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.
Your Aetna plan benefits & Star Ratings
Knowing more about your plan can help you get the most from your benefits and covered services. Find your plan’s Summary of Benefits and other coverage details below. Your member ID card shows your plan’s name. See a word or term you don't know? Check our glossary.
Review your Evidence of Coverage to learn about comprehensive plan details, and your rights and responsibilities. You can request a copy of your Evidence of Coverage if you need one.
Schedule a one-on-one appointment with an Aetna representative to talk about the Aetna plan
Find Medicare forms
See below for helpful resources for managing your plan and how to get started with common requests.
File claims & reimbursement requests
If you were billed directly by a provider, mail us your completed form to request reimbursement.
Reimbursement form - English (PDF) | Español (PDF)
Printer-free reimbursement instructions - English (PDF) | Español (PDF)
Give someone permission to manage your care
Call us with your caregiver or another person on the line to give them permission to speak with us (just one time, while on that call). Or you can mail us a completed Protected Health Information (PHI) form to give them permission on a regular basis.
PHI form - English (PDF) | Español (PDF)
You can choose someone to do all of the above. This person is your appointed representative. An appointment is good for one year from the date that you and your representative sign an Appointment of Representative form.
Fill out the form below and mail it to us. Any time your representative makes a request for you, they should send us a signed copy. You'll leave Aetna Medicare and go to the Center for Medicare & Medicaid Services (CMS) website if you link to the form.
Appointment of Representative CMS Form - English (PDF) | Español (PDF)
Exceptions, appeals & grievances
We want to be your first stop when you have a concern about your coverage or care. Call us at 1-800-663-0885 (TTY: 711), Monday to Friday, 8 AM to 9 PM ET, or learn more here.
Additional information
While you can find these documents online, sometimes you may need a printed version mailed to you.
Request a printed Evidence of Coverage (EOC)
Request a printed Provider Directory - Call us at 1-800-663-0885 (TTY: 711), Monday to Friday, 8 AM to 9 PM ET.
Medicare Helpline & Website - Get general or claims-specific Medicare information, request documents in alternate formats and make changes to your Medicare coverage. Call 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day. If you need help in a language other than English or Spanish, say “Agent” to talk to a customer service representative. Or visit the Medicare website.
Social Security Administration - For questions about Medicare eligibility, Social Security retirement benefits or help paying for prescription drugs. Call 1-800-772-1213 or TTY: 1-800-325-0778, Monday to Friday, 8 AM to 7 PM or visit the Social Security website.
Most health care professionals and organizations that provide Medicare services are honest. Unfortunately, there may be some who are not. If you ever suspect fraud, please contact Member Services at the number on the back of your ID card, or call Medicare toll-free at 1-800-MEDICARE (1-800-633-4227) or TTY: 1-877-486-2048, 7 days a week, 24 hours a day.
If you’re moving or getting a new phone number, let us know right away. Just call Retiree Health Care Connect at 1-866-637-7555 (TTY: 711), Monday to Friday, 8:30 AM to 4:30 PM ET. Based on where you move, you may need to enroll in a new plan.
We help you get medically necessary health care services in the most cost-effective way under your health plan. And we work with you and doctors to evaluate services for medical appropriateness, timeliness and cost.
Specifically, we:
Base our decisions on appropriateness of care, service and plan coverage
Use nationally recognized guidelines and resources to make changes
Don’t pay or reward providers, employees or others for denying coverage or care
Focus on reviewing the risks of members who aren’t fully using certain services
Doctors and health care companies continuously develop new technologies. This can include anything from a new procedure to a new way to use a device.
When we learn about a new technology, we:
Carefully review the latest information and ask experts for their opinions
Compare the information with well-known standards
Base all of our decisions on making sure you have the right care and services
The Aetna Medicare Advantage plan we've designed for the UAW Trust lets you use doctors and hospitals in or out of the Aetna Medicare network.
While you are not required to use Aetna network doctors, you may want to see if they are in the Aetna network. You may pay more if you use an out-of-network provider.
View our network of doctors, hospitals and other providers
If you need help submitting a claim for a provider that is out of network, we can help. If your doctor is not in network, they may have questions about submitting a claim. Call us at 1-855-406-4062 (TTY: 711), 8 AM to 9 PM ET.
With the Aetna Medicare Advantage plans, you have the option to choose a primary care physician. But when we know who your doctor is, we can better support your care.
Please call us or see your Evidence of Coverage for more information, including the cost share for out‐of‐network services.
The Centers for Medicare & Medicaid Services periodically issues National Coverage Determinations. They issue these when coverage rules change for a service.
We're here to help
${memberhours}.
Members:
Email us or call ${groupPhoneNumber} ${tty}
Not yet a member?
${groupProspectNumber} ${tty}