The information you will be accessing is provided by another organization or vendor. If you do not intend to leave our site, close this message.
Print and complete this form for medical, dental, vision, hearing, or vaccine reimbursement.
No printer? No problem. Learn what to send us for reimbursement.
Call us at the number on your ID card if you want to leave or cancel your current plan and not join another one. Or, select your current plan and find its specific phone number on our Contact Member Services page.
We’ll let you know your options. Like joining a plan, there are only certain times when you can disenroll.1 You may also download, complete and submit a disenrollment form — use the PDF link for your plan below to print its form:
Please complete the relevant form and mail it to:
PO Box 14088
Lexington, KY 40512
Timing Considerations: If there are 10 days or fewer left until the end of the month, please fax the form to 1-888-665-6296. If you leave us during the annual election period, your last day of coverage is usually Dec. 31.
Important Note: If you change from a Medicare Advantage plan that includes prescription drug coverage to a Medicare prescription drug plan, this will disenroll you from your Medicare Advantage plan. You’ll return to Original Medicare if you switch from a Medicare Advantage plan (with drug coverage) to a Medicare prescription drug plan.
If you receive care at a VA center, privacy laws mean you must let the VA know that it’s OK to share your treatment information with Aetna. Please fill out and return this form so that we can better coordinate our outreach. This helps us make sure you get the care you need and don’t get unnecessary communications.
9401 Indian Creek Parkway
Overland Park, KS 66210
Attn: Angie England
1 If you don't have creditable coverage for 63 days or more, you may have to pay a late enrollment penalty. For example, creditable coverage from an employer or union is expected to pay, on average, at least as much as Medicare's standard prescription drug coverage. You can generally keep your coverage without paying a penalty if you decide to enroll in Medicare prescription drug coverage later.
Aetna handles premium payments through InstaMed, a trusted payment service. Your InstaMed log-in may be different from your Caremark.com secure member site log-in.
Aetna handles premium payments through Payer Express, a trusted payment service. Your Payer Express log-in may be different from your Aetna secure member site log-in.
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