[PDF] ExxonMobil Medical Plan: POS II “A” PDF posii_a

1 jan 2017 · Questions: Call 1-800-255-2386 or visit us at www aetna com If you aren´t clear about any of the underlined terms used in this form, see the Glossary 25 co- insurance Not subject to annual deductible for in-network

Incomplete forms will delay payment Send the completed claim form and the bills to: Aetna P O Box 981106 El Paso, TX 79998-1106 If you have questions,

[PDF] Medical Claim Form - Aetna

Medical Benefits – Claim Instructions person submits an enrollment form for insurance or statement of claim containing any materially false information or

[PDF] ExxonMobil Medicare Supplement Plan Claim Form

ExxonMobil Medicare Supplement Plan Claim Form Because this plan supplements Medicare, Aetna cannot process your claim for expenses covered by Medicare unless you have first filed member who has received medical treatment

[PDF] ExxonMobil Dental Plan Claim Form

If you have questions, call Aetna at 800-255-2386 Overseas, call collect 210-366 -2416 Is patient employed? No Yes Name/Address of Employer 4

[PDF] Information on Filing Claims for Reimbursement from Your Pre-Tax

ExxonMobil Medical Plan or the ExxonMobil Dental Plan, you must Spending Account claim form and attach adequate You must submit a claim form for reimbursement For and you or your provider files a health care claim, Aetna will:

[PDF] ExxonMobil Retiree Medical Plan: Aetna Select HMO

1 jan 2017 · ExxonMobil Retiree Medical Plan: Aetna Select HMO If you aren´t clear about any of the underlined terms used in this form, see the Glossary You can view the Lens and frame reimbursement amount per 24-month period

[PDF] ExxonMobil Medical Plan (EMMP) Fully-Insured Health

How the ExxonMobil Medical Plan Fully-Insured HMO Option Works effective the first day of the month following receipt of the forms by Benefits Administration You must Aetna and Cigna are responsible for processing claims and are the