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Prescriptions

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We Have You Covered

Prescription Drugs

Prescription drug coverage is included in your medical plan and is provided by Aetna. Aetna has a 4-tier prescription drug program that divides covered medications into tiers or coverage/cost levels. Typically, the higher the tier, the greater the cost of the medication.

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KNOW WHAT'S COVERED AND ESTIMATE YOUR COST
Medications can be reclassified in different tiers, so whether you have a new prescription or one you take regularly, it’s wise to determine if your medication is covered and at what tier. You can also estimate your costs in advance if you’re purchasing at an in-network pharmacy or through Aetna's CVS Caremark® Mail Service Pharmacy. Download the Prescription Value Plan and Preventive Generic List below.

AETNA STANDARD PLAN
PREVENTIVE GENERIC LIST

Click below to find a National Retail pharmacy chain included in the Harris County network

HC PHARMACY DIRECTORY

To estimate the cost of your medication:

Visit aetna.com or use the Aetna mobile app.

Questions?

Talk with a Aetna representative at 800-228-6481.

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Key Prescription Terms

NO-COST PREVENTIVE GENERIC MEDICATIONS
Preventive medications are used to prevent conditions like high blood pressure, high cholesterol, diabetes, asthma, osteoporosis, heart attack, stroke and prenatal nutrient deficiency. Harris County and Aetna cover certain preventive generic medications at 100%, or no cost ($0) to you.
90-DAY PRESCRIPTION REFILLS
You can fill your maintenance medication in a 90-day or 30-day supply at a retail pharmacy. Aetna offers a retail pharmacy network that gives you more choices for where you can fill your 90-day prescriptions. Some major pharmacies include CVS, Walmart and HEB. Log in at aetna.com or use the Aetna Health mobile app to compare cost and find a nearby, participating retail pharmacy.
PRIOR AUTHORIZATION
Under your plan, certain medications need approval from Aetna first before they’re covered. These medications have a (PA) next to them on your drug list and will only be covered by your plan if your doctor requests and receives approval from Aetna. Types of medications that typically need approval are those that:
• May be unsafe when combined with other medications
• Have lower-cost, equally effective alternatives available
• Should only be used for certain health conditions
• Are often misused or abused
For medications, prior authorizations are typically handled by your doctor's office, which will work directly with Aetna. Aetna will then contact you with the results to let you know if your drug coverage has been approved or denied, or if they need more information.

SPECIALTY MEDICATIONS

Specialty medications are used to treat complex conditions like multiple sclerosis, hepatitis C and rheumatoid arthritis.
PRUDENTRX
CVS Caremark has collaborated with PrudentRX exclusively for a program that may help you save money when you fill eligible specialty medications.
HOW IT WORKS
A PrudentRX trained member advocate will be able to assist you through a high-touch, proactive engagement process to facilitate enrollment and help you obtain non-need-based manufacturer assistance where applicable. Participating members will have a $0 out-of-pocket cost on eligible specialty medications!