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Not all forms may apply to your coverage and benefits. To find forms customized for your benefits, log in to your secure member account.

If you have questions about which forms are meant for your use, call the toll-free number on the back of your member ID card.  

Medical, dental & vision claim forms

Pharmacy mail-order & claims

Spending account reimbursement (FSA, HSA)

Critical illness & accident forms

Massachusetts residents: health insurance mandate

Are you a Massachusetts resident? Are you 18 or older? Can you afford health insurance? If you answered yes to all three questions, you must have health coverage according to Massachusetts laws. If you do not, you must pay a penalty through your tax return.

Read more about this requirement

CALIFORNIA GRIEVANCE FORMS

Aetna Health of California HMO has procedures for Members to use if they are dissatisfied with a decision that the HMO has made or with the operation of the HMO.

View more information on how California members can get help 

Tax Form 1095

If you had health insurance coverage at any time in 2016, you will receive a tax form 1095. There are three versions:

1095-A comes from the federal government Federal Exchange Marketplace or state-based Exchange Marketplace.

1095-B comes from your insurance company.

1095-C comes from your employer.

People generally receive only one version, though some may get both a 1095-B and a 1095-C.

See our information about what this form is for, what to do with it, and how to get one if yours is lost or misplaced.

Learn more about your Form 1095

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