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Aetna Better Health of Illinois statement on pharmacy access in Medicaid network

February 11, 2021 | Health Insurance

Aetna Better Health of Illinois is committed to helping Medicaid recipients obtain access to affordable prescription drugs when they need them.

Aetna Better Health of Illinois is committed to helping Medicaid recipients obtain access to affordable prescription drugs when they need them. Criticism about the access to pharmacy services we provide in our Medicaid pharmacy networkPharmacy counts reflect network participation as of February 11, 2021. The state of Illinois requires our network to only permit approved pharmacies as determined by the state’s Pharmacy Roster File. As such, the number of pharmacies in the Aetna Better Health of Illinois managed Medicaid network is subject to slight changes based on the status of each individual pharmacy. We regularly monitor the number of disenrolled pharmacies and confirm disenrollment with the state if more than five pharmacies are disenrolled from the same roster file. are not accurate and seem to be based on incomplete information.

  • Across Illinois, nearly 2,000 pharmacies participate in our Medicaid network.

  • In Chicago, our members live - on average - just six blocks or a half-mile from one of 271 in-network Chicago pharmacies, including many independently-owned community drugstores, as well as Jewel-Osco, HY-VEE, Kroger/Mariano’s, Meijer, Walmart, Target, and CVS Pharmacy locations.

  • On Chicago’s West Side, our Medicaid network consists of 44 pharmacies in or bordering this community’s five ZIP codes (60612, 60623, 60624, 60644, 60651), including 33 chain and independent pharmacies, eight clinic pharmacies, two institutional pharmacies and one long-term care pharmacy.

None of the pharmacy chains in our network is designated a preferred pharmacy, and many of our members choose to support locally-owned independent pharmacies in their neighborhood. Support of these small businesses is an important long-term solution to addressing pharmacy deserts and stimulating local economies.

Our strategy to address greater access for members living near pharmacy deserts includes free delivery from many chain and independent pharmacies and 90-day prescriptions shipped directly to members’ homes. Ongoing dialogue with provider partners has been critical to ensuring health equity and we invest in partnerships to drive innovation and community-based solutions to address this issue.

We regularly review our network and geographic access points to ensure we are meeting the needs of our members and maintaining network adequacy. We continue to meet or exceed all of the state’s access requirements for managed care organizations.