Aetna: Prescription drug coverage
Through our four Aetna medical plans, Iron Mountain provides prescription drug coverage administered by Aetna/CVS. Certain preventive care prescriptions are covered at 100% or are not subject to the deductible. Preventive prescriptions include drugs that help prevent heart attacks, heart disease, high blood pressure, stroke, blood clots, and diabetes.
Compare costs:
| Pharmacy | Select Network Plan (multi-tier EPO) | Choice PPO Plan (multi-tier POS) | Enhanced HDHP (multi-tier HSA plan) | Basic HDHP (HSA plan) |
|---|---|---|---|---|
| Retail | ||||
| Generic | $10 | $10 | Ded & 20% | Ded & 20% |
| Preferred | 35% ($45 min, $75 max) | 35% ($45 min, $75 max) | Ded & 20% | Ded & 20% |
| Non-preferred | 35% ($75 min, $100 max) | 35% ($75 min, $100 max) | Ded & 30% | Ded & 30% |
| Generic | $20 | $20 | Ded & 20% | Ded & 20% |
| Preferred | 35% ($112.50 min, $187.50 max) | 35% ($112.50 min, $187.50 max) | Ded & 20% | Ded & 20% |
| Non-preferred | 35% ($187.50 min, $250 max) | 35% ($187.50 min, $250 max) | Ded & 30% | Ded & 30% |
Specialty Medications
To provide a comprehensive, cost-effective prescription drug program for you and your family, Iron Mountain offers the PrudentRx copay program for certain specialty medications used to treat medical conditions like Hepatitis C, autoimmune disorders and and multiple sclerosis. The program is available to Mountaineers and their dependents enrolled in on of our Aetna medical plans.
With PrudentRx, you’ll receive help enrolling in a manufacturer copay assistance program, which will entitle you to a $0 copay for specialty medications covered under the program. If you or your dependents are eligible for the program, PrudentRx will contact you to assist with enrollment. If you do not enroll in the program, you’ll be subject to 30% coinsurance for these medications.
If you’re prescribed a specialty medication A specialty medication is a high-cost medication used to treat complex, chronic conditions such as cancer, rheumatoid arthritis, HIV and hepatitis C., please reach out to Aetna One Advocate (A1A) for assistance at 888-216-8573.
Prior Authorization and Step Therapy
Prior Authorization and/or Step Therapy may apply to your medications.
Prior Authorization (PA)
PA makes sure you’re getting the right medication for your condition. It may also help keep your medication affordable. The following are some common reasons PA is needed:
There may be a lower cost option that’s just as effective.
The medication has the potential for misuse or abuse.
The medication is for certain conditions or diagnoses.
Step Therapy
Medications that cost more don’t always work better. Many lower-cost medications provide great health benefits and save you money. In fact, you may be paying too much to treat your condition. We want to help you and your doctor choose a lower-cost medication as the first step in treating your health condition. This is called step therapy.