Forms & Documents

For your convenience we are making our forms, documents, and other literature available online. You may either download selected documents or fill out our online forms below.

Forms to Download Online Forms
Join Today!
Sign up in the Vital Savings by Aetna® program with this form.

Participant Change Form
Make changes to name, address, dependents, and billing information for your Vital Savings by Aetna® account.


Vital Savings by Aetna® Program Brochure
Vital Savings by Aetna® Program Brochure En Español
Download the current brochure of Vital Savings by Aetna® program information. Not for use in Florida or Oklahoma.

Sign Up Online
Sign up in the Vital Savings by Aetna® program, using our secure online form.

Contact Us
Questions or Comments? Let us know!
 


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Vital Savings by Aetna® is not available in Vermont or Montana.

Vital Savings on Pharmacy is not available in Tennessee.

The Vital Savings by Aetna® program (the "Program") is not insurance. The Program provides Members with access to discounted fees pursuant to schedules negotiated by Aetna Life Insurance Company for the Vital Savings by Aetna® discount program. The Program does not make payments directly to the providers participating in the Program. Each Member is obligated to pay for all services or products but will receive a discount from the providers who have contracted with the Discount Medical Plan Organization to participate in the Program. Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825, is the Discount Medical Plan Organization.