Aetna® member benefits and services FAQs

A summary of benefits and coverage (SBC) shows what your plan covers and your share of the costs.

Have insurance through your job, or your spouse’s or partner’s job? Contact the employer’s benefits office. They can give you a summary of benefits.

You may be able to find your summary of benefits online. Log in to your member website.

Aetna plans include extra benefits just for members. These extras can help you save money and feel your best.

Learn about the discounts your plan offers. To get started, log in to your member website.

Once you receive your new ID card, here are your next steps:

Log in to file your claim. We’ll ask you a few questions about your claim. And you can upload your bill.

Rather send a paper copy? Log in to get a medical claim form. Complete and mail it to us at the address on the back of your member ID card.

Don’t have an account? Find a claim form.

Traveling or have an emergency? You may need to use a pharmacy that isn’t in our network. You can file a claim on your member website. Log in to file a pharmacy claim.

Don’t have an account? Find a claim form.

You have options to get the help you need.

For 24/7 self-service

You can log in to your member website and choose “Help” to get phone, email and chat options. You can also find doctors, check coverage, file claims and more.

Don’t have an account? Send us a message on our public form.

For personal service

Call the Member Services number on your ID card. Our reps are ready to help you.

Call our corporate contact center. They can help you with general questions. They can also share contact info for Aetna Member Services.

1-800-872-3862 ${tty}
Monday to Friday, 8 AM to 6 PM ET

If you're a Medicare member, find your plan's contact details. If you’re not a member yet, we can help you find a new plan.

Aetna members get one of the largest nationwide networks of doctors, hospitals and walk-in clinics — plus the convenience of MinuteClinic® locations. You have options to find the care you need.

Find a provider

Have more questions about finding or changing your doctor? Go to our choosing a provider FAQs.

There are two steps to change your PCP:
 

1. Log in to your member website. You can search for a PCP by ZIP code, language spoken and other preferences.
2. Call the toll-free Member Services number on your ID card. We can change your PCP for you or help you choose one that’s right for you.
   

Rest assured — if your PCP is no longer in our network, we can help you find another care provider who’s right for you.

First, log in to choose another PCP who participates with us. We offer an expansive network of doctors to choose from. And you can search by ZIP code, language spoken and other preferences.

Next, call the toll-free Member Services number on your ID card. We can change your PCP for you or help you choose one that’s right for you.

Your member ID card is always available on your member website. When you log in, you can:

• Pull up your digital ID card. You can print it or email it. Your digital ID card is the same as your plastic ID card.
• Request a new ID card. We can send a new plastic ID card to your home.

Need help? Contact us.

To register, have your member ID number handy. You can find this number on your ID card, welcome letter or any EOB (Explanation of Benefits) we’ve sent you.

Create an account

Your member website includes tools and resources to make the most of your Aetna plan.

You can:

• Check coverage and claims
• Find doctors, pharmacies and hospitals
• Manage prescriptions
• Estimate costs
• Access your digital ID card, or request a new card
• Take a health assessment

To find even more, log in to your member website.

It’s important to keep your name and address up to date with your health plan.

Here’s how to report a change:

If you have an Aetna plan through your employer: Let your employer know your name or address has changed. Your employer will send this update to us.

If you bought a plan directly from us (not through your employer): Log in to send us your name and address change through the “Contact Us” feature. Or call Member Services at the number on your ID card.

If you bought a plan on the Health Insurance Marketplace®: Contact the plan to update your name and address.

First, contact your past employer’s benefit office. Let them know you’d like to buy a COBRA policy. This lets you continue your health coverage for a limited time. Companies with more than 20 employees need to make you aware of your options for buying this coverage.

Go to COBRA insurance guide

Your child is generally covered for 31 days from their date of birth. To continue coverage, you’ll need to enroll your child within those 31 days. Then pay the plan premium. Guidelines apply.*

You can change your plan, including who’s covered on your plan, during the annual Open Enrollment Period. To get started, contact your employer.

Had a big life event outside the Open Enrollment window, or one coming up? Typically, you can change your plan within 30 to 60 days of:

• Marriage
• Divorce
• The death of your spouse or dependent
• Having a baby or adopting a child
• The start or end of your spouse’s employment
• A change from full-time to part-time employment for you or your spouse
• Unpaid leave of absence for you or your spouse
• Major change in your coverage or your spouse’s coverage (when caused by your spouse’s employment)