Get to know your member handbook
Need plan details? Your member handbook has them. Read on to learn what’s inside.
Your member handbook explains your health plan and how to use your benefits.
You can read your handbook online at AetnaBetterHealth.com/<STATE>/member-materials-forms.html.
Want a printed copy? Call Member Services at 1-XXX-XXX-XXXX (TTY: 711). We’ll mail it to you at no cost. Let us know if you need it in another language, a larger font or other formats.
Here's what you'll find in your member handbook:
- What your plan covers, and what it does not
- How to get medicines and use your pharmacy benefits
- Copays and other costs you may pay
- What’s covered outside the Aetna Better Health network
- How to get language help at no cost
- How to ask for auxiliary aids and services at no cost
- How to submit a claim
- How to get info about providers in the Aetna Better Health network
- How to get primary care services
- How to get specialty care, including:
- Behavioral health care
- Hospital services
- Care for specific conditions
- How to get a referral
- How to get care after normal office hours
- How and when to use emergency room care
- How to get care outside of your service area
- How to talk to a care manager
- How to get rides to your appointments
- How to file a complaint or grievance
- How to appeal a decision that affects your coverage, benefits or relationship with your plan
- How we decide which new services or tools we cover
- How we make decisions about your care (called utilization management)
- Your member rights and responsibilities
- Our privacy practices
We update the handbook every year. If we make major changes, we’ll send a letter at least 30 days before we start.
