Prescription Drugs

What is the D-SNP Plan Formulary?

The Aetna® D-SNP plan formulary is a list of drugs selected in consultation with a team of health care providers. The drugs we chose represent the prescription therapies believed to be a necessary part of a quality treatment program. Aetna will generally cover the drugs listed on our formulary as long as the drug is medically necessary.

View the latest Formulary. The formulary is continuously under review, and as changes occur, the version on the website is updated.

For a drug that is not on the List of Covered Drugs (formulary), a statement must be provided documenting trial and failure of the formulary medications or a medical reason why the formulary medications cannot be used.

For information on benefits, see Part D Prescription Drug. For more information on prescription drug coverage, please view the Evidence of Coverage and other materials, or contact Member Services at 1-855-463-0933 (TTY: 711) 8 AM to 8 PM, seven days a week.

 

Find preferred drugs

We’ve compiled the Part B Step Therapy Preferred Drug Lists below for your convenience. Please click below:

2024 Medicare Part B Step Therapy Preferred Drug List 

2025 Medicare Part B Step Therapy Preferred Drug List (Aetna Medicare Assure Value)

2025 Medicare Part B Step Therapy Preferred Drug List (Aetna Medicare Better Health (HMO D-SNP)

Abraxane (albumin-bound paclitaxel) Medicare (PDF)
Actemra (Tocilizumab) Medicare (PDF)
Avsola (infliximab-axxq) Injectable Medicare (PDF)
Beovu (brolucizumab-dbll) Injectable Medicare (PDF)
Botulinum Toxins Medicare (PDF)
Entyvio (Vedolizumab) Medicare (PDF)
Erythropoiesis Stimulating Agents (ESAs) Medications/Dialysis Medicare (PDF)
Evenity (Romosozumab) Medicare (PDF)
Eylea (Aflibercept) Medicare (PDF)
Pegfilgrastim (Fulphila, Neulasta, Nyvepria, Udenyca, and Ziextenzo) Medicare (PDF)
Filgrastim (Granix, Neupogen, Nivestym, Zarxio) Medicare (PDF)
Herceptin (trastuzumab) Medicare (PDF)
Ilumya (Tildrakizumab) Medicare (PDF)
Immune Globulin (IG) Therapy Medicare (PDF)
Inflectra (Infliximab) Medicare (PDF)
Lemtrada (Alemtuzumab) Medicare (PDF)
Lucentis (Ranibizumab) Medicare (PDF)
Pegfilgrastim (Fulphila, Neulasta, Nyvepria, Udenyca, and Ziextenzo) Medicare (PDF)
Filgrastim (Granix, Neupogen, Nivestym, Zarxio) Medicare (PDF)
Filgrastim (Granix, Neupogen, Nivestym, Zarxio) Medicare (PDF)
Pegfilgrastim (Fulphila, Neulasta, Nyvepria, Udenyca, and Ziextenzo) Medicare (PDF)
Orencia (Abatacept) Medicare (PDF)
Prolia, Xgeva (Denosumab) Medicare (PDF)
Remicade (Infliximab) Medicare (PDF)
Pulmonary Arterial Hypertension (Infusible, Inhalation, or Injectable Medication) Medicare (PDF)
Renflexis (Infliximab-abda) Medicare (PDF)
Rituxan (Rituximab) Medicare (PDF)
Simponi Aria Medicare (PDF)
Stelara (Ustekinumab) Medicare (PDF)
Tysabri (Natalizumab) Medicare (PDF)
Pegfilgrastim (Fulphila, Neulasta, Nyvepria, Udenyca, and Ziextenzo) Medicare (PDF)
Viscosupplementation Medications Medicare (PDF)
Filgrastim (Granix, Neupogen, Nivestym, Zarxio) Medicare (PDF)
Pegfilgrastim (Fulphila, Neulasta, Nyvepria, Udenyca, and Ziextenzo) Medicare (PDF)

Cimzia (Certolizumab Pegol) Medicare (PDF)

ESA Agents Medicare (PDF)
Leqvio (Inclisiran) Medicare (PDF)
Tremfya (Guselkumab) Medicare (PDF)
Susvimo (Ranibizumab) Medicare (PDF)
Vabysmo (Faricimab-SVOA) Medicare (PDF)
Alpha 1 (PDF)
Feraheme (PDF)
Signifor (PDF)
Lupron (PDF)
Kyprolis (PDF)
Darzalex (PDF)
Darzalex Faspro (PDF)
Cinqair (PDF)
Ocrevus
Fasenra (PDF)
Avastin (PDF)
Somatuline (PDF)
Zoladex (PDF)
Trelstar (PDF)
IVIG (PDF)