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 January 1, 2015, Prime Therapeutics will begin processing Medicare Part D and Part B claims for Covered Persons of Blue Cross Blue Shield of Illinois (BCBSIL) Blue Cross Medicare Advantage (PPO) and Blue Cross Blue Shield of Texas (BCBSTX) Blue Cross Medicare Advantage (HMO).