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.

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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)

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

We're here to help! (collapsed): Members:
Email us or call Member Services at the number on your ID card.

Don’t have your ID card handy?
Find a phone number

Not yet a Member?
Email us or call an Aetna representative at (TTY: 711), Monday through Friday, 8 a.m. to 8 p.m.

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

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What coverage do you need?

Select your plan to request a directory

Request an Information Kit

You are now leaving the Aetna 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 coverage do you need?

Select your plan to request a directory