Determinación de cobertura

Complete el formulario de determinación de cobertura en línea. Como alternativa, usted puede descargar o solicitar una copia impresa de este formulario y enviárnoslo por correo o fax.

For questions or to request a paper copy, call 1-866-600-2139 (TTY: 711). We are available 24 hours a day, 7 days a week.

Correo postal:

Aetna Better Health Premier Plan MMAI
Part D Coverage Determination
Pharmacy Department
PO Box 818001
Cleveland, OH 44181-8001

Fax:

Aetna Better Health Premier Plan MMAI
Determinación de cobertura de la Parte D
Departamento de Farmacia
1-855-365-8109

Who may make a request: Your prescriber may ask us for a coverage determination on your behalf. Your prescriber can call 1-866-600-2139 (TTY: 711), 24 hours a day, 7 days a week. If you want another individual (such as a family member or friend) to make a request for you, that individual must be your representative. Contact us to learn how to name a representative.