Pharmacy

Pharmacy network changes effective September 1, 2020

Effective September 1, 2020, Aetna Better Health of Virginia members (Medallion 4.0/FAMIS and CCC Plus) will transition to a network with CVS Caremark that continues to meet member access requirements but may offer fewer pharmacy providers.

As of September 1, 2020, Walgreens will no longer be in our pharmacy network. The new pharmacy network will include CVS Pharmacy, Walmart, and some independent pharmacies. Members will be able to utilize their current pharmacy until September 1, 2020.

Our pharmacy network directory may be accessed at any time on our website at our provider directory, available here under Pharmacy providers. Members may also contact Member Services for help in locating a pharmacy near them.

What this means to you:

If you electronically transmit or call in prescriptions for Aetna Better Health of Virginia members, please be sure the pharmacy is not a Walgreens pharmacy after September 1, 2020.

If you have questions or require more information, please contact Provider Relations at 1-855-652-8249.

Formulary Drug List

The formulary is a list of drugs chosen by Aetna Better Health of Virginia and a team of doctors and pharmacists. Drugs on this list are generally covered under the plan as long as they are medically necessary. Members must fill their prescriptions at an Aetna Better Health of Virginia network pharmacy and follow other plan rules.

Please review the formulary for any restrictions or recommendations regarding prescription drugs before prescribing a medication to an Aetna Better Health of Virginia patient.

You can download the formulary or you can also use the searchable formulary. Both of these resources contain the most up to date listing of step therapy requirements and quantity limits.  You can also view a list of this month's formulary updates.

Check back frequently as the formulary, prior authorization guidelines, and prior authorization forms are updated regularly.

CCC Plus (nondual beneficiaries) and Medallion/FAMIS 4.0 Formulary

CCC Plus (nondual beneficiaries) and Medallion/FAMIS 4.0 Formulary Search Tool

Formulary Updates

Dual-eligible Formulary

*Dual-eligible beneficiaries are enrolled in Medicare Part A and/or Part B and Medicaid