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If you can't find the form you need below, please log on to your secure member website. Here you will find other forms, specific forms from your employer and general information.

 

Medical, dental & vision claim forms

Health care professionals in our network should file claims for you. (Some who are not in the network may also submit claims for you.) Ask your doctor or other health care professional if you need to submit a claim.

If you get a bill or receive care from a health care professional who is not in the network, and you need to submit a claim, please complete and mail one of the forms below to the address on your ID card.

Authorization to release information

Use this form to give us permission to share information about you (or a dependent) with another person or company. You can also choose the types of coverage for which the permission applies.

Pharmacy forms
Aetna Rx Home Delivery® brochures & order forms
Flexible Spending Account (FSA) forms
Critical illness & accident forms
Massachusetts residents’ tax form
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