2026 Advanced Control Plan - Aetna

The 2026 Advanced Control Plan by Aetna covers medical exceptions for patients facing serious health risks and those currently using non-covered drugs, along with preventive drugs fully covered with no member cost share. Key requirements include submitting a request through the precertification team, and decisions are communicated within 24 hours; however, coverage may have limitations based on service area availability and plan exclusions. Additionally, certain drugs from the value drug list are subject to fixed copays and may be treated as if the deductible is met.

"Patients with a health condition that may seriously jeopardize their life, health, or ability to regain maximum function may request a medical exception."

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