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For Virginia HMO SNP: FAX: 18332805224 PHONE: 18554630933MEDICARE FORM Ontario (vedolizumab) Injectable Medication Recertification Requestor other lines of business: Please use other form. Page 1
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Aetna Rx - Virginia is a prescription drug plan offered by Aetna for residents of Virginia.
Individuals who are eligible and enrolled in the Aetna Rx - Virginia prescription drug plan are required to file it.
You can fill out Aetna Rx - Virginia by providing your personal information, prescription details, and any other required information on the designated form.
The purpose of Aetna Rx - Virginia is to provide prescription drug coverage to residents of Virginia.
You must report your personal information, prescription details, and any other relevant information required by the plan.
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