A separate Claim Form is needed for each family: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by filling out all sections marked with 'M'. This includes personal details such as the patient's name, Aetna ID number, and date of birth. Ensure accuracy to avoid processing delays.
In the reimbursement details section, select your preferred method of reimbursement (bank transfer or cheque) and provide the necessary banking information if applicable.
Complete the claim details section by entering the date of service, claimed amount, and type of claim. If applicable, check if details are provided by your treating practitioner.
If medical information is required, have your medical practitioner complete that section. This may include diagnosis and treatment details.
Finally, sign and date the authorization in Section 6 to confirm that all information is accurate before submitting your claim along with any required documents.

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