Formulary
The Aetna® D-SNP formulary can be found below.
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Formulary
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View the 2024 formulary (English|Spanish|Vietnamese|Arabic)
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Formulary Updates
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View the 2024 Formulary Change Notice
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Prior Authorization Criteria
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Step Therapy criteria
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Medicare Part B Step Therapy
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Requirements or limits on Part B drugs
Under Medicare Advantage plans, some drugs may have special requirements or coverage limits. We’ll help you find the information you need.
How step therapy works
Some medically administered Part B drugs, like injectables or biologics, may have additional requirements or coverage limits. That may include step therapy, where we require a trial of a preferred drug to treat a medical condition before covering another non-preferred drug.
Here’s an example:
If Drug A and Drug B both treat a medical condition, we may prefer Drug A and require a trial of it first. If Drug A does not work, we’ll then cover Drug B. The listed preferred products should be used first.
Note: The step therapy requirement does not apply to patients who’ve already received treatment with the non-preferred drug within the past 365 days.
Find preferred drugs
We’ve compiled the Aetna® Part B Step Therapy Preferred Drug Lists below for your convenience. Please click below: