Formulary

The Virginia (HMO-SNP) formulary can be found below.

View the 2019 formulary (English|Spanish)

View the 2020 formulary (English|Spanish)

View the 2019 Formulary Change Notice

View the 2019 PA criteria

View the 2020 PA Criteria

 

View the 2019 Step Therapy criteria

View the 2020 Step Therapy criteria

 

Requirements or limits on Part B drugs

Under Medicare Advantage plans, some drugs may have special requirements or coverage limits. We’ll help you find the information you need.

How step therapy works

Some medically administered Part B drugs, like injectables or biologics, may have additional requirements or coverage limits. That may include step therapy, where we require a trial of a preferred drug to treat a medical condition before covering another non-preferred drug. 

Here’s an example:

If Drug A and Drug B both treat a medical condition, we may prefer Drug A and require a trial of it first. If Drug A does not work, we’ll then cover Drug B. The listed preferred products should be used first.

Note: The step therapy requirement does not apply to patients who’ve already received treatment with the non-preferred drug within the past 365 days.

Find preferred drugs

We’ve compiled the Aetna Preferred Drug Lists below for your convenience. Please click below:

Preferred Drug list for Virginia (HMO SNP)