Aetna 2023 Medicare plans put money back in members’ pockets

Large reductions in prescription drug prices throughout the MAPD portfolio

Aetna made main adjustments to our formularies (drug lists) for 2023 to take away many value and entry obstacles and assist our members be extra adherent with their medicines. Prescription drug profit adjustments will end in important value financial savings for our 2023 Particular person MAPD members. Highlights embody:

  • $0 deductibles: 100% of MAPD members will get pleasure from a $0 deductible on all Tier 1 medication, with 74% of plans providing a $0 deductible on all tiered medication (Tiers 1 – 5).
  • $0 copays at most well-liked community pharmacies: Over 97% of our MAPD plans will provide $0 copay on Tier 1 medication, and 50% of our MAPD plans will provide $0 copay on Tier 1 and Tier 2 medication, for 30-, 60- or 100-day provide.
  • Strong drug protection: New for 2023, our most generally used formulary will transfer practically 300 medication from higher-cost drug tiers to decrease tiers. This implies direct cost-share financial savings for our members, giving them entry to many extra medication for a $0 or low copay. Plans utilizing our different formularies can rely on related financial savings. For instance, a member who had a drug (like Ezetimibe/generic Zetia used to deal with excessive ldl cholesterol) down-tiered from Tier 3 in 2022 to Tier 2 in 2023 on a plan with a $0 Tier 2 copay in 2023 and a $47 Tier 3 copay in 2022 would save $564 subsequent 12 months.
  • Pharmacy community: 99.9% of our MAPD plans provide prescription drug protection with entry to just about 66,000 community pharmacies, with 24,000 most well-liked choices providing further financial savings.
  • 100-day provide at no additional value: All MAPD plans will provide 100-day provide5 for medication on Tiers 1-4 at each retail and mail-order pharmacies with no improve in copay/coinsurance. Members who select to make use of our most well-liked mail-order pharmacy to fill their 100-day provide prescriptions can rely on handy, no-cost commonplace transport. Prolonged-day provides will save members cash and assist them keep on their drug remedy program.
  • Tier 1/Tier 2 Protection Hole: 99.3% of our MAPD plans present sturdy Tier 1 and Tier 2 hole protection on the identical cost-share as within the preliminary protection part, permitting predictable copays by the donut gap and decreasing the opportunity of members reaching the catastrophic part.
  • $0 copays and $0 deductibles on Twin Eligible Particular Wants Plans: All D-SNPs will share one set of frequent options — sturdy drug protection, $0 deductibles and $0 prescription drug copays. Members merely have to qualify for D-SNP enrollment to obtain this profit.
  • Insulin: Members will not pay greater than $35 for a one-month provide of every insulin product coated by our plan.
  • Vaccines: Many coated Half D vaccines will likely be out there at $0 copay for Medicare beneficiaries.

Cash-saving MA advantages and extras that make a distinction

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