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Important Information Regarding Aetna/Coventry Plans

Important Information Regarding Aetna/Coventry Plans


We have verified that there is a special enrollment period for beneficiaries who selected Aetna/Coventry Medicare Part D plans to choose another plan for 2015.

Incorrect pharmacy-network information was provided to CMS (Center for Medicare and Medicaid) during open enrollment and therefore was not an accurate representation of which pharmacies would be in-network with the Aetna/Coventry Plans. Sources indicate that Aetna/Coventry is at fault for this misinformation and therefore Aetna Plan Finders, Medicare Plan Finder, and any tools using CMS data were affected. With iMedicare you are able to determine which changes affected your pharmacy. 

CMS has opened up a special enrollment period available to these beneficiaries to allow them to elect coverage in another plan. Although we recommend advising your patients to call Medicare directly to enroll in a new plan for February 1, 2015, patients can also enroll online as they did during the Open Enrollment period. If you have examples of problems that beneficiaries are facing while enrolling, please report that to CMS at 1-800-Medicare.

In order to facilitate this process, we have provided you with the plans' BIN numbers so you can find your patients currently on these Aetna/Coventry plans:

Aetna Medicare Rx Premier (PDP) BIN: 610502
Aetna Medicare Rx Saver (PDP)  BIN: 610502
First Health Part D Premier Plus (PDP) BIN: 610014
First Health Part D Value Plus (PDP) BIN: 610014

Although CMS was unclear of the end date for this special enrollment period, we would suggest reaching out to patients as soon as possible to let them know they will not be able to use their pharmacy. Their effective date will be the first of February. When they check off the reason for enrollment, choose "Other" and type in "Aetna pharmacy and copayment misinformation during the 2015 AEP".

Unfortunately, when filling their prescriptions in January your patients will have to go to a pharmacy that takes the Aetna/Coventry Plans. CMS has not indicated any intention of restitution regarding this matter. However, patients may qualify for a one-time-in-network cost sharing refund from Aetna if they pay full price for their prescriptions at your pharmacy before March 31. 

If you have examples of problems that beneficiaries are facing, please report that to CMS at 1-800-Medicare (633-4227)