Know Your Options. Save on Prescriptions.
Prescription drug coverage is included with your UVA Health Plan and managed by Aetna.
There is no separate premium for prescription drug coverage. What you pay for some covered prescriptions depends on whether you've met your health plan deductible or reached your out-of-pocket maximum.
First, identify if your current pharmacy is in the Aetna Network. You can do this by visiting Aetna's website and using the Find a Pharmacy tool.
Switching to UVA or CVS pharmacy locations
If you have refills remaining:
If you don't have refills remaining:
When you have specialty pharmacy needs, the UVA Specialty Pharmacy is available to assist you by filling prescriptions for complex medical conditions that require special storage, handling, and delivery that most retail pharmacies aren't equipped to handle. Remember that medication prices at the UVA Pharmacy are often less expensive than those at other pharmacies for UVA employees.
You may filled these through the CVS Specialty Pharmacy or UVA Specialty Pharmacy. All other specialty drugs must be filled through the UVA Specialty Pharmacy.
Retail pharmacies will be able to distribute a maximum drug supply of 30 days, except for CVS Pharmacies and UVA Pharmacy, which can distribute 90-day fills of maintenance drugs.
If you would prefer to fill a 30-day supply of maintenance drugs through your local retail pharmacy, you must call Aetna and opt out of the Maintenance Choice program. Otherwise, your maintenance drugs will not be covered.
UVA Pharmacy offers a $3 discount per prescription on the member cost-share at all UVA pharmacy locations for UVA Health Plan participants. UVA Pharmacy has 8 locations throughout central Virginia, including one located at the UVA Health Education Resource Center that is open 24/7 year-round. You can also use this discount on the member cost-share for prescriptions delivered directly to your home.
*Discount is automatically applied using your UVA Aetna Health Plan card.
Medications included on the Aetna Advanced Control Formulary are covered under your UVA Health Plan. Check the formulary to see whether your current prescriptions are covered.
Health Savings participants have a deductible that applies to both medical and prescription costs. You must pay for covered health care services and prescriptions up to your deductible amount before the UVA Health Plan begins to pay.
UVA PPO and Choice Health participants have a deductible that applies to both medical and prescription costs for preferred brand and non-preferred brand retail drugs. You must pay for covered prescriptions up to your deductible amount before the UVA Health Plan begins to pay for preferred brand and non-preferred brand retail prescriptions and specialty prescriptions. Generic medications are not subject to the deductible.
The table below shows costs for retail pharmacy outside of UVA and CVS pharmacies (such as Target, Walgreens, Kroger, etc.); excludes specialty prescriptions and mail order prescriptions.
| Drug Tier | Choice | UVA PPO | Health Savings |
|---|---|---|---|
|
Generic, low cost |
$6 co-pay 30-day supply |
$6 co-pay 30-day supply |
Deductible + 20% for up to 30-day supply |
|
Preferred Brand |
Deductible + 20% $34 min/$200 max 30-day supply |
Deductible + 20% $34 min/$200 max 30-day supply |
Deductible + 20% for up to 30-day supply |
|
Non-Preferred Brand |
Deductible + 20% $68 min/$275 max 30-day supply |
Deductible + 20% $68 min/$275 max 30-day supply |
Deductible + 20% for up to 30-day supply |
If you are currently taking any maintenance drugs for chronic conditions, read the Maintenance Choice with Opt-Out Flyer resource.
The Maintenance Choice program expands the options for UVA PPO and Choice Health participants (Choice Health will close to new enrollees starting January 1, 2026) to pay the reduced 90-day cost-sharing amounts for maintenance drugs while using UVA Pharmacy, CVS Pharmacies, and CVS Caremark Mail Service Pharmacy.
If you would prefer to fill a 30-day supply of maintenance drugs through your local retail pharmacy, you must call Aetna and opt out of the Maintenance Choice program. Otherwise, your maintenance drugs will not be covered.
If Aetna does not hear from you:
Chronic Medicine Drugs - If you are enrolled in UVA PPO or Choice Health, check the Chronic Medicine List resource and identify any of your current maintenance drugs on these lists. Those drugs will not be subject to the deductible and will only be subject to the standard coinsurance or copay.
Chronic Medicine List (PDF)Check the Specialty Drug List for a list of specialty drugs. If any of your current drugs are on this specialty list, they must be filled through the UVA Specialty Pharmacy to be covered. If they are Limited Distribution Drugs, they can also be filled through the CVS Specialty Pharmacy. All specialty drugs require prior authorization.
For UVA PPO and Choice Health participants only, specialty drug cost-sharing is subject to the deductible. The cost-share amounts will be:
For Health Savings participants, specialty drug cost-sharing is subject to the deductible. The cost-share amount will be:
Generic and preferred brand diabetic drugs, insulin, and supplies are subject to the following special cost-share amounts for all health plan options
The medications on the step therapy list require the use of generics first before the use of brand medication. You may need to try out options in steps, starting with their least expensive versions. If you have a medical need for one of the brand medications, your doctor can ask for an exception.
Seasonal and preventive vaccines are part of the pharmacy benefit for those over age 18. Those under age 18 should continue to receive their vaccines through the medical benefit at their doctor's office or at one of the pharmacies in Aetna's Expanded Vaccine Network. The pharmacies should be reminded to bill Aetna instead of AetnaRx so your medical benefit covers the vaccine.
The UVA Health Plan with Aetna follows CDC recommendations for vaccines and immunizations.
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