Does Aetna cover Symbicort?

In this article:

• Does Aetna cover Symbicort?
• Generic Symbicort cost
• Cost with Aetna
• How to check your coverage
• What to do if Aetna won’t cover Symbicort
• How to save

In this article

• Does Aetna cover Symbicort?
• Generic Symbicort cost
• Cost with Aetna
• How to check your coverage
• What to do if Aetna won’t cover Symbicort
• How to save

Symbicort is an FDA-approved inhaler used to treat asthma in adults and children six years and older, as well as chronic obstructive pulmonary disease (COPD) in adults. Symbicort usually isn’t covered by most Aetna plans. Instead, the generic versions, budesonide-formoterol and Breyna, are preferred. Coverage will depend on the plan, with some requiring prior authorization or setting other limits on brand-name Symbicort.

Does Aetna cover Symbicort?

Typically, Aetna will not cover brand-name Symbicort, but the good news is that most plans should cover generic versions of this drug. 

Symbicort is a brand-name drug. The first generics of this drug were approved in 2022 and are now widely available. Because of this, Aetna typically does not cover brand-name Symbicort but will cover generic budesonide-formoterol or Breyna. 

We checked some Aetna formularies (list of covered drugs) for coverage of brand-name Symbicort versus generic versions and discovered the following:

• The 2026 Aetna Standard Plan lists Symbicort as a non-formulary drug, meaning it is not covered unless an exception request is granted. Breyna and other generic budesonide-formoterol products are listed as covered generics on this plan. 
• For this same Aetna Standard Plan, there is a published 2026 Formulary Exclusions Drug List. On this list, brand-name Symbicort is listed as a non-covered drug, with preferred alternatives Breyna, generic budesonide-formoterol, Wixela Inhub, fluticasone-salmeterol, and Breo Ellipta.
• If you have Medicare prescription coverage, you can use the plan finder search function to see that brand-name Symbicort is not covered, while generics are covered in most cases. 
• Aetna Medicaid plans will vary by state; however, you can expect coverage to be similar to other Aetna plans. For example, Aetna Better Health of New Jersey does not list brand-name Symbicort on its formulary, but it does list generic versions. 

Although many Aetna plans cover generic Symbicort instead of brand-name Symbicort, there is significant variation between plans. The only way to know for sure whether your specific Aetna plan covers Symbicort is to contact your plan directly for more information. 

How much does generic Symbicort cost?

Without insurance or discounts, generic Symbicort can cost around $527 on average, though prices vary by pharmacy. If you choose generic Symbicort and use a SingleCare discount card, you could pay as little as $156 per month. 

Brand-name Symbicort costs about $492 for one 10.2-gram inhaler (160-4.5 mcg/actuation). However, you can use a SingleCare Symbicort coupon to pay as low as $227 for a brand-name Symbicort inhaler. 

SingleCare is accepted at over 35,000 pharmacies in the U.S. and Puerto Rico. You can use the discount on your initial prescription and on refills. 

How much does Symbicort cost with Aetna?

Your out-of-pocket costs will vary by plan. As mentioned above, many Aetna plans do not cover brand-name Symbicort. However, if you fill your prescription with a generic version of Symbicort, you’ll likely pay a generic copay, which is often much lower than the brand-name price. 

Your total costs are also affected by other factors, such as whether you met your deductible, or if you have Medicare Part D, which phase of coverage you are in. The best way to get an accurate estimate is to contact Aetna member services or your pharmacy.

How to check whether your Aetna plan covers Symbicort 

Because Symbicort coverage depends on your specific Aetna plan, you’ll want to verify coverage by looking up your plan’s formulary. You can do this by:

• Visiting the Aetna website and logging in or registering to find drug coverage information specific to your plan. 
• Calling the member services phone number on your ID card for more information. If you call, have your member ID card handy, since the representative will ask for your ID and group number. 
• Having your healthcare provider send the prescription to your preferred pharmacy. The pharmacy staff will process the prescription and tell you right away whether the drug is covered, not covered, or requires prior authorization. 

What to do if Aetna won’t cover Symbicort

If your Aetna plan won’t cover Symbicort, you still have other options. Many people do well with switching to a generic version. However, if you need the brand-name version for a valid medical reason, your healthcare provider can submit a prior authorization or an exception request. If the request is denied, you can appeal it. Your healthcare provider may also recommend a Symbicort alternative, such as fluticasone-salmeterol (Advair, Wixela Inhub), Breo Ellipta, or Dulera, which may be covered at a lower cost.

How to save on Symbicort

One of the best ways to save money on your prescription drugs is by using a free SingleCare prescription discount card or the SingleCare app. You can use your discount at a participating pharmacy every month to save up to around $336 on brand-name Symbicort or up to $371 on generic versions. 

Save on COPD inhalers

Here are some other ways to save on Symbicort:

• Call different pharmacies in your area to ask about the prices of generic versions of Symbicort. You can also ask about the price difference between a one-month and a three-month supply, since some pharmacies may charge less when you purchase a larger quantity.
• Ask your healthcare provider or pharmacist if they know of any local resources in your area, such as health departments or clinics that may offer discounted or free medicines.
• Talk to your prescriber about manufacturer savings programs or patient assistance programs that may be available for your specific inhaler.

If your Symbicort, or generic Symbicort, is still costly, talk to your healthcare provider about Symbicort alternatives that are just as effective and may cost less with your insurance plan.