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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 and more — like our plan brochure and market summary.

 

Note: Pending regulatory approval in California, Delaware and Illinois.

Provider lookup

 

Search our national network of primary care doctors, specialists and hospitals. Plus, many local walk-in cliniclocations.

 

Medication finder

 

It's easy to find covered prescription drugs and other important pharmacy coverage details.

More coverage details

 

Expedited medical exceptions

 

In certain circumstances**, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711) or fax a request to 1-855-330-1716. You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081. We will make a coverage determination within 24 hours of receiving the request, and notify you or your prescriber of our decision.

 

 

**These circumstances exist when you are suffering from a health condition that may seriously jeopardize your life, health, or ability to regain maximum function, or undergoing a current course of treatment using a non-covered drug.

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.

 

Preventive drugs and products (PDF)

 

Maintenance Choice drug list includes drugs a person takes regularly to treat chronic conditions. For instance, arthritis, asthma, diabetes or high cholesterol. Check your plan benefit documents for details on filling a 90-day supply of drugs on this list.

 

Maintenance Medicine List (PDF)

Helpful resources

We’re here to help

 

Call your navigator support team


Our dedicated representatives are here to answer all your questions.
 

1-844-383-6125 (TTY: 711)

Call us Monday — Friday, 8 AM to 8 PM ET.

 

*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-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states.

For TX/GA: 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-preventative walk-in clinic services at no cost-share.

Legal notices

Health plans are offered or underwritten or administered by Aetna Health of California Inc., Coventry Health Plan of Florida, 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 is part of the CVS Health family of companies.

Health benefits and health insurance plans contain exclusions and limitations.