Frequently asked questions

Find answers to commonly asked questions

To change your PCP, call Member Services at 1-855-300-5528 (TDD/TTY 711). Or go log into our secure member portal and select My Online Services to change PCPs.

Aetna Better Health of Kentucky will try its best to deal with your concerns or issues quickly and bring about a result that is acceptable. You may use our grievance process or our appeal process, depending on what kind of problem you have.

There will be no change in your services or the way you are treated by Aetna Better Health of Kentucky staff or a health care provider because you file a grievance or an appeal. We will maintain your privacy and give you any help you may need to file a grievance or appeal. This includes providing you with interpreter services or help if you have vision and/or hearing problems. You may also choose someone like a relative, friend or provider to act for you.

To file a grievance or to appeal a plan action, call 1‑855‑300‑5528 (TTY users dial 711, TDD users dial 1‑800‑627‑4702), or write to:

Aetna Better Health of Kentucky
Attn: Complaint and Appeal Department
9900 Corporate Campus Drive
Suite 1000
Louisville, KY 40223
Fax: 1-855-454-5585

When you contact us, you will need to give us your name, address, telephone number and the details of the problem.

Yes. Babies born to mothers enrolled in Aetna Better Health of Kentucky should be automatically enrolled in Aetna Better Health. Please call your local Department of Community Based Services and Aetna Better Health of Kentucky at 1-855-300-5528 (TTY users dial 711; TDD users dial 1-800-627-4702.

Copay is the amount of money a member has to pay when he/she receives a service from a health care provider. Aetna Better Health of Kentucky has reduced co‑pays for 2016. Please review the co‑pay schedule below, which has been updated for 2016.

How copays work

  • Your provider will ask you to pay a copay when you receive care.
  • The pharmacist will ask you to pay a copay when you get your medicine(s).

You will not have to pay copays:

  • For emergency services
  • If you are pregnant
  • If you are a non‑KCHIP (a child who is eligible for Medicaid through income or medical reasons) child under age 19
  • If you are a foster‑care child under age 19
  • For preventative services (Well Child Checkups, shots)
  • For family planning services
  • If you are in hospice care

Limits on Copays

There is a limit on the total amount of copays you will have to pay. You will not have to pay more than 5% of your family’s income each quarter.

We keep track of the copays you pay. When you reach the limit, you will not have to pay any more copays for the quarter. If you pay copay and your family has reached the maximum out‑of‑pocket amount, we will refund the copay to you.

 

If you have questions or need additional help call Member Services. Our Member Services department is here for you. You can call us with questions at 1-855-300-5528 (TDD: 1-800-627-4702 or TTY: 711).

Emergency transportation: Call 911 or the closest ambulance service.

Non‑emergency transportation: Kentucky Medicaid will pay to take some members to get medical services covered by Kentucky Medicaid. If you need a ride, you must talk to the transportation broker in your county to schedule a trip.

Please note: KCHIP III children do not get non‑emergency transportation.

Each county in Kentucky has a transportation broker. You can only use the transportation broker for a ride if you cannot use your own car or do not have one. If you cannot use your car, you have to get a note for the transportation broker that explains why you cannot use your car. If you need a ride from a transportation broker and you or someone in your household has a car, you can:

  • Get a doctor’s note that says you cannot drive
  • Get a note from your mechanic if your car does not run
  • Get a note from the boss or school official if your car is needed for someone else’s work or school
  • Get a copy of the registration if your car is junked For a list of transportation brokers and their contact information, please visit www.chfs.ky.gov/dms/ or call Kentucky Medicaid at 1‑800‑635‑2570. For more information about transportation services, call the Kentucky Transportation Cabinet at 1‑888‑941‑7433.
  • The hours of operation are Monday through Friday, 8 a.m. to 4:30 p.m. ET and Saturday 8 a.m. to 1 p.m. ET. If you need a ride, you have to call 72 hours before the time that you need the ride. If you have to cancel an appointment, call your broker as soon as possible.

Kentucky Medicaid does not cover rides to pick up prescriptions.

You should always try to go to a medical facility that is close to you. But if you need medical care from someone outside your service area, you have to get a note from your PCP. The note has to say why it is important for you to travel outside your area. (Your area is your county and the counties next to it).