Aetna Health Insurance Plan Options - Prescription Drug Plans

Prescription Drug (Rx) Plans - Medicare-approved Part D Benefits

You have three Rx plans to choose from in 2008.

In order to better understand how the Emeriti Rx Plans work, it's helpful to understand how Medicare's Part D coverage tiers work. Please review the Standard Part D diagram below:

Emeriti’s basic Rx Plan is slightly richer than Medicare’s Standard Part D Plan.  Emeriti Plans 1 and 2 are enhanced plans with open formularies.  They also provide continuing coverage in the coverage gap.  And in Rx Plan 1, there is also 100% coverage at the catastrophic level. 

To learn more about your 2008 Medicare Part D benefits, review The A, B, C, Ds of Medicare.

Emeriti Rx Plan Provisions

The chart below provides a snapshot of how all three of the Emeriti prescription drug plans compare with one another:

For a detailed comparision of the provisions for all the Rx options, click here.

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How to Begin Thinking About Your Rx Options

When you think about your prescription drug options, consider two important factors critical to cost and coverage.  First, weigh the premium cost for each plan.  Higher premiums usually result in a richer level of insurance coverage and lower out-of-pocket limits, but you pay the higher premium whether you use the coverage or not.  If you choose a plan with a higher premium, your out-of-pocket expenditures are usually capped at a lower dollar amount than for a plan with a lower premium.  So you will want to choose a plan at the premium level (and coverage level) appropriate for your expected usage. 

Here are a few questions to ask yourself as you evaluate your options:

What are the drugs that I now take?  List all the drugs that you are taking now and do a calculation of how much you are paying for all of your prescriptions.

How much are my prescription drugs likely to cost in 2008?  Might they cost less than $2,510 next year?  Or do you think that you may fall into the Tier 2 Coverage Gap? 

• If your drug use is minimal, Rx Plan 3 may be a good choice.  It has the lowest premium, and if you don’t need an open formulary or coverage in the Tier 2 gap, it will likely meet your needs.
• If your drug use is moderate, you need to calculate if your drug expenditures would put you solidly into the Tier 2 coverage gap.  You may also find that your drugs are not covered on the closed formulary offered by Rx Plan 3, and therefore an Rx Plan with an open formulary may be important to you. 
• If you have very high prescription drug expenditures, Rx Plan 1 may be the best for your health situation.  You will pay a smaller share in the Tier 2 coverage gap and you will have no cost share at all in Tier 3 (catastrophic coverage).

To calculate your monthly premiums for the different 2008 Emeriti Health Insurance Plan Options, use the Emeriti Online Premium Rate Guide.

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How to Fill Your Prescriptions

There are two ways to fill prescriptions with the Aetna Pharmacy Management plan:

• You may fill short-term prescriptions at retail pharmacies that belong to Aetna's network. You can use DocFind^® to locate participating pharmacies near you. When you visit the pharmacy, show your Aetna ID card. If you haven't met your deductible, you'll need to pay the full cost of the prescription unless you are using a Medicare prescription drug card or other discount program. If you've met your deductible, the pharmacist will know how much to collect for your share of the cost. Important: You must visit one of Aetna's 53,000 participating pharmacies in order to receive prescription drug benefits.
• You may fill long-term prescriptions (up to a 90-day supply) through Aetna Rx Home Delivery,^® Aetna's mail order service. When you enroll, you'll receive information about this service, including how to order. When you order, Aetna will bill you for your medication if your share of the expense is $100 or less. If your share is more than $100, Aetna will contact you with cost and payment information. Your medication will be mailed once Aetna has received your payment. You can order refills by mail, phone or online at Aetna Navigator.

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The Emeriti Program provides these distinctive features:

• Catastrophic protection
• A choice of Medicare-approved Part D prescription drug coverages
• Coverage of any doctor or facility that accepts Medicare
• National access to insurance
• Annual choice among Emeriti Health Insurance Plan Options
• Preventive care
• Urgent or emergency coverage for up to six months while traveling abroad.

One of the key benefits of the Program is that you can choose the type and level of coverage for your needs this year, and then choose a different combination next year (for 2009), if your needs change.  

For more information, call the Emeriti Service Center at 1-866-EMERITI (1-866-363-7484).

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*Aetna provides all coverage for institutions and their retirees in 48 states and the District of Columbia. For institutions and their retirees in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides prescription drug only plans. For institutions in Minnesota, and their retirees residing in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides a prescription drug-only plan. Click here to see the HealthPartners Freedom Plans available in Minnesota. If your institution has fewer than 50 employees, your Emeriti insurance option will be limited to a separate insurance offering mandated by your state insurance department as part of small group insurance reform. Please call an Emeriti Specialist from Aetna to find out what insurance coverage is available to you.