Prescription Drug Coverage
What to Know
You’re automatically enrolled in prescription drug coverage when you enroll in a Qnity Medical Plan. Fill prescriptions for most drugs at any CVS Caremark network pharmacy. Get specialty medications — drugs that require sensitive care or are used to treat chronic conditions — through PrudentRx.
About Your Prescription Drug Coverage
You’re automatically enrolled in prescription drug coverage when you enroll in a Qnity Medical Plan. Your prescription drug costs vary based on whether you purchase them at retail (for example, going to a CVS pharmacy) or through mail order. The costs also are determined by your use of an in-network or out-of-network pharmacy, and the category of the drug on the CVS Caremark and PrudentRx formularies.
While you can fill prescriptions for most drugs at any CVS Caremark network pharmacy, you will have to manage specialty drugs — those that are prescribed for complex or ongoing medical conditions, such as multiple sclerosis or rheumatoid arthritis — through PrudentRx. In these cases, PrudentRx will contact you directly with additional information. Your prescription drug contact information is through Aetna One Advisor (A1A) and can be found on the back of your CVS Caremark prescription drug card, which you will receive when enrolling in a Qnity Medical Plan.
Coverage Details
Your prescription drug coverage is the same whether you enroll in the Core Option, Premium Saver Option, or Traditional Pay Option. This chart shows the in-network prescription drug coverage available through CVS Caremark for retail (up to two fills) and mail order.
Information on the CVS Caremark formulary, how to view prescription drug pricing, and how to find an in-network CVS pharmacy near you is available on the CVS Caremark website.
Coverage
Generic
Brand Formulary
Brand Non-Formulary
Maintenance Medications
(If filled more than two times at a retail pharmacy other than CVS.)
Specialty Medications
(through PrudentRx)
Health Advisors
Aetna One Advisor (A1A)
A single point of contact for questions related to your medical coverage.
1-833-728-2545
Aetna Website
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