CLAIMS & CHARGES
Where can I get a claim form?
Most likely you will not need a medical, dental, or prescription claim form since your doctor or dentist usually files this for you. If you do need a claim form, click on the appropriate link: Forms
Where do I send my claim (medical or dental)?
Send MEDICAL/PHARMACY claims to:
P.O. Box 14100
Lexington, KY 40512-4100
Send DENTAL claims to:
P.O. Box 14094
Lexington, KY 40512-4094
The addresses are also listed on the back of your Member ID cards.
What should I do if Aetna denied my claim?
Call Aetna Member Services at 888-266-5519 (medical) or 877-238-6200 (dental) and discuss with them. They should be able to tell you the reason the claim was not paid (or not paid completely), and what you can do to straighten it out, or how to appeal their decision. Always write down the date and get the name of the person you speak to in Member Services. Please Note: If you discussed your claim with Aetna Member Services and your issue remains unresolved, you may call our Aetna Liaison directly at 800-232-2385 extension 775-0255.
How can I check on the status of my claims?
To check the status of your claims, go to Aetna's website, www.aetna.com, and click on Search all claims. You can also call Member Services.
I got a bill from my doctor and he/she applied the charges to my deductible. I didn't think we had a deductible. What should I do?
If you are enrolled in the Aetna Choice POS II plan and have utilized out-of-network services, the cost for those services will be applied to your annual deductible if that deductible has not yet been met.