Provider lookup
Search our national network of primary care doctors, specialists and hospitals. Plus, local walk-in clinic* locations.
Resources for navigators and assisters
Consumers need your help to make sense of the Affordable Care Act (ACA) and their health plan options. We’re here to help you.
More coverage areas to serve more consumers
More coverage areas to serve more consumers
Choose an area below to explore state-specific highlights, local network coverage, expanded footprint details, plan brochures and more.
Next, we’ll take you to our directory of health care professionals. Log in if you’re already a member or choose “Continue as a guest” to find a medical provider in your local area for plan year 2024.
Medication finder
It's easy to find covered prescription drugs and other important pharmacy coverage details.
More coverage details
Medical exceptions
In certain cases, you or your prescriber can request a medical exception to the precertification, step therapy or quantity limits requirements or for a drug that’s not covered on your plan. This can be requested on or after the effective date of your coverage. Standard coverage decisions will be made within 72 hours of the initial request. You can ask for your request to be expedited. Expedited coverage decisions are made within 24 hours. We’ll then contact you or your prescriber with our decision. All medically necessary outpatient prescription drugs will be covered. If a medical exception is approved, you will only need to pay the copay after your deductible, if any, is met. This amount is based on your pharmacy plan design.
To submit a medical exception request for a noncovered drug, providers have these options:
- Submit their request through our secure provider website on www.availity.com.
- Call the Pharmacy Precertification Unit: Non-Specialty 1-800-294-5979 (TTY: 711) or Specialty 1-866-814-5506 (TTY: 711).
- Fax the completed request form to: Non-Specialty 1-888-836-0730 or Specialty 1-866-249-6155.
- Mail the completed request form to: Medical Exception to Pharmacy Prior Authorization Unit 1300 East Campbell Road Richardson, TX 75081
Under health care reform, you can get some drugs and products with no member cost share. This means they are covered 100 percent by your plan. This list shows some common examples.
Helpful resources
Health plan basics
Must-know info about what ACA plans cover, plan levels and costs, and more.
Bill pay guidance
Easy ways to pay online, by mail, by phone or at any CVS Pharmacy® store location.
Member website & app
Two handy tools to check claims, compare costs, access ID card and more.
Tools and training
Official Marketplace programs and resources to help you help consumers.
Questions? We’re here to help.
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Notes
*FOR WALK-IN CLINIC LOCATIONS: For a complete list of participating walk-in clinics, use our provider lookup. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states.
For Georgia and Texas: Includes select walk-in clinic services. Not all walk-in clinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventive walk-in clinic services at no cost-share.
Legal notices
Health plans are offered or underwritten or administered by Aetna Health of California Inc., Aetna Health Inc. (Florida), Aetna Health Inc. (Georgia), Aetna Life Insurance Company, Aetna Health of Utah Inc., Aetna Health Inc. (Pennsylvania), or Aetna Health Inc. (Texas) (Aetna). Aetna and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.
Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is accurate as of the production date; however, it is subject to change.
Health benefits and health insurance plans contain exclusions and limitations.