Claim Form Aetna Global Benefits 2026

1. Click ‘Get Form’ to open the Claim Form Aetna Global Benefits in our editor.
2. Begin by filling out the Employee Information section. Enter your employer name, employee's full name as shown on your Aetna ID card, identification number, birthdate, gender, address, telephone number, and primary email address.
3. Next, complete the Patient Information section. Indicate the patient's name, relationship to you (self, spouse, child), birthdate, and gender.
4. In the Summary of Medical, Pharmacy, Dental, and Vision Services section, provide details for each service received including dates of service and provider information. Be sure to include any necessary documentation such as x-rays or narratives.
5. Fill out the Claim Information section if applicable. Answer whether the claim is related to a work-related accident or accidental injury and provide relevant details.
6. Complete the Summary of Reimbursement section by selecting your preferred reimbursement method and providing bank information if necessary.
7. Finally, sign and date the Authorization section to authorize payment processing. Ensure all information is accurate before submitting.

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