Disclosure Information
Choose the disclosure that applies to your plan
These disclosure documents describe Aetna* health benefits and health insurance plans. Find your plan name. Find your state.
If no state is listed, read the "General" document at the top of the list. State versions apply only to fully insured plans. If your plan is employer funded, read the "General" disclosure at the top of the list. Not sure? Ask your benefits administrator.
Georgia Consumer Choice Unit
Please note that the phone number for the Georgia Consumer Choice Unit has changed. The new number is 1-800-443-6917, Option 5.
Select a disclosure information category
HMO and Aetna Value Network Plans*
New York City Community Plan
Healthy New York Plan
Aetna Voluntary Plans
Innovation Health Disclosures
Elect Choice, Open Access Elect Choice, Aetna Select, Open Access Aetna Select and Aetna Choice POS II plans*
Vision
QPOS* and Managed Choice POS** Plans
Open Access HMO*, Health Network Option*, Aetna Choice POS*, Open Choice PPO*, Open Access Managed Choice** and Student** Plans
New Hampshire (OA Managed Choice and Open Choice PPO)
New York Aetna Health Network Option and Aetna Choice POS plans - English
New York Aetna Health Network Option, and Aetna Choice POS Spanish
New York Open Access HMO and Health Network Only - English
New York Open Access HMO and Health Network Only Spanish
Washington OC, OA MC and Student English
Traditional Choice Indemnity Plan
GA Disclosure Acknowledgement Form
Addendums - If you have a plan in one of the states listed, include this extra disclosure with your main disclosure above.
Important information about how we cover out-of-network emergency care - English
Important information about how we cover out-of-network emergency care - Spanish
MA Disclosure Addendum – Massachusetts Mental Health Parity Laws
MA Disclosure Addendum – Massachusetts Mental Health Parity Laws - Spanish
ME Disclosure Addendum – Your costs when you go outside the network
NY Addendum - Get a review from someone outside Aetna
Aetna Advantage Plans for Individuals, Families and the Self-Employed Disclosures
Arizona Appeals Packets
Generic Dental Disclosures
State Specific Dental Plans
New Jersey Financial Arrangements Flyer
Rhode Island Consumer Disclosures
In accordance with Rhode Island Rules and Regulations for Certifying Health Plans, to follow are documents with valuable consumer information about your health plan. The following documents are provided to prospective and current enrollees via the Aetna.com website or a paper copy can be requested by calling Aetna Member Services at 1-888-982-3862.
The Consumer Rights Disclosure Document contains information about your specific health plan.
Our directory has a list of providers: http://www.aetna.com/docfind/home.do. A paper copy of the directory can be requested by calling 1-888-87-AETNA (1-888-872-3862).
Medical PPO with Pharmacy #155
Related link
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.
Life and Disability
Disability insurance plans/policies are underwritten or administered by Aetna Life Insurance Company (Aetna). Life insurance plans/policies are underwritten by Aetna Life Insurance Company. Material provided is for informational purposes only and is not an offer or invitation to contract. Life and disability insurance plans/policies contain exclusions and limitations. Members should refer to their plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. While this material is believed to be accurate, it is subject to change.
Policy Forms issued in Oklahoma include: #GR-9/GR-9N, GR-29/GR-29N-29N.
