Aetna Formularies

What Is a Formulary?

A formulary is a list of drugs that insurance companies would like doctors to use when writing prescriptions. The drugs on the formulary are considered the best choices based on safety, effectiveness and reasonable cost. The goal of a formulary is to help control drug costs while offering a wide variety of medication choices. As new drugs become available, the drugs on the formulary may change.

The formulary guide includes information on both Open and Closed Formularies. Here’s how each formulary version corresponds to an Emeriti’s health insurance plan offering:

• The Open Formulary is available for Emeriti’s Plan I, II and IV
• The Closed Formulary is available for Emeriti’s Plan III, V and VI

Because formulary lists vary from plan to plan, your doctor may not know which drugs are on the Aetna formulary. If you receive a prescription, ask your doctor or nurse to check the formulary at http://www.aetna.com/formulary to make sure the drug is listed.

If the drug your doctor wants to prescribe is excluded from the formulary, he or she can go to http://www.aetna.com/formulary/formex_2005.htmlto view a list of drugs that can be substituted for excluded drugs.

This material is for informational purposed only and is neither an offer of coverage nor medical advice. It contains only a partial, general description of benefits or programs and does not constitute a contract. Aetna Life Insurance Company (Aetna) arranges for the provision of health care services and is not a provider of health care services, and therefore cannot guarantee any results or outcomes.

Many drugs are subject to rebate arrangements between Aetna and the manufacturer of the drugs. Aetna receives rebates from the manufacturers of many drugs. These rebates do not reduce the amount the enrollee pays for an individual prescription drug. However, they help control the overall costs of prescription drug coverage.

These plans contain exclusions and some benefits are subject to limitations. Consult the plan documents to determine governing contractual provisions, including procedures, exclusions and limitations relating to the plan. While this material is believed to be accurate, it is subject to change.