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Your pharmacy benefits
At Aetna Better Health® of Louisiana, we cover a wide range of prescription and over-the-counter (OTC) medications to keep you as healthy as you can be.
Medications my plan covers
Medications my plan covers
Prescription medications
We cover the prescription medications listed on the preferred drug list (PDL). These medications need to be medically necessary. This means you need them to manage a health condition. You may or may not have copays.
You can download the PDL. Or check it online. If your medication isn’t listed, ask your provider to:
Prescribe a similar one that’s on the PDL
Get prior authorization (PA) for coverage
Need PA? Just ask your provider to complete PA. Or they can call 1-800-424-1664 (TTY: 711).
Still not sure if we cover your medication? Just call 1-800-424-1664 (TTY: 711). When you call, have a list of your prescription medications ready. We can check them for you.
You can also see the list of medications we cover for diabetes supplies.
Be sure you understand what your medication is for and how to take it. Check out these medication tips to learn more.
You can get coverage for some OTC medications on the PDL (PDF) through your pharmacy benefit when you:
Meet any added requirements (for some medications)
Get a prescription from your provider
Fill your OTC prescription at a pharmacy in our network
Still not sure if we cover your medication? Just call 1-800-424-1664 (TTY: 711). When you call, have a list of your OTC medications ready. We can check them for you.
As well as your standard coverage for some OTC products on the PDL, we added another OTC benefit for you. Enjoy $25 per month (per household) toward some OTC medications and supplies. And we’ll mail them directly to you. Just have your member ID number ready when you place your order.
Learn more about the OTC benefit
Get medications and refills
Get medications and refills
If you need medication, your provider or dentist will write you a prescription for one on the PDL. You’ll want to:
- Ask your provider to make sure the medication is on the PDL
- Take your prescription to a pharmacy in our network
- Show your plan member ID card at the pharmacy
Need refills? Your medication label notes how many refills you have. Well before you run out of medication, call your pharmacy to place a refill order. If the pharmacy doesn’t have any refills left and you need more medication, check with your provider or dentist at least five days before you run out of medication. They may want to see you before prescribing refills.
Fill your prescriptions
You can fill your prescriptions at any pharmacy in our network. We can’t cover medications that you fill at other pharmacies.
Specialty medications
Specialty medications
If your provider prescribes a specialty medication, you can fill it at any pharmacy in our network. Not all pharmacies carry these medications. So you may need to find a specialty pharmacy. Some conditions that need specialty medications include:
- Cancer
- Hemophilia
- Immune deficiency
- Multiple sclerosis
- Rheumatoid arthritis
Your provider may need to get PA for some medications. They can call 1-800-424-1664 (TTY: 711) to ask for PA.
Medication recalls
Need info about medication recalls? Just call the U.S. Food and Drug Administration (FDA) at 1-888-463-6332. Or visit the drug recalls page on the FDA website.
Pharmacy access and rules
The PDL (PDF) is up to date with covered medicines. Remember that some medications need PA before you can get them.
What is the Pharmacy Lock-in program?
With this program, members choose one in-network pharmacy to fill their prescriptions and stick with it. Or we can choose one for them.
What happens if my chosen pharmacy doesn’t have the medicine I need?
You'll be able to get a 72-hour supply of medicine from a different pharmacy. You can also do this in an emergency.
What if I don’t want to use only one pharmacy?
You can file an appeal. To get started, just call 1-855-242-0802 (TTY: 711). Or use this request for appeal form (PDF). You have 60 days to file an appeal from the date on your letter about the Lock-in program.
Contact us
Questions? Just call Prime Therapeutics at 1-800-424-1664 (TTY: 711). They’re here for you 24 hours a day, 7 days a week..