AAP Dental Election Form - Aetna Preview on Page 1

AAP Dental Election Form - Aetna 2026

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Click ‘Get Form’ to open the AAP Dental Election Form - Aetna in the editor.
Begin by entering your Social Security Number and Member ID Number in the designated fields. This information is crucial for identifying your account.
Select the reason for your application. You can choose to add PPO dental coverage or change existing DMO dental benefits. Make sure to indicate your choice clearly.
List the names of individuals (including dependents) who will be covered under this plan. Ensure that you provide accurate names as they appear on official documents.
Specify the effective date for this plan change, which will take effect on your next billing cycle.
Sign and date the form in the appropriate sections to validate your application before submission.
Finally, choose whether to fax or mail the completed form to Aetna using the provided contact details.

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