Frequently Asked Questions

We must receive your application form by the last day of the prior month; for example, if you want coverage to begin in October, we must receive your application by September 30. If you don't request a specific date for your coverage, We will assign an effective date of the 1st or the 15th of the month following the approval date of the application form.

As part of the underwriting process we may require your medical records. If we do ask for your medical records, it is your responsibility to facilitate the submission of such medical records to us.

We must receive premium payments no later than the first of the coverage month. For example, for coverage during July, we must receive your payment by July 1.

It's your choice. You may choose to have us send you monthly paper bills, sign up for our EasyPay system, or pay by credit card when enrolling on-line. With EasyPay, your monthly premium will be automatically deducted from your checking account. For more information and the enrollment form, please contact your broker or call us directly at 1-800-MY-Health.

HMO members can contact Aetna at 1-800-435-8742.
PPO members can contact Aetna at 1-866-565-1236.

HMO members can contact Aetna at 1-800-435-8742.
PPO members can contact Aetna at 1-866-565-1236.

Please mail your application form and first premium check to:

Health Coverage Insurance Services, Inc
Aetna Advantage Plans
Po Box 9417
Santa Rosa, CA 95405

You can also fax application to 800-569-1156

Generic drugs are medications that contain the same active ingredients in the same amounts as brand-name products, although generics may be a different color, shape or size. Generic drugs are medications that have been approved by the Food and Drug Administration (FDA) as safe and effective. A generic drug can be substituted for a brand-name drug when rated as an equivalent by the FDA and where permitted by law and the prescriber.

A formulary is a list of preferred medications put together by Aetna to help you to access quality, cost-effective medications. Some of Aetna's prescription drug benefit plans use a formulary. Our Preferred Drug Guide gives information about medications covered under the Aetna Advantage Plans.

A primary care physician (PCP) is trained to manage your entire health care program. Your PCP plays many roles - primary caregiver, health care advisor and consultant, coordinator of specialty care and patient advocate. PCPs can be: 

• Family/General Practitioners (Doctors who treat patients of all ages)
• Internists (Doctors who treat adults and may have a subspecialty)
• Pediatricians (Doctors who treat children)

Maternity benefits are not currently available in most states. Complications of pregnancy are normally covered in most states. A newborn is automatically covered under the policy for 31 days and can be added to the policy during this time.

For specific plan benefits, please use the "Request a Quote" function on the navigation bar.

Yes, dental coverage is offered in certain states. Dental coverage is available only in combination with an applicable medical plan and is never offered as a stand alone product.

Rates for the Aetna Advantage Plan can be modified if such modification is approved by the regulators and we give at least 30 days notice before a rate modification. You will receive notice of the rate change before its application.

Go to the Members & Consumers page on www.aetna.com and select Products & Programs, Health & Wellness, and then Fitness. You will find information on the discount fitness program, including a link to a directory of participating health club locations, as well as general fitness information on Aetna InteliHealth®, our consumer health information website.

The Aetna Advantage plans are voluntary plans that are medically underwritten, they are not conversion plans. If you are interested in an Aetna Advantage plan, you must submit a completed application form and you will be medically underwritten, even if you are covered under an Aetna group plan. If you want a conversion plan from the group plan, such plans are not available in every state so please contact your employer for information.