Your Medicare Part D prescription drug plan
Lower copays. Lower costs.
Prescription drug benefits are improving in 2024 for members with Medicare! Eligible members will see lower copays and a lower limit on out-of-pocket costs with Aetna Medicare RX® offered by SilverScript®
Change can be exciting and in 2024 you’ll have lower copays for your prescription drugs. The Office of Personnel Management (OPM) worked with health plans to introduce Medicare Part D prescription drug plans to help you save money.
Who is eligible
If Medicare Part A and/or B is primary, and you’re enrolled in:- Aetna Open Access HMO Basic or High option in Washington DC, Maryland, and Northern Virginia (plan code JN), or
- Aetna Direct (plan code N6)
Your prescription drug coverage will automatically become a Medicare Part D plan in 2024 through Aetna Medicare Rx® offered by SilverScript®.
What this means
It could mean significant savings in prescription costs! Your drugs will still be covered, but copays and coinsurance are lower!
See below to compare your savings on copays and coinsurance for your plan.
Aetna Direct
Plan codes: N61, N62, N63
Current benefits Aetna Direct
| Tier | 30-day supply Retail Aetna Direct (30-day supply of covered drugs) |
90-day supply Retail or Mail order Aetna Direct (90-day supply of covered drugs) |
|---|---|---|
| What you'll pay | ||
| Tier 1 – Preferred Generic | $6 | $2 |
| Tier 2 – Preferred Brand | 30%; $600 max | 30%; max $100 |
| Tier 3 – Non-Preferred Generic or Brand | 50%; $600 max | 50%; max $200 |
| Tier 4 – Preferred Specialty | 50%; $600 max | |
| Tier 5 – Non-Preferred Specialty | 50%; max $1200 | |
New benefits Aetna Medicare RX offered by SilverScript, 5 Tier plan
| 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (30-day supply of covered drugs) |
90-day supply Retail or Mail order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (90-day supply of covered drugs) |
||
|---|---|---|---|
| What you'll pay | |||
| Preferred and Standard pharmacies | Preferred Retail or Preferred Mail Order | Standard Retail or Standard Mail Order | |
| Tier 1 – Preferred Generic | $0 | $0 | $0 |
| Tier 2 – Generic | Preferred $1 Standard $2 |
$2 | $4 |
| Tier 3 – Preferred Brand | $45 | $75 | $75 |
| Tier 4 – Non-Preferred Brand | $75 | $125 | $125 |
| Tier 5 – Specialty Includes high-cost/ unique generic and brand drugs |
25%; max $250 | Limited to a one-month supply | |
| Out of Pocket Maximum for prescription drugs | Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. | ||
|
*If you are enrolled in Medicare Part A and/or Part B **If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/AetnaDirect for your correct Rx copays and coinsurance |
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Download plan summary for Aetna Direct with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Aetna Direct with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF)
Open Access HMO Basic Option
(Washington DC, Maryland, and Northern Virginia)
Plan codes: JN4, JN6, JN5
Current benefits Open Access HMO Basic option
| Tier | 30-day supply Retail Open Access HMO Basic option (30-day supply of covered drugs) |
90-day supply Retail or Mail order Open Access HMO Basic option (90-day supply of covered drugs) |
|---|---|---|
| What you'll pay | ||
| Tier 1 – Preferred Generic | $10 | $20 |
| Tier 2 – Preferred Brand | 50%; max $200 | 50%; $400 max |
| Tier 3 – Non-Preferred Generic or Brand | 50%; max $300 | 50%; $600 max |
| Tier 4 – Preferred Specialty | 50%; max $350 | |
| Tier 5 – Non-Preferred Specialty | 50%; max $700 | |
New benefits Aetna Medicare RX offered by SilverScript, 5 Tier plan
| 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (30-day supply of covered drugs) |
90-day supply Retail or Mail Order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (90-day supply of covered drugs) |
||
|---|---|---|---|
| What you'll pay | |||
| Preferred and Standard | Preferred Retail or Preferred Mail Order | Standard Retail or Standard Mail Order | |
| Tier 1 – Preferred Generic | $0 | $0 | $0 |
| Tier 2 – Generic | Preferred $4 Standard $5 |
$8 | $10 |
| Tier 3 – Preferred Brand | $40 | $80 | $80 |
| Tier 4 – Non-Preferred Brand | $100 | $200 | $200 |
| Tier 5 – Specialty Includes high-cost/ unique generic and brand drugs |
25%; max $150 | Limited to a one-month supply | |
| Out of Pocket Maximum for prescription drugs | Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. | ||
|
*If you are enrolled in Medicare Part A and/or Part B **If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/CapitalOpenAccess for your correct Rx copays and coinsurance |
|||
Download plan summary for Open Access HMO Basic option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Open Access HMO Basic option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF)
Open Access HMO High Option
(Washington DC, Maryland, and Northern Virginia)
Plan codes: JN1, JN3, JN2
Current benefits Open Access HMO High option
| Tier | 30-day supply Retail Open Access HMO High option (30-day supply of covered drugs) |
90-day supply Retail or Mail order Open Access HMO High option (90-day supply of covered drugs) |
|---|---|---|
| What you'll pay | ||
| Tier 1 – Preferred Generic | $3 | $6 |
| Tier 2 – Preferred Brand | $35 | $70 |
| Tier 3 – Non-Preferred Generic or Brand | 50%; $200 max | 50%; max $400 |
| Tier 4 – Preferred Specialty | 50%; max $350 | |
| Tier 5 – Non-Preferred Specialty | 50%; max $700 | |
New benefits Aetna Medicare RX offered by SilverScript, 5 Tier plan
| 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (30-day supply of covered drugs) |
90-day supply Retail or Mail Order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan** (90-day supply of covered drugs) |
|||
|---|---|---|---|---|
| What you'll pay | ||||
| Tier | Preferred and Standard pharmacies | Preferred Retail or Preferred Mail Order | Standard Retail or Standard Mail Order | |
| Tier 1 – Preferred Generic | $0 | $0 | $0 | |
| Tier 2 – Generic | Preferred $2 Standard $3 |
$4 | $6 | |
| Tier 3 – Preferred Brand | $25 | $50 | $50 | |
| Tier 4 – Non-Preferred Brand | $75 | $150 | $150 | |
| Tier 5 – Specialty Includes high-cost/ unique generic and brand drugs |
25%; max $150 | Limited to a one-month supply | ||
| Out of Pocket Maximum for prescription drugs | Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. | |||
|
*If you are enrolled in Medicare Part A and/or Part B **If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/CapitalOpenAccess for your correct Rx copays and coinsurance |
||||
Download plan summary for Open Access HMO High option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Open Access HMO High option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF)
Below are some frequently asked questions about Medicare Part D prescription drug plans.
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This is an exciting change offered for the first time in 2024 through the FEHB Program. The Office of Personnel Management (OPM) worked with health plans to introduce Medicare Part D prescription drug plans to help you save money. If you’re enrolled in Medicare Part A and/or Part B, your Aetna Direct or Open Access (plan code JN) plan will automatically enroll you in Aetna Medicare Rx® offered through SilverScript®, a Medicare Part D prescription drug plan (PDP). This could mean saving on your prescription costs. The same drugs are covered under the Aetna Medicare Rx plan offered through SilverScript, but copays and coinsurance can be lower. So, depending on your prescriptions, this could offer you a great opportunity to save while still enrolled in your current health plan.
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The Medicare Part D PDP is a Medicare approved prescription drug plan that is governed by CMS. When you have Aetna Medicare Rx offered by SilverScript your prescription costs will generally be lower.
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No. Your FEHB premiums will not increase.
However, some members may be required to pay an extra charge, known as the Part D Income-Related Monthly Adjustment Amount (IRMAA). The extra charge is figured out using your modified adjusted gross income as reported on your IRS tax return from 2 years ago. If this amount is above a certain amount, you’ll pay your FEHB premium and the additional IRMAA. For more information on IRMAA, visit the Medicare website.
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Yes.
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No. Your out-of-pocket costs for prescription drugs should decrease with Aetna Medicare Rx offered by SilverScript.
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Yes. You will receive an additional card for your Medicare Part D PDP coverage. Starting January 1, 2024, you will need to present your new card at the pharmacy.
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You can use our provider search tool to find standard and preferred pharmacies near you.
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You can opt out of Aetna Medicare Rx offered by SilverScript between October 23, 2023 and December 31, 2023, by calling Members Services at 1-833-271-9775 (TTY: 711), Monday through Friday, 8 AM to 8 PM ET or go online at AetnaRetireeHealth.com/FEHBP.
For Guest access follow these steps:
- Step 1: Find Pharmacy for Employer Plans
- Step 2: You may search by name or location
- Step 3: In the ‘Select a Plan’ dropdown choose ‘Medicare Group Part D 2024 P1 Network’
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Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Aetna Medicare Rx offered by SilverScript is a standalone Prescription Drug Plan offered by SilverScript® Insurance Company, a CVS Health company. This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the Plan's applicable Federal brochure(s). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. The formulary, provider and/or pharmacy network may change at any time. You will receive notice when necessary. For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7-10 days. You can call the number on the back of your ID card if you do not receive your mail-order drugs within this timeframe. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.
©2023 Aetna Inc.
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©2023 Aetna Inc.
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