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What’s
covered?

This is KanCare (Medicaid) coverage. As a member, you’ll enjoy benefits and services that can help you reach your health goals. To learn more, check your member handbook — English (PDF) | Spanish (PDF).

 

Ready to enroll?

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. You can also view your value added benefits brochure English (PDF) | Spanish (PDF).

Pregnancy and newborn care

Pregnant members are encouraged to make early and frequent prenatal and postnatal visits. The Promise Pregnancy Program includes: A redeemable reward of $75 for a first pre-natal visit within the first trimester or within 42 days of plan enrollment. Earn a $75 gift card by completing a postpartum visit within 84 days of delivery.  Earn a $10 gift card for dental check-up during your pregnancy.

Healthy Rewards

The Healthy Rewards Incentive program is where members can get up to $35 gift cards when they complete wellness activities such as: Vaccines, Yearly check-ups, Diabetic eye exams, HbA1C tests, Chlamydia screenings, cervical cancer screenings.

 

$25 for over-the-counter (OTC) products

Each household can order $25 per month of certain over the counter (OTC) drugs and supplies from an Aetna Better Health catalog. Monthly supplies can be ordered online or by phone and will be mailed directly to the member’s home.

Kids’ after-school activities


Members ages 5 to 18 can get up to $50 per year for activities at participating YMCA, Boys and Girls Clubs, Boy Scouts or Girl Scouts.

 

Questions? You can call us at 1-855-221-5656 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.

Adult dental care

Members 21 and older receive $500 per year for dental services. It can be used for dental exams/cleanings twice each year, annual bitewing X-rays, fillings and extractions and fluoride treatments.

Rides

Free rides for members going to the pharmacy, WIC eligibility appointments and prenatal classes. 12 round trips per year for members going to job interviews, job training, shopping for work type clothing, food bank or grocery store for food, senior services and getting community health services otherwise not covered.

Benefits in your plan

Benefits in your plan

Learn about all your plan benefits, from vision and dental care to telehealth, pregnancy and newborn care and help with rides. You can learn more about all these topics in your member handbook — English (PDF) | Spanish (PDF).

 

 

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

  • The date you got the services

  • The procedures done during the visit

  • The amount your provider billed for the services

  • If your claim is denied 

  • If you owe any money for the services you received

 

Member Portal

 

 

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.

 

 

Members don’t have any copays for the services we cover. If a provider bills you, don’t pay the bill. Just call us at 1-855-221-5656 (TTY: 711).


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
  • Covered

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.

 

Find a provider

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.

 

Learn more about your dental benefits

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.

 

Questions? Just call SkyGen at 1-855-918-2259 (TTY: 711). You can call Monday through Friday, 8 AM to 5 PM (CST). Or, to find a provider, just visit the Vision Provider directory.

 

Vision Provider directory

We make it easy to get the medications you need to feel better.

 

Learn more about pharmacy benefits

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: 

 

  • Us at 1-855-221-5656 (TTY: 711). We’re here for you 24 hours a day, 7 days a week. And we'll connect you to resources for help.

 

Learn about mental and behavioral health care

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  

 

Learn more about pregnancy care

We’ll help you get birth control counseling and supplies. You can see any in-network or out-of-network provider. Any family planning care that you get is private. You can call us at 1-855-221-5656 (TTY: 711) to choose a family planning provider. Or you can read more 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. 

 

Calculator tool

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.   

 

Learn more about care management

 

Chronic disease management

 

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.  

 

Learn more about chronic disease management

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)

  • Dentist appointments

  • 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.

 

Questions? Just call us at 1-855-221-5656 (TTY: 711).

 

More about EPSDT

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.

 

Just call us at 1-855-221-5656 (TTY: 711). Then, choose the option for Nurse Line.

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

  • Unlimited texts

  • Voice minutes each month

  • Health tips and reminders by text

  • One-on-one texting with your health care team

  • Calls to Member Services that won’t count against your monthly minutes

 

Apply for your smartphone

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:

 

  • Doctor visits

  • Dental care 

  • 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.

 

Learn more about rides

 

Other language and format needs

 

Need language help? Just call us at 1-855-221-5656 (TTY: 711). We’re here for you 24 hours a day, 7 days a week. You can get:

 

  • 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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