Open Choice PPO

Aetna Claims

The address to which Aetna claim forms should be sent is as follows:

Aetna Inc.
P.O. Box 981106
El Paso, TX 79998-1106

Recourse if a claim is denied

If Aetna denies a claim in whole or in part, the subscriber will receive a written notice from Aetna. This notice will explain the reason for the denial and the appeal procedure. The request for review must be submitted in writing within 60 days of receipt of the notice. The subscriber should include the reasons for requesting the review and submit the request to the Aetna Texas Claim Office. Aetna will review the claim and ordinarily notify the subscriber of its final decision within 60 days of receipt of the request. If special circumstances require an extension of time, notification will be given to that effect.

Time limit for filing claims

Subscribers should note that claims for reimbursement must be submitted to Aetna no later than two years from the date on which the medical expense was incurred. Claims received by Aetna later than two years after the date on which the expense was incurred will not be eligible for reimbursement.