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Disclosure Information

Consumer disclosures for health, dental & vision plans

The drop down lists below contain documents that describe many types of Aetna health, dental and vision plans.

  • Find a category below based on your plan type.
  • Click to expand the list.
  • Select the document for your state, or select the “General” document if your state is not listed.
  • Check also the Addendum category to see if any new or additional disclosure content applies for your state (fully insured plans only).

Directory of Aetna company names, by state

Women's Health & Cancer Rights Act

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

  • All stages of reconstruction of the breast on which the mastectomy was performed
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance
  • Prosthesis
  • Treatment of physical complications of the mastectomy, including lymphedema

Benefits will be provided to a person who has already undergone a mastectomy as a result of breast cancer while covered under a different health plan. Coverage is provided in accordance with your plan design and is subject to plan limitations, copays, deductibles, coinsurance and referral requirements, if any, as outlined in your plan documents. For more information, please contact Member Services at the number on your ID card, or the links below.

Centers for Medicare & Medicaid Services fact sheet
Facts about breast reconstruction after a mastectomy

Do you need help in another language? 

Most drop-down lists below have a flyer that can help you. In some cases, the information is within the full disclosure documents.

Do you have a group plan?

If you have insurance through an employer, you are part of a group plan. Group plans may be:

  • Fully insured – these plans are offered, underwritten and administered by Aetna.
  • Self-funded – Aetna provides administrative services only.  

Contact the employer’s benefits office if you are not sure which type of plan you have.

National Committee for Quality Assurance (NCQA)

We follow health plan accreditation standards of NCQA and offer you quality health plans.

This document details how to:

  • Understand your health plan
  • Get plan information online and by phone
  • Know the costs and rules for using your plan
  • Understand your rights and responsibilities

NCQA standards – English

NCQA standards – Spanish

Group self-funded medical plans

Group HMO (fully insured)

Group QPOS? and Managed Choice? POS (fully insured)

Group PPO, Aetna Open Access?, Aetna Student, Med Premier (fully insured) - (Aetna Choice? POS; Aetna Choice POS II; Aetna Open Access Elect Choice? EPO; Aetna Open Access? HMO; Aetna Open Access Managed Choice?; Health Network Only; Health Network Option; Open Access Aetna Select?; Open Choice? PPO [For Aetna Student and Med Premier, use Open Choice PPO.])

Group Traditional Choice? Indemnity (fully insured)

Group Innovation Health medical plans

Group dental plans

Vision plans

Addendums (including Arizona Appeals packets)

Note about employer-funded plans: State mandates do not apply to self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefits administrator. Specific plan documents supersede general disclosures contained within, as applicable.

Managed Plans offered by HMO entities are: Aetna Health Network OnlySM, Aetna Primary Care? Plan HMO, Aetna Health Network OptionSM, Aetna Open Access? HMO, Aetna Choice? POS and QPOS?.

Managed Plans offered by Aetna Life Insurance Company are: Managed Choice? POS, Aetna Choice? Plan POS, Aetna Open Access? Managed Choice, Open Choice? PPO, Aetna Choice? Plan PPO, Aetna Open Access? Elect Choice, Aetna Choice? POS II, Aetna SelectSM and Open Access Aetna SelectSM.

Dental plans are offered, underwritten or administered by: Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna Life Insurance Company (Aetna), Aetna Dental Inc., and/or Aetna Dental of California Inc.

Policy Forms issued in Oklahoma include: #GR-9/GR-9N, GR-29/GR-29N-29N.

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