Your Medicare Part D prescription drug plan
Lower copays. Lower costs.
Prescription drug benefits are are better for members with Medicare! Eligible members will see lower copays and a lower limit on out-of-pocket costs with Aetna Medicare RX® offered by SilverScript®
Who is eligible
If Medicare Part A and/or B is primary, and you’re enrolled in:- Aetna Open Access HMO Basic or High option in Washington DC, Maryland, and Northern Virginia (plan code JN), or
- Aetna Direct (plan code N6)
Your prescription drug coverage will automatically become a Medicare Part D plan through Aetna Medicare Rx offered by SilverScript®.
What this means
It could mean savings in prescription costs! Your drugs will still be covered, but copays and coinsurance can be lower!
IMPORTANT NOTICE: If you choose this plan and have Medicare, please call us at 1-866-241-0262 to make sure your Medicare Part D prescription drug coverage begins on 1/1/25.
Select a plan below to view your prescription drug benefits:
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Drug benefits without Medicare Aetna Direct
Table of rates. Tier 30-day supply Retail Aetna Direct
(30-day supply of covered drugs)90-day supply Retail or Mail order Aetna Direct
(90-day supply of covered drugs)What you'll pay Tier 1 – Preferred Generic $6 $2 Tier 2 – Preferred Brand 30%; $600 max 30%; max $100 Tier 3 – Non-Preferred Generic or Brand 50%; $600 max 50%; max $200 Tier 4 – Preferred Specialty 50%; $600 max Limited to a one-month supply Tier 5 – Non-Preferred Specialty 50%; max $1200 Limited to a one-month supply Drug benefits with Medicare Aetna Medicare RX offered by SilverScript, 5 Tier plan
Table of rates. 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(30-day supply of covered drugs)90-day supply Retail or Mail order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(90-day supply of covered drugs)What you'll pay Tier Preferred and Standard pharmacies Preferred Retail or Preferred Mail Order Standard Retail or Standard Mail Order Tier 1 – Preferred Generic $0 $0 $0 Tier 2 – Generic Preferred $1
Standard $2$2 $4 Tier 3 – Preferred Brand $45 $75 $75 Tier 4 – Non-Preferred Brand $75 $125 $125 Tier 5 – Specialty
Includes high-cost/ unique generic and brand drugs25%; max $250 Limited to a one-month supply Out of Pocket Maximum for prescription drugs Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. *If you are enrolled in Medicare Part A and/or Part B
**If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/AetnaDirect for your correct Rx copays and coinsurance2025 Aetna Direct Formularies
Download 2025 Prescription Drug Formulary for Aetna Direct with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2025 Prescription Drug Supplemental Benefit (PDF)
2024 Aetna Direct Formularies
Download plan summary for Aetna Direct with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Aetna Direct with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF) -
Drug benefits without Medicare Open Access HMO Basic option
Table of rates. Tier 30-day supply Retail Open Access HMO Basic option
(30-day supply of covered drugs)90-day supply Retail or Mail order Open Access HMO Basic option
(90-day supply of covered drugs)What you'll pay Tier 1 – Preferred Generic $10 $20 Tier 2 – Preferred Brand 50%; max $200 50%; $400 max Tier 3 – Non-Preferred Generic or Brand 50%; max $300 50%; $600 max Tier 4 – Preferred Specialty 50%; max $350 Limited to a one-month supply Tier 5 – Non-Preferred Specialty 50%; max $700 Limited to a one-month supply Drug benefits with Medicare Aetna Medicare RX offered by SilverScript, 5 Tier plan
Table of rates. 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(30-day supply of covered drugs)90-day supply Retail or Mail Order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(90-day supply of covered drugs)What you'll pay Tier Preferred and Standard Preferred Retail or Preferred Mail Order Standard Retail or Standard Mail Order Tier 1 – Preferred Generic $0 $0 $0 Tier 2 – Generic Preferred $4
Standard $5$8 $10 Tier 3 – Preferred Brand $40 $80 $80 Tier 4 – Non-Preferred Brand $100 $200 $200 Tier 5 – Specialty
Includes high-cost/ unique generic and brand drugs25%; max $150 Limited to a one-month supply Out of Pocket Maximum for prescription drugs Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. *If you are enrolled in Medicare Part A and/or Part B
**If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/CapitalOpenAccess for your correct Rx copays and coinsurance2025 Open Access HMO Basic Option Formularies
Download 2025 Prescription Drug Formulary for Open Access HMO Basic option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2025 Prescription Drug Supplemental Benefit (PDF)
2024 Open Access HMO Basic Option Formularies
Download plan summary for Open Access HMO Basic option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Open Access HMO Basic option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF) -
Drug benefits without Medicare Open Access HMO High option
Table of rates. Tier 30-day supply Retail Open Access HMO High option
(30-day supply of covered drugs)90-day supply Retail or Mail order Open Access HMO High option
(90-day supply of covered drugs)What you'll pay Tier 1 – Preferred Generic $3 $6 Tier 2 – Preferred Brand $35 $70 Tier 3 – Non-Preferred Generic or Brand 50%; $200 max 50%; max $400 Tier 4 – Preferred Specialty 50%; max $350 Limited to a one-month supply Tier 5 – Non-Preferred Specialty 50%; max $700 Limited to a one-month supply Drug benefits with Medicare Aetna Medicare RX offered by SilverScript, 5 Tier plan
Table of rates. 30-day supply Retail Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(30-day supply of covered drugs)90-day supply Retail or Mail Order Aetna Medicare Rx* offered by SilverScript, 5 Tier plan**
(90-day supply of covered drugs)What you'll pay Tier Preferred and Standard pharmacies Preferred Retail or Preferred Mail Order Standard Retail or Standard Mail Order Tier 1 – Preferred Generic $0 $0 $0 Tier 2 – Generic Preferred $2
Standard $3$4 $6 Tier 3 – Preferred Brand $25 $50 $50 Tier 4 – Non-Preferred Brand $75 $150 $150 Tier 5 – Specialty
Includes high-cost/ unique generic and brand drugs25%; max $150 Limited to a one-month supply Out of Pocket Maximum for prescription drugs Once you reach the $2,000 max for prescription drugs, you will pay $0 for prescription drugs. This $2,000 will also apply to the medical plan’s total calendar year out-of-pocket maximum. *If you are enrolled in Medicare Part A and/or Part B
**If you do not have Medicare Parts A and B as primary please check AetnaFeds.com/CapitalOpenAccess for your correct Rx copays and coinsurance2025 Open Access HMO High Option Formularies
Download 2025 Prescription Drug Formulary for Open Access HMO High option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2025 Prescription Drug Supplemental Benefit (PDF)
2024 Open Access HMO High Option Formularies
Download plan summary for Open Access HMO High option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Formulary for Open Access HMO High option with Aetna Medicare Rx offered by SilverScript (PDF)
Download 2024 Prescription Drug Supplemental Benefit (PDF)
Below are some frequently asked questions about Medicare Part D prescription drug plans.
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The Office of Personnel Management (OPM) worked with health plans to introduce Medicare Part D prescription drug plans to help you save money. If you’re enrolled in Medicare Part A and/or Part B, your Aetna Direct or Open Access (plan code JN) plan will automatically enroll you in Aetna Medicare Rx® offered through SilverScript®, a Medicare Part D prescription drug plan (PDP). This could mean saving on your prescription costs. The same drugs are covered under the Medicare Part D PDP plan, but copays and coinsurance will generally be lower. So, depending on your prescriptions, this could offer you a great opportunity to save while still enrolled in your current health plan.
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The Medicare Part D PDP is a Medicare approved prescription drug plan that is governed by CMS. When you have Aetna Medicare Rx offered by SilverScript your prescription costs will generally be lower.
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No. Your FEHB premiums will not increase.
However, some members may be required to pay an extra charge, known as the Part D Income-Related Monthly Adjustment Amount (IRMAA). The extra charge is figured out using your modified adjusted gross income as reported on your IRS tax return from 2 years ago. If this amount is above a certain amount, you’ll pay your FEHB premium and the additional IRMAA. For more information on IRMAA, visit the Medicare website.
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Yes.
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No. Your out-of-pocket costs for prescription drugs should generally be lower with Aetna Medicare Rx offered by SilverScript.
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Yes. You will receive an additional card for your Medicare Part D PDP coverage. Starting January 1, 2025, you will need to present your new card at the pharmacy.
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You can use our provider search tool to find standard and preferred pharmacies near you.
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If you want to opt out of the Medicare Part D PDP, please complete and return the SilverScript Group Disenrollment Form (PDF) to:
Group Aetna Medicare
PO Box 7082
London, KY 40742
or, you can fax to 1-833-806-0689 Attn: Group DisenrollmentIf you have any questions, please call Member Services at 1-833-271-9775 (TTY: 711), Monday through Friday, 8 AM to 8 PM ET or go online at AetnaRetireeHealth.com/FEHBP
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