Get Application Form Aetna International Please Read Through The Following Before Completing This

Filling out the Aetna International Application Form is an essential step towards securing your international healthcare coverage. This guide will help you navigate the form efficiently and accurately, ensuring that all required information is correctly submitted.

Follow the steps to complete the application form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Begin by entering your personal information in Section 1, which includes your family name, first name(s), marital status, date of birth, gender, height, weight, industry, occupation, nationality, country of residence, and contact details. Make sure to use BLOCK CAPITALS as instructed.
3. Proceed to Section 2 to list any dependents who will be included in your plan. For each dependent, provide their family name, first name(s), title, date of birth, occupation, nationality, gender, height, weight, and relationship to you.
4. Section 3 requires you to specify your desired commencement date for the policy; keep in mind that this date should not exceed 30 days from the completion of your application.
5. In Section 4, choose the options that best suit your needs. Clearly select your product preference from the list provided, as well as the currency of your policy. Be aware of the different benefit options available.
6. Continue to Section 5 to provide payment details. Indicate your card type, credit card number, cardholder’s name, expiry date, and address. Choose your payment type, whether annual or monthly.
7. Section 6 requires your authorization for recurring transactions. You need to confirm your consent to allow Aetna to charge your card for premiums.
8. Provide details about your usual medical practitioner in Section 7, including their name, address, and qualifications.
9. In Section 8, declare any pre-existing conditions or treatments that may affect your coverage.
10. Section 9 features a medical questionnaire, where you will need to indicate whether any individual included in the application has had recent medical history that could affect coverage.
11. Finally, sign and date the declaration in Section 10. Ensure all provided information is accurate and complete before submission.
12. Once you have filled out all sections, review your form for any errors. You can then save the changes, download, print, or share the completed form as needed.

Start completing your Application Form Aetna International online today!