Medicare Supplement Plans And Features | Coverage And Rates | Eligibility | Enrollment

How To Enroll

If you wish to enroll after reviewing the Aetna Individual Medicare Supplement Plan^SM insurance policy*, underwritten by Aetna Life Insurance Company (Aetna), as well as information about rates, co-payments and benefits for your state, please follow the steps below:

1. Open and print the Application for your state.



2. Open and print the Notice to Applicant Regarding Replacement of Medicare Supplement Insurance for your state.



3. Complete both the Application and Notice to Applicant forms.



4. Write a check for your first month's premium made payable to Aetna Life Insurance Company.



5. Mail:
   1. the completed Application for your state,
   2. Notice to Applicant for your state, along with
   3. your check to:

Aetna Individual Medicare Supplement Plan
Aetna Administrator
PO Box 10374
Des Moines, IA 50306-9500

*The Aetna Individual Medicare Supplement Plan is administered by Seabury & Smith.

Aetna Individual Medicare Supplement Plan Application
To open and print the application for your state, please:

1. Select your state.
2. Click "Go" to open the document.

The following documents are provided in Adobe PDF format. 

Notice to Applicant Regarding Replacement of Medicare Supplement Insurance
To open and print the Notice to Applicant for your state, please:

1. Select your state.
2. Click "Go" to open the document.

The following documents are provided in Adobe PDF format. 

You will have 30 days to review the policy for the Aetna Individual Medicare Supplement Plan you select. If you change your mind, simply return the policy within those 30 days for a refund of your plan premium.

Electronic Funds Transfer (EFT)
After enrolling, if you wish to have your monthly premium automatically deducted from your checking account or charged to your credit card, please print and complete our Electronic Funds Transfer (EFT)  form and mail it to:

Aetna Administrator
P.O. Box 10425
Des Moines, IA 50306-9011

Electronic Funds Transfer (EFT) Form  (2 pages)

Contact Us
Questions? Call us at 1-800-345-6022 (TDD 1-800-628-3323) Monday - Friday, 8:00 a.m. - 6:00 p.m. Click here for general Medicare information contacts.