Keep Track of Your Prescription Drug Changes and Updates

In the Exchange’s DoD NAF Aetna medical plan, the prescription benefit covers many drugs listed on what’s called a formulary.

But if you come across a prescription drug that is not on the formulary, then the medical plan won’t cover it, you will.

So where is this formulary?

Find the formulary on Aetna’s website, on NAFHealthPlans.com on the pharmacy page in the left margin, or call Aetna and ask for a printed copy.

The 2018 Aetna Pharmacy Drug Guide/Aetna Premier Plus Plan contains  more than 150 pages, organized by medication types. An alphabetical index is at the end.

Next to each drug is a code indicating the tier, which tells you the level of copay. For instance, “G” is the code for “Generic,” which indicates Tier One/lowest copay. It doesn’t say “$10 Generic” because many different companies use the same list, and each company has different copays.

Find the plan’s copay prices here.

Aetna will notify you about upcoming formulary changes if pharmacy records show you’ll be affected.

Please keep your address updated. Read carefully any mail you receive about the Exchange’s health plan.

Formulary changes

Throughout the year, Aetna may update the formulary, by adding or removing certain drugs, requiring pre-authorization, changing tiers or adding restrictions.

Each quarter, Aetna sends letters to participants if they are affected by upcoming formulary changes. Aetna may call participants about the changes and send letters to the doctors who are prescribing the affected medications.

2018 changes

Among the 2018 changes are:

• Imposing a seven-day safety limit on the initial prescription for some drugs, such as opioid pain medications.
• Removing some diabetes drugs from the formulary. They will not be covered because the plan covers alternative drugs.