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Complete the form below. You can find your member number on your ID card. Enter the first 9 numbers only. All fields marked with an asterisk (*) are required.

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This is for Internal customer service use only

 

 

Disclaimers

Aetna Medicare is a HMO, PPO plan with a Medicare contract. 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.

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Call us at  1-855-395-9722 (TTY: 711), Monday to Friday, 8 AM to 6 PM ET.


       GRP_4037_1522 (05/2018)
       Page last updated: Mon Apr 23 15:38:06 EDT 2018

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