Under the Affordable Care Act, also known as health care reform, you can get some drugs at no member cost share. This means they are covered 100 percent by your plan. The following list of drugs and products shows some items that are
available at no member cost share with a prescription. This is not a complete list.
There are additional drugs and products available.
Category
Aspirin products
Covered for members (men and
women) a es 50 - 69 years when
prescribeå by a doctor.
Aspirin 81 mg is covered for
preeclampsia.
Vitamin D
Covered for members ages 65 and
Older when prescribed by a doctor
Generic name
aspirin tab aspirin 75 rng, 81 nig
cholecalciferol cap 400u, 1,000U
cholecalciferol chew tab 40011, 1,000u
cholecalciferol drops 400 unit/003 mL
(per drop)
cholecalciferol oral liquid 400 unit/rnL
cholecalciferol tab 40011, 1,000u
Brand name
ST. JOSEPH
D-VI-SOL
Fluoride
Oral fluoride covered for children
ages 6 months - 11 years without
flüoride in their water source.
Fluoride dental products
Covered with a prescription from a
doctor. Age limits under the fluoride
category above apply.
Tobacco-cessation medications
Covered With a prescription.
(Limits apply. Limits vary by plan.)
Folic acid
Recommended for members
who are or may become pregnant'*
Statin medications
Covered for member betw•een
40-75 years of age with no restriction
besides current quantity limits.
sodium fluoride chew tab O. 25 mg
0.5 mg, mg
sodium fluoride tab 0.5 mg, mg
sodium fluoride soln O. 125 mg/drop,
05 mg/mL
c/inpro 5000 (sodium fluoride paste
denta 5000 plus (sodium fluoride
cream 1.1%)
s/ (sodium fluoride gel f))
buwoøon HCI (smoking deterrent) tab
nicotine TD patch
nicotine polacrilex gum
nicotine polacrilex lozenge
folic acid cap 0.8 mg
folic acid cap 20 mg
folic acid cap 5 mg
folic acid tab mg
folic acid tab 400 mcg
folic acid tab 800 mcg
atorvastatin TO mg
simvastatin 5 mg
simvastatin 'O mg
FLUORABON
FLURA.DROPS
LOZI.FLUR
LURIDE
PREVIDENT 5000 DRY MOUTH gel
PREVIDENT 5000 PLUS cream
PREVIDENT 5000 SENSITIVE paste
PREVIDENT rinse
CHANTIX
NICOTROL INHALER
NICOTROL NS
none
*Only when prescribed for smoking cessation.
U_S_ Preventive Services Task Force recommends that all women planning or capable Of pregnancy take a daily
supplement containing 04 to 0.8 mg (400 to 800 mcg) of folic acid.
Health benefits and health insurance plans are offered. administered and/or underwritten by Aetna Health
Inc.. Aetna Health Insurance Company of New York. Aetna Health Insurance Company. Aetna HealthAssurance
Pennsylvani
Aetna Life I
Copyfish
Company. I
sole financi
unit Of Aetni
available at no member cost share with a prescription. This is not a complete list.
There are additional drugs and products available.
Category
Aspirin products
Covered for members (men and
women) a es 50 - 69 years when
prescribeå by a doctor.
Aspirin 81 mg is covered for
preeclampsia.
Vitamin D
Covered for members ages 65 and
Older when prescribed by a doctor
Generic name
aspirin tab aspirin 75 rng, 81 nig
cholecalciferol cap 400u, 1,000U
cholecalciferol chew tab 40011, 1,000u
cholecalciferol drops 400 unit/003 mL
(per drop)
cholecalciferol oral liquid 400 unit/rnL
cholecalciferol tab 40011, 1,000u
Brand name
ST. JOSEPH
D-VI-SOL
Fluoride
Oral fluoride covered for children
ages 6 months - 11 years without
flüoride in their water source.
Fluoride dental products
Covered with a prescription from a
doctor. Age limits under the fluoride
category above apply.
Tobacco-cessation medications
Covered With a prescription.
(Limits apply. Limits vary by plan.)
Folic acid
Recommended for members
who are or may become pregnant'*
Statin medications
Covered for member betw•een
40-75 years of age with no restriction
besides current quantity limits.
sodium fluoride chew tab O. 25 mg
0.5 mg, mg
sodium fluoride tab 0.5 mg, mg
sodium fluoride soln O. 125 mg/drop,
05 mg/mL
c/inpro 5000 (sodium fluoride paste
denta 5000 plus (sodium fluoride
cream 1.1%)
s/ (sodium fluoride gel f))
buwoøon HCI (smoking deterrent) tab
nicotine TD patch
nicotine polacrilex gum
nicotine polacrilex lozenge
folic acid cap 0.8 mg
folic acid cap 20 mg
folic acid cap 5 mg
folic acid tab mg
folic acid tab 400 mcg
folic acid tab 800 mcg
atorvastatin TO mg
simvastatin 5 mg
simvastatin 'O mg
FLUORABON
FLURA.DROPS
LOZI.FLUR
LURIDE
PREVIDENT 5000 DRY MOUTH gel
PREVIDENT 5000 PLUS cream
PREVIDENT 5000 SENSITIVE paste
PREVIDENT rinse
CHANTIX
NICOTROL INHALER
NICOTROL NS
none
*Only when prescribed for smoking cessation.
U_S_ Preventive Services Task Force recommends that all women planning or capable Of pregnancy take a daily
supplement containing 04 to 0.8 mg (400 to 800 mcg) of folic acid.
Health benefits and health insurance plans are offered. administered and/or underwritten by Aetna Health
Inc.. Aetna Health Insurance Company of New York. Aetna Health Insurance Company. Aetna HealthAssurance
Pennsylvani
Aetna Life I
Copyfish
Company. I
sole financi
unit Of Aetni
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