If you elect medical coverage, you automatically receive prescription drug benefits through Aetna Pharmacy Benefits through its pharmacy benefit manager CVS Caremark. The amount you pay for your prescriptions depends on whether you:
- Have met the applicable deductible
- Choose generic, brand-name formulary or brand-name non-formulary drugs
- Purchase your prescription at a participating pharmacy or through the mail-order service
Review the table below for a high-level view of how prescription costs compare based on your medical plan election.
| Aetna Choice POS II CDHP with HSA | Aetna Choice POS II (PPO) | |||
|---|---|---|---|---|
|
Aetna Pharmacy Benefits Participating Pharmacy |
Non-participating Pharmacy |
Aetna Pharmacy Benefits Participating Pharmacy |
Non-participating Pharmacy |
|
|
Annual deductible |
$1,800/employee only coverage $3,600/all other coverage levels All retail and mail-order pharmacy expenses (except preventive drugs) are subject to the combined medical and prescription drug annual deductible1 |
$3,600/employee only coverage $7,200/all other coverage levels All retail and mail-order pharmacy expenses (except preventive drugs) are subject to the combined medical and prescription drug annual deductible |
$50/individual $100 maximum per family (Applies to retail only) |
|
|
Annual out-of-pocket maximum |
$4,000/employee only $8,000/all other coverage levels All retail and mail-order pharmacy expenses are subject to the combined medical and prescription drug annual out-of-pocket maximum |
$8,000/employee only $16,000/all other coverage levels All retail and mail-order pharmacy expenses are subject to the combined medical and prescription drug annual out-of-pocket maximum |
$2,000/individual $4,000/family Applies to retail and mail-order prescription drugs only (Separate from medical out-of-pocket maximum) |
|
|
Retail through participating pharmacy |
|
You must meet the deductible before the plan begins to pay benefits. You pay 100% of the retail cost and submit a claim for reimbursement. The plan will reimburse you for the participating pharmacy cost of the prescription drug less the member coinsurance. Note that any amounts in excess of the participating pharmacy will not be reimbursed. |
You must meet the deductible before you pay coinsurance for eligible expenses:
|
You must meet the deductible before the plan begins to pay benefits. You pay 100% of the retail cost and submit a claim for reimbursement. The plan will reimburse you for the participating pharmacy cost of the prescription drug less the member coinsurance. Note that any amounts in excess of the participating pharmacy cost will not be reimbursed. |
|
Mail-order |
|
Not available |
|
Not available |
1 Through the CDHP, preventive drugs such as vitamins, fluoride preparations, and other drugs that are prescribed by your medical care provider are subject to any applicable copay or coinsurance amount, before the annual deductible. You do not need to meet the annual deductible for preventive drugs before the plan begins to pay coinsurance. For a complete list of preventive drugs, visit CDHP Preventive Medications List 2025.
2 If a generic drug is available and you purchase a brand-name (formulary or non-formulary) drug, you will pay the applicable retail coinsurance or mail-order copay, plus the difference in the cost between the brand-name and generic drug.
3 You must meet the combined medical and prescription deductible before the plan begins to pay benefits.
Accessing Your ID Card
You should have received a new ID card for your medical and prescription drug coverage. You must use the ID card you received in the mail. If you have any questions, visit aetna.com. Login, then click Benefits Tab > View ID Cards. Your member ID and a picture of the card will display, so you can either print a copy or request a hard copy be sent to your home address or to an out-of-area dependent. You can use the Chat feature for online help or speak to a member services representative at 1-800-238-3488. You must present your new ID card to your pharmacy and providers.
Find In-Network Pharmacies
Aetna National Pharmacy Network is a broad network of over 66,000 locations and includes most chain stores and select independent pharmacies. You can still get your prescription filled at any participating pharmacy such as CVS, Costco, Albertsons, Duane Reade, Kroger, Rite Aid, Target, Walgreens, Walmart, and Wegmans. You can see what local pharmacies are in the retail pharmacy network by using the provider search tool posted on at aetnaresource.com/n/Arkema-2025. You can review the list of in-network retail pharmacies at aetna.com, under Prescriptions, or use the search feature to find -in-network pharmacies.
Don’t forget to check the Aetna Pharmacy Benefits formulary at aetna.com. Login as a member and then select the “Prescriptions” tab.
Prescription Drugs and the CDHP Plan
You must pay the full price of prescription drugs (except preventive drugs) until you meet your deductible. If you use an in-network participating pharmacy, prescription drug costs are counted toward the combined medical and prescription drug deductible. If you do not use a participating pharmacy, you must first meet the out-of-network combined deductible before the plan begins to pay benefits. The plan will pay 100% of eligible expenses for the rest of the year when you meet the combined out-of-pocket maximum.
Certain preventive drugs are not subject a deductible and no copay is charged. See the Preventive Drug List for more information.
Prescription Drugs and the PPO Plan
You will pay the full price of drugs until you meet the annual retail-only prescription drug deductible of $50 per individual or $100 per family. After you meet the deductible, you pay coinsurance until you reach the prescription drug out-of-pocket maximum. You pay copays for your mail-order prescriptions, with no deductible, until you reach the prescription drug out-of-pocket maximum.
If you do not use a participating pharmacy, you will pay the full cost of the prescription and file a claim for reimbursement. You will be reimbursed at the price that would have been charged at the participating pharmacy, less your applicable copay. The plan will pay 100% of eligible retail and mail-order prescription drug expenses for the rest of the year when you meet the prescription drug out-of-pocket maximum.
Arkema offers you a range of tips and programs to save money on your prescription drugs.
Generic Drugs
Using generic drugs can save you money. Your prescriptions will be filled with a generic drug, unless your provider specifically requests a brand-name drug and writes “dispense as written” on your prescription. If a generic drug is available and you purchase a brand-name (formulary or non-formulary) drug, you will pay the applicable retail coinsurance or mail-order copay, plus the difference in cost between the brand-name and generic drug.
Mail-Order Service (Required For Maintenance Medications)
The cost of mail-order service is often less than you would pay for a 90-day supply at a retail pharmacy. If you take maintenance medications for conditions such as high blood pressure, high cholesterol or asthma, you will be required to have them filled by the mail-order service. Log in at aetna.com and select the prescriptions tab. You can upload a prescription for mail-order directly on the website or call 1-800-238-3488 for additional guidance about receiving your medications through mail-order. Many physicians can send prescriptions directly to mail-order if they know you are with Aetna Pharmacy Benefits. There is also a Maintenance Choice option where you can pick up your Mail-order medication at a local CVS or other designated pharmacy. Call the number above for additional information.
Rx Savings Solutions
You and your family members enrolled in an Arkema medical plan will have access to Rx Savings Solutions, a program that can identify cost savings opportunities for prescriptions. This program is available at no cost to you. To find out more and register for the program, visit rxsavingssolutions.com/solutions/members or call 1-800-268-4476.
CVS PrudentRx for those enrolled in the Aetna PPO Plan
If you’re enrolled in the Aetna PPO plan, you can use PrudentRx, a program that can help you save money on certain specialty medications for complex conditions like multiple sclerosis, cancer, rheumatoid arthritis, and other conditions. If your specialty medication is on the PrudentRx drug list, you must participate in the PrudentRx program and the drug manufacturer’s assistance program to receive your medications at no cost. If you opt out of the PrudentRx program, you will be responsible for the full amount of the 30% coinsurance on specialty medications that are eligible for the PrudentRx Solution. If eligible, PrudentRx will reach out to you to gather information upon filling your first prescription through CVS Specialty, CVS’ specialty mail pharmacy. To learn more about PrudentRx, call 800-578-4403.
CVS Specialty Pharmacy
If you take specialty medications, you can fill your prescriptions through CVS’ CVS Specialty Pharmacy. CVS Specialty pharmacists are available to answer questions 24/7, and their care team will follow up with you after you receive your medication to ensure you receive the clinical care and support you need. You can visit the CVS Specialty site through aetna.com under the Prescription tab. To register for CVS Specialty Pharmacy, visit cvsspecialty.com or call 800-238-3488.