Aetna Formulary for RX

[somarco]

Anyone know how to get Aetna's formulary?

I have a client that wants to switch from a Humana Total Plus HSA to the Aetna $10,000 copay plan that does not cover non-preferred brand Rx. In my opinion, the $100/mo savings isn't worth the risk if something major happens. I want to show him the limited number of meds on the preferred list and the price of some commonly used meds (mostly for cancer) that are not on the list.

 

[The Rabbi]

Re: Aetna Rx Formulary

Since you must have already searched their website or called them, I would assume it isn't available.

Your client may be making a wise decision - more self-insuring. Retaining more of the risk. It could be a cash flow situation where now is more important than a future maybe.

 

[moonlightandmargaritas]

Re: Aetna Rx Formulary

Aetna® - Medication Search
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Your client may be making a wise decision - more self-insuring. Retaining more of the risk.

It's very smart...until you need an $1,800 per month med...

 

[somarco]

Re: Aetna Rx Formulary

Thx, Paul.

I poked all around their site (which is always frustrating) and couldn't find it. Even with that link I still don't know if it is closed or open formulary and it doesn't want to let me view non-Medicare plans.

 

[moonlightandmargaritas]

Re: Aetna Rx Formulary

I poked all around their site (which is always frustrating) and couldn't find it. Even with that link I still don't know if it is closed or open formulary and it doesn't want to let me view non-Medicare plans.

Aetna's IT stuff is absolutely gawd-awful. Nothing like making it simple and user friendly.

They ought to hire Seth Grodin (not that he'd do it) for about six months...

 

[somarco]

Re: Aetna Rx Formulary

I will call them tomorrow and see if they will cough it up. They probably hired programmers who designed Windows.
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Found out how to download the list. Quite extensive (88 pgs).

Notably absent are meds like Erbitux, Avastin (colon cancer meds) and Herceptin (breast cancer).

Herceptin runs $36k per year, Avastin $50k and Erbitux is $120k.

Can't imagine why these are not on their preferred list.