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Click ‘Get Form’ to open the Aetna RX Reimbursement Form in our editor.
Begin by entering your Aetna Member Number and Group Number at the top of the form. Ensure these are accurate, as claims cannot be processed without them.
Fill in your personal details, including your name, birthdate, address, and company information. This section is crucial for identifying you as the claimant.
Indicate if you are enrolled in Medicare by checking the appropriate box. Then, provide your spouse or dependent's information if applicable.
In the Pharmacy Information section, enter details for each prescription. Include the date filed, Rx number, medication name, quantity, and price. Make sure to attach detailed receipts for processing.
Complete any additional fields regarding coordination of benefits and reasons for manual filing if necessary.
Finally, sign and date the form before submitting it to Aetna Pharmacy Management at the provided address.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (20 Votes)
2014	4.4 Satisfied (60 Votes)
2007	4.4 Satisfied (71 Votes)

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How long does it take to get reimbursement from Aetna?

Aetna to halt paper checks and remittances by September 2022.

Does Aetna insurance pay for prescriptions?

Aetna prescription plans cover thousands of drugs. To find a list of commonly covered drugs, youll need the pharmacy plan name.

Does Aetna do direct deposit for claims?

An Aetna HealthFund Health Reimbursement Arrangement (HRA)* gives you access to quality care. And it helps you stretch your health care dollars. Our HRA combines an Aetna health insurance or benefits plan with a fund paid for by your employer. This fund helps you pay eligible out-of-pocket health care costs.

Does Aetna send a check?

Make changes online quickly and easily on your secure Aetna member website! Now you can enroll, change or cancel your direct deposit account information online so your account reimbursements are automatically deposited into your bank account.

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