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The Aetna Better Health® difference
You deserve to be as healthy as you can be. That’s why we offer unique benefits that take care of the whole you. We have experience you can count on — with a range of services to help you on your health journey. We’ve added some benefits that go beyond your standard health coverage. You can check your member handbook (PDF) to see the complete list of additional benefits.
Pregnancy and newborn care
Are you planning to start a family or expecting a child? We’ll help you stay healthy during your pregnancy. Our PROMISE program can help you get the care and services you need. And you can earn rewards for making healthy choices.
Did you know that you can get rewards for taking care of your health? Complete a preventive care action, like a health screening, and you can earn up to $35 in gift cards. Both adults and kids are eligible for rewards. We’ll show you how it works.
$25 for over-the-counter (OTC) products
You can get $25 per month toward some OTC medications and supplies. And we’ll mail them directly to you. Just have your member ID number ready when you place your order.
Kids’ after-school activities
Kids (ages 5 through 18) can get $50 per year toward an after-school program like Boys & Girls Clubs, Boy Scouts, Girl Scouts or Big Buddy. They can also get $50 per year toward swim lessons at participating YMCA™ locations.
Adult dental care
Your dental benefits cover $500 per year toward dental care for things like: exams and cleanings (twice a year) and X-rays and extractions. If you’re part of the frail elderly (FE), physical disability (PD) or intellectual/developmental disability (I/DD) waiver program, you can also get a complete set of dentures every five years.
Need help with getting rides for nonmedical reasons? Along with nonemergency medical rides, you can get unlimited rides to places like the pharmacy, pregnancy care classes and Women, Infants and Children (WIC) appointments. You can also get 12 round trips per year to job interviews and training, grocery stores, other community health services and more.
Benefits in your plan
Benefits in your plan
You deserve to have all the information you need about the service(s) you receive. Your provider will submit a claim to us when you receive your services. And we’ll also share details about these services with you. This is called an explanation of benefits (EOB). You can check them out on your Member Portal.
An EOB will let you know:
How and for what services we paid the claim
La fecha en que recibió los servicios
Los procedimientos realizados durante la consulta
El monto que le facturó su proveedor por los servicios
If your claim is denied
If you owe any money for the services you received
Health literacy matters
What is health literacy? It’s how well a person understands and can use health information and services to make health decisions for themselves.
Many people struggle to read, understand and act on health information. This puts people at risk of not getting the care they need. We want to help our members understand certain health terms to get them on their way to better health.
For a list of health-related words and their meanings, see your member handbook.
What about spenddowns?
If you have a spenddown, the medical card won’t pay your bill until the spenddown amount is met. You’ll need to pay the bills that are being used to meet the spenddown amount. You should not receive a bill for Medicaid-covered services once your spenddown is met.
Some services need approval or prior authorization (PA), before you get them. We base all our decisions on whether the service is:
- Needed for your health
- Likely to help you
You can learn more about PA. Just visit our PA page.
We take care of the whole you. That means you’re covered if you need to see a specialist, have an emergency or plan to start a family.
You can also get a wide range of preventive care and vaccines. Start by finding a provider today.
A healthy smile goes a long way. Dental care is part of your overall health. That’s why you should see your dentist every six months. We work with SkyGen to provide you with your dental and oral health care.
Check your Aetna Better Health member ID card for contact info for your dental plan. Then, call your plan for answers to questions about care and coverage.
Routine eye exams are an easy way to keep your eyes healthy. We work with SkyGen to provide you with vision care and eye health services.
You don’t need a referral to see a provider in the network. Just be sure to show your member ID card at every visit.
You deserve to be healthy in body and mind. Your plan covers health for you as a whole person. That includes help with your mental health or substance use. You or your child can go to any behavioral health provider in our network.
Help in a crisis
Call 988 or go to the nearest hospital if:
You have thoughts of harming yourself or someone else
You have an emergency and need help right now
You can use any hospital for emergency care, even if it isn’t in our network. Just show your member ID card.
You can also call:
We can help you and your baby be as healthy as possible. When you take part in our PROMISE program, here are some benefits you’ll enjoy:
Info about healthy pregnancies and baby care
Help from a care manager
Text4baby™, a text service that sends health tips and reminders
Local community programs and resources
Info about family planning
Stopping nicotine use is hard, whether you smoke, chew, vape or use another method, but you can do it. Most people need help to quit, and we’re here for you.
You can find lots of helpful information from these resources:
See how much money you could save
You can also use a quit calculator tool to see how much you could save if you become nicotine-free.
Do you need help getting care? Our care management team is here for you. Care managers are nurses and social workers who understand your health conditions and help connect you to the right care. A care manager can help you learn more about your health, find a ride to your appointments and more.
Control de enfermedades crónicas
Some health issues need more care. Our care managers can help you manage chronic conditions like [asthma, diabetes, chronic obstructive pulmonary disease (COPD) and more.
Through EPSDT, children under 21 can get full preventive health care services at no cost. This includes preventive health and wellness visits, like:
Annual checkups (Kan Be Healthy)
Eye doctor appointments
Why do these visits matter? They can help doctors treat symptoms before they get worse. And in some cases, they can help prevent health issues before they start.
If it’s late at night or you can’t reach your PCP, you’re not alone. You can speak with a nurse about your health care questions 24 hours a day, 7 days a week. Not sure if you should find urgent care or go to the emergency room? The Nurse Line can help. It doesn’t take the place of your PCP, so be sure to follow up later.
You can get a smartphone with an Android™ platform and Assurance Wireless Lifeline cell service at no extra cost to you. If you already have Lifeline, you can switch to Assurance Wireless. You’ll get:
A smartphone with an Android platform
Data each month
Voice minutes each month
Health tips and reminders by text
Mensajes de texto individuales con su equipo de atención médica
Calls to Member Services that won’t count against your monthly minutes
If you have no way to get to the hospital during an emergency, call 911. We cover ambulance rides on the ground in a medical emergency for all members.
Nonemergency medical rides
If you don’t have a ride to your appointment, we’ll help you get one. These rides are for the medical services we cover, like:
Behavioral health care
You may also get extra help for approved long-distance trips, including coverage for lodging and meals.
To schedule a ride, you can contact Access2Care at 1-866-252-5634. Be sure to schedule a ride at least three business days before you need it.
Other language and format needs
Interpreter services at no cost during any service or complaint process, including American Sign Language and real-time oral interpretation
Interpreter services for your medical visit (be sure to call 48 hours before your visit)
- Info in another format, like audio, large print and braille
Materials in other languages if your primary language isn’t English
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