Appeal Process and Denial of Benefits

If the participant believes a claim was improperly settled, please complete the following process:

  1. Within 60 days of receipt of the claim, the participant may request, in writing, that the plan administrator conduct a review of the processed claim. The plan administrator will review the processed claim and inform the participant whether or not an error was made.
  2. If the participant is not satisfied with the above review, a written request for a second review may be submitted to the plan administrator within 60 days of the first review. The request should state, in clear and concise terms, the reason for disagreement with the way the claim was processed. When the written request is received, the claim will be reviewed again and the results of this review furnished in writing to the participant within 60 days in most cases, but no longer than 120 days.

All requests for review of denied claims should include a copy of the initial denial letter and any other pertinent information. Send all information to:

Aetna Student Health
P.O. Box 981106
El Paso, Texas 79998