pharmacy can do it for you at no extra cost. They'll put your maintenance medications in 30-day packs. And clearly label the time and date when you should take them. Then, they’ll send them to your home or local CVS Pharmacy. 

 

You can sign up today: 

By phone 

 

Call CVS Pharmacy at 1-800-753-0596 (TTY: 711). They’re here for you Monday through Friday, 8 AM to 6 PM.

In person

 

Sign up with a pharmacist at your local CVS Pharmacy. 

Online 

 

Fill out an enrollment form online to sign up. 

 

Sign up for SimpleDose

Contact us

Questions? Just call Member Services at 1-855-232-3596 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.