This document outlines which Aetna retail pharmacy network is associated with each 2017 Aetna/Coventry MAPD and PDP plan.

Aetna will use the same Medicare retail pharmacy networks in 2017 as in 2016.

• P1: A broad network with both preferred and standard cost‐sharing components.
• S2: A broad network without a preferred cost‐sharing component.

*Please see attached PDF for more information.

Effective 08/01/2015, the structure of the drugs listed in the following table has been changed. You may proceed with these changes on August 1, 2015 unless otherwise notified under separate cover. The reason for the change is also noted below.

Effective April 28, 2015, Prime Therapeutics (Prime) will no longer accept claims submitted with an incorrect Processor Control Number (PCN) for Covered Person’s of Blue Advantage and Blue RX.

If the Participating Pharmacy does not take immediate action to make the necessary software changes prior to this date, claims will reject. If a Medicare Part D claim is submitted with an invalid PCN on or after April 28, 2015, the following reject codes may be returned: 

• 01 – M/I BIN 
• 04 – M/I Processor Control Number 
• 06 – M/I Group Number

TEMPORARILY your pharmacy was able to process claims for all Aetna Part D plans at CVS/Caremark Medicare Part D Network 12 and CVS/Caremark Medicare Part D Extended Days Supply Network 12 in network reimbursement rates. TEMPORARY ACCESS was effective for claims dating back to January 1, 2015. Please be advised that your TEMPORARY ACCESS for certain plans is through March 31, 2015.

This means that effective April 1, 2015 your pharmacy will receive Reject 40 (out-of-network) notices for claims submitted for the Standard and Standard Preferred Networks (Please download the PDF file listed below for more details).