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` Aetna
Application Code Description Submission Information
MA Applies to some Aetna plans
Fax: 1-866-441-2341 or 1-888-665-6296
Email: MedicareEnrollmentTransactions@aetna.com
Mail: Aetna Medicare, P.O. Box 14088, Lexington, KY 40512-4088
NG Applies to legacy Coventry plans moving to Aetna brand and expansion markets
Fax: 1-866-756-5514
Mail: P.O. Box 7405, London, KY 40742
JV Applies to Allina Health | Aetna Medicare and Innovation Health plans
Fax: 1-866-756-5514
Mail: P.O. Box 7405, London, KY 40742
DS Applies to all DSNPs except those in Georgia
Fax: 1-866-756-5514
Mail: P.O. Box 7405, London, KY 40742
US Applies to DSNPs in Georgia
Fax: 1-844-984-0393
Mail: P.O. Box 7083, London, KY 40742

America's 1st Choice

  • Fax: (888) 883-0703

AllWell

  • Fax: (844) 222-3180

CareFree

  • Fax: (855) 301-1569

CarePlus

  • Fax: (855) 819-8679

Freedom

  • Fax: (888) 883-0703

HealthSun

Humana

  • MAPD
    • Fax: (877) 889-9936
  • Med Supp
    • Fax: (877) 889-9936
  • Dental & Vision
    • Fax: (502) 508-6500

MMM

  • Fax: (786) 584-4595

Molina Healthcare

  • Fax: (844) 541-6848

Silver Scripts

  • Fax: (866) 552-6205

Simply Healthcare

  • Fax: (800) 833-8554

Solis

  • Fax: (305) 675-0933

United Healthcare (including AARP, Preferred Care Partners, and Medica Health Plans)

  • MAPD Fax: (888) 950-1170
  • PDP Fax: (888) 950-1170
  • Med Supp Fax: (888) 836-3985

WellCare

  • Fax: (866) 473-9124
  • Part D
    • Fax: (866) 388-1521
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CF290 8/2021
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