As a contracted provider in the Aetna Better Health of Ohio network, you will receive a copy of the Preferred Drug List (PDL) that is updated annually in the Provider Manual.
For additional information and guidelines about the PDL, please review your Provider Manual. There also are several forms available below to assist you with a variety of needs.
What is the Aetna Better Health of Ohio Formulary?
The Aetna Better Health of Ohio formulary is a list of drugs selected in consultation with a team of health care providers. The drugs we chose represent the prescription therapies believed to be a necessary part of a quality treatment program. Aetna Better Health of Ohio will generally cover the drugs listed on our formulary as long as the drug is medically necessary.
Aetna Better Health of Ohio prescription drug plans are available to all of its members. In addition, prescription drug plans filled at an Aetna Better Health of Ohio network pharmacy may qualify for additional savings; however, other plan rules may apply.
View the latest Formulary. The formulary is continuously under review, and as changes occur, the version on the website is updated.
For a drug that is not on the List of Covered Drugs (formulary), a statement must be provided documenting trial and failure of the formulary medications or a medical reason why the formulary medications cannot be used.
For information on benefits, see Part D Prescription Drug. For more detailed information on prescription drug coverage, please review the Aetna Better Health of Ohio Evidence of Coverage and other member materials, or contact Member Services at 1-855-364-0974 (24 hours a day, 7 days a week).
Prescription Drug Information
- View monthly Formulary Updates
- Mail-Order Drugs (English and Spanish)
- Medication Therapy Management Program
- Out of Network Coverage (coming soon)
- Transition of Care
- 2021 Prescription Drug Search Tool
- 2021 Find a pharmacy
- Pharmacy Coverage Determination Form
- Prior Authorization Criteria
- Part D Step Therapy Criteria
- Hospice Part D exception form
Electronic Prior Auth
We are committed to making sure our providers receive the best possible information, and the latest technology and tools available.
We have partnered with CoverMyMeds® and SureScripts to provide you a new way to request a pharmacy prior authorization through the implementation of Electronic Prior Authorization (ePA) program.
With Electronic Prior Authorization (ePA), you can look forward to:
- Time saving
- Decreasing paperwork, phone calls and faxes for requests for prior authorization
- Quicker Determinations
- Reduces average wait times, resolution often within minutes
- Accommodating & Secure
- HIPAA compliant via electronically submitted requestsGetting started is easy. Choose ways to enroll:
No cost required! Let us help get you started!
Aetna Better Health of Ohio MMP
- PCN: MEDDADV
- Group: RX8812
- BIN: 610591
- Time saving
Part B Step Therapy Prior Authorization Fax Forms