Request an Information Kit

Complete the form below to get an information kit for . Please allow 7 to 15 business days for delivery.

All fields marked with an asterisk ( * ) are required.

The system was unable to locate a state for the zip code you entered. Please return to the plan page and enter a valid zip code.

This page requires you to enter a zip code on the previous step. Please return to the plan page and enter your zip code.

This page requires you to select a plan on the previous step. Please return to the plan page and select again.

*First Name

*Last Name

*Home Address (please enter the permanent address of the applicant)

City

State

ZIP Code

Phone Number

Re-enter Phone Number

Email Address

Re-enter Email Address

By giving us your email address or telephone number, you agree to allow us to contact you. We'll give you details about our health plans, services and/or educational information related to health care.

If you enter your phone number, we'll call you in a few weeks during regular business hours. The reason for the call is to see if you have any questions or need help selecting a plan.

Do you want the information sent to another address?

Check this box if you want your plan information sent to another person or a different address. Complete the information below and click "Submit."

*First Name of Recipient

*Last Name of Recipient

Recipient Address

City

State

ZIP code

Let us help you

Email us or call an Aetna representative at (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m.

Have us call you

Schedule an in-home visit

Disclaimers

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

Request an Information Kit

Let us help you

You are now leaving the Aetna Medicare website.

You are now leaving the Aetna Medicare website.

You are now leaving our Medicare website.

What 2016 coverage do you need?

Select your plan to request a directory

What 2016 coverage do you have?

What 2017 coverage do you have?

Doctors & Hospitals

Mental Health Providers

What coverage do you need?

Choose a 2017 plan type to enroll

Choose a 2016 plan type to enroll

Choose a plan type (and year) to enroll

Request an Information Kit

Let us help you

You are now leaving the Aetna Medicare website.

You are now leaving the Aetna Medicare website.

You are now leaving our Medicare website.

Select your plan to log in or register

What 2016 coverage do you need?

Select your plan to request a directory

What 2016 coverage do you have?

What 2017 coverage do you have?

Doctors & Hospitals

Mental Health Providers

What coverage do you need?

Choose a 2017 plan type to enroll

Choose a 2016 plan type to enroll

Choose a plan type (and year) to enroll