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Plan benefits & forms

Medicare plans have many different details and forms, so we’ve organized everything together into one convenient place.

View your plan benefits & Star Ratings

View your plan benefits & Star Ratings

To access your plan’s Summary of Benefits, Star Ratings and other coverage details, refer to the plan name on the cover of your Aetna enrollment guide or to the letter you received from Boeing.


  • If your plan name is a number (for example: XX-XX): Enter the first 2 digits in the box below
  • If your plan name is a letter: Enter the letter in the box below

If you need help, we can provide your code. Just call us at ${groupPhoneNumber} ${tty}, ${memberhours}.




Review your Evidence of Coverage to learn about comprehensive plan details, and your rights and responsibilities. You can request a copy of your Evidence of Coverage and Schedule of Cost Sharing if you need one.


Find Medicare forms


See below for helpful resources for managing your plan and how to get started with common requests.



File claims & reimbursement requests

If you were billed by a pharmacy for a prescription drug, mail us your completed form to request a reimbursement. 


Prescription drug claim form - English (PDF)Español (PDF)

If you were billed directly by a provider, mail us your completed form to request reimbursement. 


Reimbursement form - English (PDF) | Español (PDF)

Printer-free reimbursement instructions - English (PDF) | Español (PDF)

Give someone permission to manage your care

Call us with your caregiver or another person on the line to give them permission to speak with us (just one time, while on that call). Or you can mail us a completed Protected Health Information (PHI) form to give them permission on a regular basis.


PHI form - English (PDF) | Español (PDF)

You can choose someone to do all of the above. This person is your appointed representative. An appointment is good for one year from the date that you and your representative sign an Appointment of Representative form. 


Fill out the form below and mail it to us. Any time your representative makes a request for you, they should send us a signed copy. You'll leave Aetna Medicare and go to the Center for Medicare & Medicaid Services (CMS) website if you link to the form. 


Appointment of Representative CMS Form - English (PDF) | Español (PDF)

Manage your medications

Complete and return this form to get your prescriptions delivered to you. 


Medication order form for CVS Caremark® Mail Service Pharmacy - English (PDF) | Español (PDF)


Learn more about Rx home delivery

Complete these forms with your Medication Therapy Management (MTM) providers, and update them (as needed) with every doctor, pharmacist, nurse or caregiver you see. Take notes with your Medication Action Plan to remember medical advice, important things to do and questions to ask. Use your Personal Medication List to save and update your medication history.


Medication Action Plan - English (PDF) | Español (PDF)


Personal Medication List - English (PDF) | Español (PDF) 


Explore MTM resources

Exceptions, appeals & grievances

We want to be your first stop when you have a concern about your coverage or care. Call us at the number on your member ID card, or learn more here.


See how to get started

Additional information

While you can find these documents online, sometimes you may need a printed version mailed to you.  


Request a printed Evidence of Coverage (EOC)

Request a printed Provider Directory – Call us at ${groupPhoneNumber} ${tty}, ${memberhours}.


Request a printed formulary 

Medicare Helpline & Website - Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Call 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day. If you need help in a language other than English or Spanish, say “Agent” to talk to a customer service representative. Or visit the Medicare website


Social Security Administration - For questions about Medicare eligibility, Social Security retirement benefits or help paying for prescription drugs. Call 1-800-772-1213 or TTY: 1-800-325-0778, Monday through Friday, 8 AM to 7 PM or visit the Social Security website.

Most health care professionals and organizations that provide Medicare services are honest. Unfortunately, there may be some who are not. If you ever suspect fraud, please contact Member Services at the number on the back of your ID card, or call Medicare toll-free at 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day.

If you are moving or getting a new phone number, please let Boeing know right away. 


  • If you retired before 2011, call the Boeing Service Center for Health and Insurance at 1-866-504-4256 (TTY: 711). 

  • If you retired during or after 2011, call Boeing Worklife at 1-866-473-2016 (TTY: 711). 

Representatives are available Monday through Friday, 9 AM to 8 PM ET, 8 AM to 7 PM CT, 7 AM to 6 PM MT, 6 AM to 5 PM PT. 


Be sure to have your BEMSID and unique pin code. If you have not created a unique pin code, you will be routed to a representative to assist you with creating one. 

We help you get medically necessary health care services in the most cost-effective way under your health plan. And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost. 


Specifically, we: 

  • Base our decisions on appropriateness of care, service and plan coverage 

  • Use nationally recognized guidelines and resources to make changes 

  • Don’t pay or reward providers, employees or others for denying coverage or care 

  • Focus on reviewing the risks of members who aren’t fully using certain services

Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device.


When we learn about a new technology, we:

  • Carefully review the latest information and ask experts for their opinions

  • Compare the information with well-known standards

  • Base all of our decisions on making sure you have the right care and services

You’re enrolled in an Aetna Medicare plan (PPO) with Extended Service Area (ESA): 


The Aetna Medicare PPO plan with ESA gives you freedom of access. In many PPO plans, you pay more when you use providers who are not in the plan’s network. The Aetna Medicare PPO plan with ESA is different! 


You can see any provider, in or out of network, at the same cost, according to the costs listed in your plan benefits summary. They just have to be licensed, eligible to receive Medicare payments and willing to accept your plan.   


Nearly 99% of doctors that Boeing retirees see today are either in the Aetna network, or accept payment from the Aetna plan. You can have the peace of mind knowing that you can use almost any doctor or hospital that you’re using today.


View our network of doctors, hospitals or other providers


Please call us or see your Evidence of Coverage for more information, including the cost share for out‐of‐network services.

The Centers for Medicare & Medicaid Services periodically issues National Coverage Determinations. They issue these when a service’s or drug’s coverage rules change. 


View a list of coverage determinations

We're here to help

Call us ${memberhours}.


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