Know Your Options. Save on Prescriptions.

Understanding The Prescription Drug Program

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.

Return to Open Enrollment 2027 Homepage Frequently Asked Questions NOTICE: Prescription Drug Coverage and Medicare

Filling Prescriptions

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:

  • Ask the pharmacy to which you want to move the prescription  to help transfer the script.
  • Tell the pharmacy where the perscription is currently being processed. Provide name, street address of pharmacy and specific name of drug(s) for transfer.
  • All outstanding refills will follow with transfer.

If you don't have refills remaining:

  • Ask your provider for a new script.
  • Provide the name and address of the new pharmacy you wish to send the perscription to your provider.

UVA Benefits

Compare Prescription Drug Costs

Choose your health plan and the type of prescription you want to compare. The tool will show the applicable 2027 prescription drug cost-sharing.

This is a cost-sharing comparison, not a drug-coverage search. Whether a specific medication is covered depends on the applicable formulary and health plan rules.
Which health plan are you comparing?
Health Savings: Most prescription drug costs are subject to the Health Savings deductible before 20% coinsurance applies. Special cost-sharing applies to generic and preferred-brand diabetic drugs, insulin and supplies.
What kind of prescription are you comparing?
Health Savings

Retail Pharmacy

Cost-sharing for up to a 30-day supply at a participating pharmacy.

View Full Plan Schedule
Health Savings Retail Pharmacy prescription drug cost-sharing
Drug Tier UVA Pharmacies Aetna National Pharmacy Network
Generic After deductible: 20% coinsurance After deductible: 20% coinsurance
Preferred Brand After deductible: 20% coinsurance After deductible: 20% coinsurance

Remember: For Health Savings, the deductible generally must be met before the 20% prescription coinsurance shown above applies.

Prescription Drug Information

What do minimum and maximum costs mean?

For some brand-name prescriptions, you pay 20% coinsurance after meeting the applicable deductible, but a minimum and/or maximum cost may apply.

For example, if the benefit says 20% coinsurance, $34 minimum / $200 maximum , your cost will not be less than $34 and will not exceed $200 for that covered prescription, subject to the plan rules.

How does Maintenance Choice work?

Maintenance medications for chronic conditions are generally filled as 90-day prescriptions through UVA Pharmacies, CVS retail pharmacies or CVS Caremark Mail Service Pharmacy.

You may opt out of Maintenance Choice if you want to continue filling 30-day supplies of your maintenance medications at another participating retail pharmacy.

Contact Aetna at 800-987-9072 before your third fill.

Where can specialty prescriptions be filled?

Specialty drugs must be filled through UVA Specialty Pharmacy to be covered.

Limited Distribution Drugs may be filled through CVS Specialty Pharmacy .

What should I know about generic substitution?

The UVA Health Plan requires generic substitution when a generic equivalent is available.

If you choose the brand-name drug when a generic equivalent is available, you may be responsible for the difference between the brand-name and generic drug cost in addition to the applicable cost-sharing.

That additional difference in cost does not count toward your deductible or out-of-pocket maximum.

Which pharmacies count as UVA Pharmacies?
https://www.uvahealth.com/search#tab=locations&q=pharmacy

Aetna Covered Prescription Medication

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.

  • Pricing a Drug
    • Click on the appropriate link depending on which health plan option you are enrolled in:
    • You will have to sign-in
    • Once signed in, enter the name of the drug and click "search" to view the cost estimate and plan details.
    • Please note that the Digital Care Tool provides cost estimates that are based on Aetna's  2026 formulary and pricing.

  • Maintenance Drugs

    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:

    • 30-day fills of maintenance drugs can only be filled twice at other retail pharmacies unless you opt out of Maintenance Choice Program 
    • After two fills, you may pay full price for the medication
    Maintenance Choice with Opt-Out Flyer (PDF)

  • Chronic Medicine Drugs

    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)

  • Specialty Drugs

    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:

    • Generic Specialty - Deductible +20% ($150 maximum)
    • Preferred Specialty - Deductible +20% ($200 maximum)
    • Non-Preferred Specialty - Deductible +20% ($350 maximum)

    For Health Savings participants, specialty drug cost-sharing is subject to the deductible. The cost-share amount will be:

    • Generic Specialty - Deductible +20%
    • Preferred Specialty - Deductible +20% 
    • Non-Preferred Specialty - Deductible +20% 
    Speciality Drug List (PDF)

  • Diabetic Drugs, Insulin, Supplies and Free Glucometer

    Generic and preferred brand diabetic drugs, insulin, and supplies are subject to the following special cost-share amounts for all health plan options 

    • 30-day supply generic - $0
    • 30-day supply preferred brand - $34
    • 90-day supply generic through Maintenance Choice - $0
    • 90-day supply preferred brand through Maintenance Choice - $75
    • All non-preferred brand diabetic drugs, insulin, and supplies will be subject to standard non-preferred cost-share amounts
    • Each member with diabetes is eligible for one free Glucometer and an upgrade annually
    • Insulin pumps will be added to the pharmacy benefit; medical coverage will not change

  • Step Therapy Program

    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. 

  • Resource Link List

Vaccines

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.

  • Seasonal Vaccines
    • Influenza (Flu)
      • Also available for free annually at UVA Benefits Expos 
    • COVID-19 Vaccine and Booster

  • Non-seasonal Vaccines

    • Chicken Pox (Varicella)
    • Hepatitis A
    • Hepatitis B (Recombinant)
    • Hepatitis A and B
    • HPV (Human Papillomavirus)
    • MMR (Measles, Mumps & Rubella)
    • Meningococcal (meningitis)
    • Pneumococcal (pneumonia)
    • RSV (Respiratory Syncytial Virus) >65 years of age
    • Shingles (Herpes Zoster)
    • Tetanus
    • Td (tetanus and diptheria)
    • TdaP (tetanus, diptheria, and pertussis)

Dates and Next Steps

  • Open Enrollment begins on Monday, October 5 and remains open until 11:59 p.m. on Friday, October 16
    • You will receive a task in your Workday Inbox on October 5 to get started
    • After open enrollment ends, benefit changes will be limited to Qualifying Life Events
  • On January 1, 2027, the elections you made during Open Enrollment will take effect
    • Any updates to your paycheck deductions will appear on your first 2027 paycheck
Opens a list of quick links to Open Enrollment resources.

I want to learn the Cost-Saving Benefits of a Health Savings Account (HSA)

HSA Webpage

I want to learn the Cost-Saving Benefits of a Flexible Savings Account (FSA)

FSA Webpage

I want to learn more about the Health Plan

Health Plan Webapage

Postdoctoral Fellows

The Open Enrollment process for all Postdoctoral Fellows (non-UVA employees) is managed through UVA Human Resources. For additional information specific to Postdoctoral Fellows, contact AskHR@virginia.edu with the subject line "Postdoc Fellow Benefits".

Quick Links

How To Elect Benefits in Workday Changes Coming in 2027 Frequently Asked Questions I Need Help