Formulary

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

View the 2020 formulary (English|Spanish)

View the 2021 formulary (English|Spanish)

View the 2020 Formulary Change Notice

View the 2020 PA 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)