| 5-Tier Plan | 30-Day Supply Through Retail | 90-Day Supply Through Retail or Mail | |||
|---|---|---|---|---|---|
| Preferred | Standard | Preferred Retail | Preferred Mail | Standard Retail or Mail | |
| Tier 1 – Preferred Generic (Generic) | $0 | $0 | $0 | $0 | $0 |
| Tier 2 – Generic (Generic Drugs) | $9 | $10 | $18 | $18 | $20 |
| Tier 3 – Preferred Brand (Preferred Brand Drugs) | $35 | $35 | $70 | $70 | $70 |
| Tier 4 – Non-Preferred Brand (Non-Preferred Brand Drugs) | $50 | $50 | $100 | $100 | $100 |
| Tier 5 – Specialty (Includes high-cost/unique generic and brand drugs | $50 | $50 | Limited to one-month supply | Limited to one-month supply | Limited to one-month supply |
You only pay $400 out-of-pocket maximum.
The Fresno Unified School District Aetna® Medicare Advantage Plan offers a unique benefit that allows you to pay a $0 copay for covered drugs for the remainder of the year after you reach $400 in out-of-pocket maximum costs per person. This applies regardless of what Medicare Part D drug coverage phase you are in.
Prescription Drug Coverage Rates
- Prior authorization: Some drugs require that your doctor first show a medical need for you to use the drug before the plan will cover it.
- Quantity limits: This places a limit on how much of a drug you can get at one time.
- Step therapy: You must first try another drug on the plan’s formulary before you can move to another drug.
Note: These rules keep your care safe and more affordable. With the Aetna Medicare Advantage PPO Plan, we are working to provide you with a consistent experience with your prescriptions. The Aetna Medicare Advantage PPO Plan is set up to have the same copays as your previous plan; however, since formularies differ, please check the drug list to see what you will pay for your drugs.
How to Find Covered Prescriptions and Other Helpful Documents
- Visit aetnaretireeplans.com.
- Scroll down to the middle of the page to “Manage your prescription,” then continue scrolling until you see the box labeled “CHOOSE A 2024 FORMULARY (DRUG LIST) NAME TO SEE DOCUMENTS.”
- Find the dropdown menus labeled “Plan Type” and “Formulary Name.”
- Make your selections using the dropdown menus.
- Plan Type: MAPD
- Formulary Name: 2024 GRP Comprehensive Plus (5 Tier) Formulary – MAPD
- You are then able to download various documents, including topics like:
- List of Covered Drugs
- Step Therapy
- Prior Authorization
If you have any questions about your prescription coverage, drug listings, or preferred pharmacy locations, contact Aetna using the number on the back of your Aetna insurance card.
For information about coverage gaps, deductibles, non-Part D Supplemental Benefits, and more, click here.
How to Find an In-network Pharmacy
- Visit http://aetnaretireeplans.com.
- Click on the “Find doctors & prescription drugs” menu item.
- Click on “Prescription drugs.”
- Click on “Find a pharmacy.”
- Click on “Find a network pharmacy.”
- Fill out the search fields, either choosing to search for a pharmacy by name or by location. For the “Select a Plan” field, choose “Aetna Medicare Plan PPO with ESA” under “2024 Medicare Advantage.”
- Select your desired pharmacy from the list.
CVS Is Aetna’s Preferred Pharmacy
While you have the option to seek prescription drugs anywhere, choosing a CVS® pharmacy will ensure the best prices.
Using a CVS Specialty® Pharmacy
Aetna’s network specialty pharmacy focuses on medicines that aren’t usually available at retail pharmacies. It offers:
- Injection supplies, like needles, syringes, alcohol swabs, adhesive bandages and containers for needle waste at no cost to you
- Fast, no-cost delivery
- Package tracking
- Delivery to your home, doctor’s office or place of choice
- Support and education to help you use your medicines and manage your health condition
- Flexible payment options
2024 Preferred Pharmacies
The Joint Health Management Board and Aetna® want you to pay the lowest price possible for your prescription drugs. It’s easy to find a pharmacy near you.
In addition to CVS® pharmacies, here is a list of preferred pharmacies under your plan located in the Fresno and Clovis areas:
- CVS in Target Stores
- Costco
- Walmart
- Vons
Here are more preferred pharmacies under your plan located across the country:
- Bartell
- Bel Air*
- Big Y
- Cannon Pharmacy*
- Carrs
- ACME Pharmacy*
- Albertsons
- Allina Health Pharmacies
- Aurora*
- Bakers*
- Cashwise
- Centerwell Pharmacies
- City Market
- Coborn’s
- Copps
- Kessel Pharmacy
- King Soopers
- Kinney Drugs
- Kroger
- Lewis Drugs*
- Longs Drugs*
- Marcs
- Mariano’s
- Meijer
- Mercy Pharmacy* including Dierbergs
- Metro Market Pharmacy
- Navarro Discount Pharmacy
- Osco Pharmacy
- Pavilions Pharmacy
- Pick N Save Pharmacy
- Publix
- QFC
- Raley’s Drug Center
- CUB Pharmacy*
- CVS in Schnucks stores
- Dillon Pharmacy*
- Discount Drug Mart*
- Fred Meyer
- Fry’s Food & Drug
- Gerbes
- Giant Eagle
- Haggen Pharmacy
- Harmons Whole Health
- Harris Teeter
- Hartig Drug
- H-E-B
- Hen House
- Hy-Vee*
- Ingles
- Jay-C Food Stores
- Kelsey-Seybold Pharmacies
- Ralphs*
- Randalls Pharmacy
- Safeway*
- Sav-on Pharmacy*
- Scotts Pharmacy*
- ShopRite
- Smith’s Pharmacy*
- SortPak
- Thrifty White*
- Tom Thumb Pharmacy
- United Market Street
- United Supermarkets*
- Wegmans
- Weis Markets
- White Drug*
- Winn Dixie
*Not all pharmacies with this name are part of the preferred chain. Please consult the online directory at aetnaretireeplans.com.
In 2024, CVS Caremark Mail Service Pharmacy™ is your preferred mail-order provider.
What to Do if You Have Further Questions About Prescription Coverage
Call the Aetna® Customer Service Team
Connect with Aetna® regarding questions about pharmacies and prescription coverage.
1-888-267-2637 (TTY: 711)
Monday through Friday, 8 a.m. to 9 p.m. ET
AetnaRetireePlans.com
Receive Assistance From the Fresno Unified Benefits Office
You can also call the Benefits Office if you have other benefits-related questions or concerns.
(559) 457-3520
Monday through Friday, 8 a.m. to 5 p.m. PT
Benefits.FresnoUnified.org
Contact the Joint Health Management Board
We want to hear from you about your healthcare plan experiences, and we are committed to providing you with the resources to manage your wellness effectively.
JHMB Email Address:
info@JHMBHealthConnect.com
