This Preferred Provider Organization (PPO) for this plan is Aetna. You are allowed to visit any provider, but if you use an in-network provider, you will pay less money out-of-pocket.
Contact the provider prior to your visit to confirm their membership in the network.
If the Provider does not file the claim directly with Aetna Student Health, then you can file the claim by submitting an Aetna Claim Form along with an itemized bill and proof of payment (if you paid for the service) immediately after treatment to us. Always retain copies for your records.
For prescription drug claims, to receive reimbursement, you will need to submit a claim form and the prescription receipt to Aetna. Fax your completed Aetna Prescription Drug Claim Form and receipts to (888) 472-1128 or mail it to:
Aetna Pharmacy Management
P.O. Box 52444
Phoenix, AZ 85072-2444
Personal health information requests
We need your permission to release your Personal Health Information. Print out the PHI Request 67902-5 form and fax it to
(860) 907-3017 or mail it to:
Aetna Legal Support Services
151 Farmington Avenue, RT65
Hartford, CT 06156-9998