Consumer disclosures for health, dental & vision plans
These documents describe many types of Aetna health, dental and vision plans.
- Choose a category below to see the documents we have for that category.
- Select the document for your state, or select the “General” document if your state is not listed.
- Choose the Addendum category to see new or additional disclosure content.
Do you have a group plan?
If you have insurance through an employer, you are part of a group plan. Group plans may be:
- Fully insured – these plans are offered, underwritten and administered by Aetna.
- Self-funded – Aetna provides administrative services only.
Contact the employer’s benefits office if you are not sure which type of plan you have.
Aetna Leap and Innovation Health Leap plans
Arizona Open Access HMO English
Arizona Open Access HMO Spanish
Arizona Appeals Packet English
Arizona Appeals Packet Spanish
North Carolina/South Carolina Open Access HMO English
North Carolina/South Carolina Open Access HMO Spanish
Pennsylvania Open Access HMO English
Pennsylvania Open Access HMO Spanish
Aetna Advantage Plans for Individuals
Group self-funded medical plans
Network-only plans English: HMO, Elect Choice® EPO and Aetna Select®
Network-only plans Spanish: HMO, Elect Choice® EPO and Aetna Select®
Point of service plans English: QPOS® and Managed Choice® POS
Point of service plans Spanish QPOS® and Managed Choice® POS
Aetna Open Access, PPO, Aetna Student, and Med Premier plans: Spanish
Group HMO and Elect Choice EPO (fully insured)
Group QPOS and Managed Choice POS (fully insured)
Group PPO, Aetna Open Access, Aetna Student, Med Premier (fully insured) - (Aetna Choice® POS; Aetna Choice POS II; Aetna Open Access Elect Choice® EPO; Aetna Open Access® HMO; Aetna Open Access Managed Choice®; Health Network Only; Health Network Option; Open Access Aetna Select®; Open Choice® PPO [For Aetna Student and Med Premier, use Open Choice PPO.])
New York English Aetna Open Access® HMO; Health Network Only; Health Network Option
New York Spanish Aetna Open Access® HMO; Health Network Only; Health Network Option
Texas Open Access HMO, Health Network Only, Health Network Option, Aetna Choice POS
Texas Open Access Managed Choice, Open Access Elect Choice, Open Choice PPO
Washington English Open Choice
Washington Spanish Open Choice COMING SOON
Group Traditional Choice Indemnity (fully insured)
Innovation Health group medical
Consumer Medical (GA, NY, RI) - Use our online search tool to find health care providers. You can also ask for a printed disclosure or provider list at 1-888-982-3862.
Georgia Consumer Choice – Call the Georgia Consumer Choice Unit at 1-800-443-6917, Option 5
New York City Community Plan English
New York City Community Plan Spanish
Rhode Island Aetna Student Health Version
Group dental plans
Consumer dental plans (Rhode Island only)
Vision plans
Use our online search tool to find vision care providers. You can also request a printed disclosure or provider list by calling 1-888-982-3862.
Aetna Vision Preferred (Use for all states, including Rhode Island commercial plans)
Addendums (including Arizona Appeals packets)
These documents are in addition to the disclosure brochures otherwise posted on this website. State-specific disclosures do not apply to employer-funded plans. Not sure if your plan is employer funded? Ask your benefits administrator.
Aetna Provider Network flyer: How to get the care you need at a lower price
Arizona appeals packet for medical plans underwritten by Aetna Life Insurance Company - English
Arizona appeals packet for medical plans underwritten by Aetna Life Insurance Company - Spanish
Arizona appeals packet for dental PPO plans – English
Arizona appeals packet for dental PPO plans – Spanish
Arizona appeals packet for DMO plans – English
Arizona appeals packet for DMO plans – Spanish
GA Disclosure Acknowledgement Form
New York Addendum Large Group Disclosure Reimbursement examples
New York Addendum Small Group Disclosure Reimbursement examples
Note about employer-funded plans: State mandates do not apply to self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Specific plan documents supersede general disclosures contained within, as applicable.
Managed Plans offered by HMO entities are: Aetna Health Network OnlySM, Aetna Primary Care® Plan HMO, Aetna Health Network OptionSM, Aetna Open Access® HMO, Aetna Choice® POS and QPOS®.
Managed Plans offered by Aetna Life Insurance Company are: Managed Choice® POS, Aetna Choice® Plan POS, Aetna Open Access® Managed Choice, Open Choice® PPO, Aetna Choice® Plan PPO, Elect Choice® EPO, Aetna Open Access® Elect Choice, Aetna Choice® POS II, Aetna SelectSM and Open Access Aetna SelectSM.
Dental plans are offered, underwritten or administered by: Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna Life Insurance Company (Aetna), Aetna Dental Inc., and/or Aetna Dental of California Inc.
Policy Forms issued in Oklahoma include: #GR-9/GR-9N, GR-29/GR-29N-29N.
