Request an information kit

Each kit contains helpful details about your selected plan‘s benefits and covered drugs, along with other important information.

Complete the form below so we can mail you an information kit.

Please allow 7 to 15 business days for delivery.

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

*First Name

*Last Name

Phone number

Email Address

I consent to receive autodialed marketing calls from or on behalf of Aetna about health insurance. I understand that I am not required to provide this consent as a condition of purchase or receiving insurance and that my consent can be revoked at any time.

*Address

*Zip code

*City

*State

WANT TO SEND A KIT TO ANOTHER PERSON OR ADDRESS?

Check the box to add another recipient’s information.

WOULD YOU LIKE US TO CALL YOU?

Check the box and we’ll call you to talk about your selected kit.

Member Resources

Member Resources

Request an information kit

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