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Aetna has more Medicare Part D members than any other company. More than 6 million Medicare beneficiaries have Aetna Part D plans as of April 2022.
Aetna is a CVS Health company, and it sells prescription drug plans under the SilverScript brand name. Its Part D premiums are among the lowest on the market, but Aetna plans fall behind most competitors in quality ratings from the Centers for Medicare & Medicaid Services, or CMS.
Here’s what you should know about Aetna Medicare Part D prescription drug plans.
Aetna Medicare Part D pros and cons
Medicare prescription drug plans from Aetna have advantages and disadvantages.
Available Medicare Part D prescription drug plans
Medicare beneficiaries with Original Medicare (Part A and/or Part B) can purchase a Medicare Part D plan for prescription drug coverage. Part D plans are sold by private insurance companies. The costs and coverage can vary significantly, so it’s important to compare options.
Aetna offers three stand-alone Medicare prescription drug plans for 2022:
SilverScript SmartRx: Aetna highlights this plan’s low premiums, $0 deductibles and $1 copays for certain drugs.
SilverScript Choice: Aetna highlights this plan’s $0 copay for Tier 1 generic drugs and $0 deductible for Tier 1 and Tier 2 generic drugs.
SilverScript Plus: Aetna highlights this plan’s coverage of more drugs, vitamins and supplements, savings on certain insulins and coverage of Tier 1 and Tier 2 drugs in the coverage gap.
Aetna Medicare Part D service area
Stand-alone Medicare prescription drug plans from Aetna are available in all 50 states and Washington, D.C..
Aetna offers all three of its Medicare Part D plan options in all of its markets.
Aetna Medicare Part D premiums and deductibles
Here are the 2022 premiums and deductibles for Aetna’s stand-alone Medicare prescription drug plans:
Annual deductible: $480.
Annual deductible: $480.
Annual deductible: $0.
Aetna Medicare Part D drug formulary tiers
A formulary is a list of the prescription drugs covered by an insurance plan. The plans often organize different kinds of drugs into tiers according to the cost of the drugs.
Aetna’s Medicare prescription drug plans use a five-tier formulary:
Tier 1: Preferred generic
Many common, lower-cost generic drugs.
Tier 2: Generic
Higher-cost generic drugs.
Tier 3: Preferred brand
Many common, lower-cost brand-name drugs without a generic version and some generic drugs that cost as much as brand-name drugs.
Tier 4: Non-preferred drug
Higher-cost brand-name drugs and generic drugs for which a cheaper alternative is available.
Tier 5: Specialty tier
High-cost drugs that meet Medicare’s definition of a specialty drug.
Each tier has copay or coinsurance requirements. You’ll generally pay more for drugs listed in higher tiers up to Tier 4, but Tier 5 specialty drugs have a lower coinsurance requirement than Tier 4 drugs.
The drugs included in tiers and what you’ll pay for each tier depends on your choice of prescription drug plan and what kind of pharmacy you use. For example, Aetna plans have the lowest copays for prescriptions from preferred (in-network) pharmacies. Unlike some other companies, however, Aetna doesn’t have different cost-sharing requirements for retail and mail-order pharmacies.
All of Aetna’s Medicare Part D plans have a $0 deductible for certain covered drugs:
SilverScript SmartRx: $0 deductible for Tier 1 (preferred generic) drugs. The deductible is $480 for Tier 2-5 drugs.
SilverScript Choice: $0 deductible for Tier 1 (preferred generic) and Tier 2 (generic) drugs. The deductible is $480 for Tier 3-5 drugs.
SilverScript Plus: $0 deductible for all covered drugs.
The SilverScript Choice and SilverScript Plus plans have $0 copays for Tier 1 drugs from preferred pharmacies. The SilverScript SmartRx plan gets close with a $1 copay for Tier 1 generic drugs from preferred pharmacies.
All of the plans have copay or coinsurance requirements for Tier 2 and above, which can quickly get more expensive. As a result, it’s important to check where your medications and pharmacies fall on each plan’s formulary.
Coinsurance vs. copay requirements
You’ll want to check whether you’ll pay a copay or coinsurance for your medications. Copays are set dollar amounts, so it’s easy to see what you’ll pay. Coinsurance is a percentage of the price for your medications, so coinsurance requirements can be more unpredictable and more expensive.
Aetna starts requiring coinsurance rather than copays at either Tier 3 or Tier 4, depending on the plan:
SilverScript SmartRx: Copays for Tiers 1-3; coinsurance for Tiers 4-5.
SilverScript Choice: Copays for Tiers 1-2; coinsurance for Tiers 3-5.
SilverScript Plus: Copays for Tiers 1-3; coinsurance for Tiers 4-5.
You can enter your medications and pharmacy information on Aetna’s website to see which drugs are covered and review your estimated costs with different plan options.
Aetna Medicare Part D star ratings
Average Part D star rating: 3.5
The Centers for Medicare & Medicaid Services rates Medicare Part D plans on 12 quality measures. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)
These ratings use a 5-point scale where 5 is the best and 1 is the worst. The agency bases its ratings on drug plans’ quality of service and customer experiences, and ratings are updated annually.
Based on the most recent year of data, stand-alone Aetna prescription drug plans get an overall rating of 3.5 stars. The 2022 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.7 stars.
Compare Aetna Part D star ratings
Stand-alone Medicare Part D plans from Aetna outperformed the national average on two Part D measures, but fell behind the national average on the remaining 10 measures.
Here’s how stand-alone Aetna prescription drug plans compared with national averages for each of the 12 Part D measures:
American Customer Satisfaction Index: 73 out of 100
The American Customer Satisfaction Index, or ACSI, rates consumer satisfaction with products and services based on a scientific model developed at the University of Michigan. Ratings are derived from surveys that measure consumers’ expectations and perceived quality and value of products and services.
In 2021, Aetna scored 73 out of 100 on the ACSI health insurance satisfaction benchmark. ACSI measures satisfaction with the health insurance industry as a whole — Aetna’s score represents all of its health insurance products, not just Medicare Part D insurance. For comparison, the highest score was 75 and the health insurance industry average was 73.
AM Best Financial Strength Rating: A
AM Best is a credit rating agency that specializes in the insurance industry. In December 2021, AM Best affirmed its Financial Strength Rating of A (Excellent) for Aetna Life Insurance Company and the other members of Aetna Health & Life Group that are wholly owned subsidiaries of CVS Health.
An A rating in this category indicates that AM Best believes Aetna has an excellent ability to meet its ongoing insurance obligations.
Aetna was founded in 1853 in Hartford, Connecticut, and the insurer became a subsidiary of CVS Health in 2018. The company’s headquarters are still in Hartford.
Aetna’s health insurance offerings include medical, dental, pharmacy and behavioral health. Aetna offers both individual and group health insurance, including Medicare Advantage plans, Medicare prescription drug plans and Medicare Supplement Insurance. As of June 2021, Aetna covers almost 9.8 million Medicare members in the U.S.
CVS Health posted annual revenues of $292.1 billion in 2021.
Compare Medicare Part D prescription drug plan companies
Average Medicare Part D star rating (2022)
Find the right Medicare Part D prescription drug plan
The interactive tool on Medicare.gov can help find a Medicare Part D plan that covers your prescriptions. It also helps you compare costs among Medicare Part D and Medicare Advantage plans available to you.
Here are some things to keep in mind when comparing plans:
Check the formulary: You’ll want to make sure the medicines you currently take and, importantly, any you think you might need in the future, are covered under each of the plans you’re considering. Talk to your health care providers about what brand-name and generic medicines to look for and any alternatives that may also work in case you can’t find your current medicines on the plans available in your area.
Look for plan changes: Formularies change frequently. Your insurer should send you a Notice of Plan Change when the formulary changes. Read this document carefully.
Check the pharmacy network: Most Medicare Part D plans negotiate with a network of pharmacies for the lowest cost. Check to see if your pharmacy or an equally convenient one is in the plan’s network. Also, compare prices for using mail order.
If your plan does change, and the change affects the prescription drugs you need, you can switch plans during Medicare's open enrollment period, Oct. 15 to Dec. 7. Changes go into effect on the following Jan. 1.
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).