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FormsThe following forms may be useful in managing your health care and transitioning to Aetna. Adobe Reader is required to view and print the forms. If you do not have a recent version of Adobe Reader, you can download it here. Aetna RX Home Delivery FormUse this form to order home delivery of prescription drugs. CIGNA Dentist Nomination Form Use this form to nominate a dentist for recruitment into CIGNA's dental network. Physician Nomination Form Use this form to nominate a physician for recruitment into Aetna's network. Medical Benefits Claim Form Use this form for claims with non-network providers. RX Medical Exception/Precertification Request Form Your pharmacy plan may require precertification before it will pay for certain drugs. That means your doctor must first contact Aetna to get approval before the drug will be covered under your health plan. In addition, if you are denied coverage for a specific drug, your physician may seek a medical exception to allow coverage. Have your physician complete and sign this form when seeking precertification or a medical exception for a specific drug. Transition Coverage Request Use this form to make a formal request of Aetna to cover continuing care from an out-of-network doctor or other health care professionals.
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