Disease management

Aetna Better Health offers benefits and services for members based on their individual health care needs.

If you have a chronic condition, Aetna Better Health can help you get care. It is part of your health benefits.  To offer you support, your doctor, hospital discharge planner or other provider may refer you to Care Management. Or a nurse on our health information line may refer you. However, don’t wait for a referral if you need help. You can self-refer by calling us at 866-212-2851 and asking for Care Management. Our care management program includes all levels of care management and assistance to members with the management of chronic conditions (disease management).

If you are identified with a chronic condition, you are automatically eligible to participate in the program.  Some of the services that we offer are

  • Help from our nurses to look at your overall health - we will help you understand the best ways to manage your condition
  • We send you a newsletter twice a year that will have the latest information related to management of your chronic condition
  • Information about online programs that include a health appraisal and  self-management tools

Our disease management program is voluntary. You can stop taking part in the program at any time.  Just call us and let us know.

Aetna Better Health can help you get care if you have asthma. Some people have bad asthma problems and a lot of trouble breathing. Some people have fewer asthma problems and less trouble breathing. Everyone with asthma needs care from a doctor.

We have a disease management program for members with asthma. If you have asthma, tell us and your doctor. If you learn you have asthma from your doctor, tell us. We will work with you to see if you are low risk or high risk for problems.

If you are low risk, we will give you information to help you take care of yourself.

If you are high risk, a case manager will call you to talk about your care. Here are some things the case manager will talk about with you:

  • Taking care of your asthma at home
  • Why taking your medicine is important
  • What causes asthma attacks
  • Why you need to do what your doctor tells you
  • Ways to change your habits so you feel better

It is important to know as much as you can about your asthma. If you want to learn more about Aetna Better Health's disease management program for asthma, call Member Services toll free at 1-866-212-2851. Ask to talk to an asthma case manager. If you have trouble hearing, call Illinois Relay at 7-1-1.

Aetna Better Health can help you get care if you have diabetes. People with diabetes have too much sugar in their blood. If they do not get treatment or care, they could have major health problems such as heart disease and blindness.

Some people have mild diabetes. They take care of it by exercising and eating healthy foods. Other people have more serious diabetes. They have to take shots of a hormone called insulin. Insulin helps your body's cells use food the right way. Everyone with diabetes needs care from a doctor.

We have a disease management program for members with diabetes. Tell us and your doctor if you have diabetes. Call us if your doctor tells you that you have diabetes. We will work with you to see if you are low risk or high risk for problems.

If you are low risk, we will give you information to help you care for yourself. Also, we will work with your doctor to get you the right care.

If you are high risk, a case manager will call you to see if you need more help.

We will teach you about diabetes and help you take care of yourself. You will learn:

  • How to take care of your diabetes
  • How to watch your blood sugar
  • Why you need to take your medicine
  • How to take good care of your feet
  • Why you need to do what your doctor tells you
  • How to learn healthy habits so you feel better

It is important to learn as much as you can about your diabetes. If you want to learn more about Aetna Better Health's disease management program for diabetes, call Member Services toll free at 1-866-212-2851. Ask to talk to a diabetes case manager. If you have trouble hearing, call Illinois Relay at 7-1-1.

Aetna Better Health can help you get care if you have COPD. COPD stands for chronic obstructive pulmonary disease, which is a lung disease. A lot of people can live well with COPD. We can help you live well too.

COPD happens slowly over time. People often will not know there is a problem. COPD makes people’s lungs not work as well as they used to. Some people have worse COPD than others. That is why everyone gets different kinds of treatment. We will work with you and your doctor to find the best treatment for you.

We have a disease management program for members with COPD. Tell us and your doctor if you have lung disease. Call us if your doctor tells you that you have lung disease. We will see if you are low risk or high risk for problems with COPD.

If you are high risk, a case manager will call you to see if you need more help. The case manager will talk to you about not smoking and your treatment. Some people need oxygen, medicines or other care.

It is important to learn as much as you can about your COPD.

If you want to learn more about Aetna Better Health's disease management program for COPD, call Member Services toll free at 1-866-212-2851. Ask to talk to a COPD case manager. If you have trouble hearing, call Illinois Relay at 7-1-1.

Aetna Better Health can help you get care if you have Congestive Heart Failure (CHF). CHF is not a disease. It is a condition that happens when the heart cannot pump enough blood for your body. We have a disease management program for members with CHF.

Everyone with CHF needs care from a doctor. If you do not get care, your heart could get weaker and you will feel very sick. You may even have to go to the hospital.

Many people live very well with CHF. To live well, you must see a doctor regularly and do what the doctor tells you. We will work with you and your doctor to get you the right treatment.

Most people with CHF fit in one of four groups:

  • Group One: A person may not have signs of CHF or heart damage. He or she may have other problems such as high blood pressure, diabetes or blocked blood vessels in the heart. We will teach you ways to live healthier if you are part of this group. This will help you be less likely to get CHF.
  • Group Two: A person's heart has been damaged. The heart is not as healthy as it could be. But the person does not show symptoms of heart failure. Maybe the person has had a heart attack or an infection in the heart. Maybe the heart valves are not working correctly. Your doctor may give you medicine called ACE inhibitors or beta blockers if you are part of this group.
  • Group Three: A person's heart may be damaged, like in group two. The person shows signs of heart failure. We will teach you about having healthier habits if you are part of this group. You will learn about exercise and eating healthy food. Also, your doctor may give you medicine for your CHF.
  • Group Four: This is the most serious group. A person's heart may be getting weaker. It may not be able to pump blood to the body very well. Your doctor may refer you to a heart doctor, or you may have to go to the hospital if you are part of group four.

It is important to learn as much as you can about your CHF. If you want to learn more about Aetna Better Health's disease management program for CHF, call Member Services toll free at 1-866-212-2851. Ask to talk to a CHF case manager. If you have trouble hearing, call Illinois Relay at 7-1-1.