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Quality health plans & benefitsHealthier livingFinancial well-beingIntelligent solutions 2014 Preventive Medicine List
www.aetna.com
TIER THREE
Preferred generic medicine
Preferred brand-name medicine
Non-preferred medicine
ACE inhibitors (hypertension, diabetes)
ACE inhibitors/calcium channel blocker combination (hypertension/diabetes)
Angiotensin II receptor antagonists (hypertension)
TIER THREE
Preferred generic medicine
Preferred brand-name medicine
Non-preferred medicine
Anti-adrenergic antihypertensives (hypertension)
Miscellaneous antihypertensives (hypertension)
Antihyperlipidemics (high cholesterol)
Beta-blockers (hypertension)
Blood thinning agents
TIER THREE
Preferred generic medicine
Preferred brand-name medicine
Non-preferred medicine
Calcium channel blockers (heart disease, hypertension)
Direct renin inhibitor (hypertension)
Diuretics (hypertension)
Antidiabetic drugs (diabetes)
TIER THREE
Preferred generic medicine
Preferred brand-name medicine
Non-preferred medicine
Diabetic supplies (diabetes)
Anti-asthmatics (asthma)
TIER THREE
Preferred generic medicine
Preferred brand-name medicine
Non-preferred medicine
Osteoporosis drugs (osteoporosis)
Prenatal multivitamin with fluoride
trivitamin/fluoridevitamins a/d/c/ Prenatal multivitamin with iron and folic acid
Smoking cessation medications (tobacco cessation)
Health benefits and health insurance plans are offered, administered and/or underwritten by Aetna Health Inc., Aetna
Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna).
In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington
Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.
Please remember that this is not a complete list of medications covered under your plan. Because there are thousands of medications
included in your pharmacy benefit, we only list the most common ones. Certain drugs such as those for smoking cessation or vitamins may not be covered by your particular pharmacy plan. Diabetic supplies may be covered under your medical plan. If you have any questions about your pharmacy benefits, please visit www.aetna.com and log in to your Aetna Navigator® member
website. If you don’t have access to our website, call the toll-free number on your member ID card.
To check coverage and copay information for a specific medicine, visit www.aetna.com and log in to Aetna Navigator. For more
details, please call the toll-free number on your member ID card.
Aetna Pharmacy Management refers to an internal business unit of Aetna Health Management, LLC. This is not an inclusive list. Products that are not represented on this list may be subject to plan-specific copayment or coinsurance. Void where prohibited by law.
Specific prescription benefits plan design may not cover certain categories or may be subject to additional charges or restrictions, regardless of their appearance in this document. Aetna may receive rebates, discounts and service fees from pharmaceutical manufacturers for certain listed products.
Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. Information is believed to be accurate as of the production date; however, it is subject to change. For questions, please call the toll-free number on your member ID card. www.aetna.com

Source: http://media.mcclatchy.com/static/livewell/media/2014/2014PreventiveMedList.pdf

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