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What’s covered?
Aetna Better Health® of Maryland provides Maryland HealthChoice coverage. We offer a wide range of benefits and services to help members reach all their health goals. For complete information, check out our provider manual.
Telehealth services
Teladoc® connects members with licensed doctors in seconds without the hassle of waiting rooms and traveling to appointments. Teladoc lets members video chat with a doctor 24/7, at no extra cost, to treat common issues like the flu, rashes, acne and more. Members can also set up mental health appointments and talk to a therapist. Our goal is to improve:
Access to outpatient specialty care and psychiatric services to prevent hospitalizations and improve diagnostic timing and accuracy
The capacity to choose ongoing outpatient treatment
You can learn more about the telehealth program when you:
The Aetna Better Health difference
At Aetna Better Health of Maryland, we have experience that our members can count on. We help them live their healthiest lives and offer a variety of specialty services to take care of them.
Maternity Matters
If our members are expecting a child, our Maternity Matters Program can help them and their child stay healthy during pregnancy and take care of them after their child is born. They can earn gift cards for going to appointments. If members sign up for the Text4baby service, they'll text free tips and reminders to help them have a safe and healthy pregnancy.
Ted E. Bear, M.D.® kids club
We’ll help members pay for an annual Boy Scouts or Girl Scouts membership. Boy Scouts will get a copy of Boys’ Life magazine. Girl Scouts will get The Girl’s Guide to Girl Scouting. Scouts will also get one Journey book or a basic uniform, six months after they join.
It’s OK if they’re not a scout. We’ll pay for an annual membership at their local YMCA instead (up to $60 per year). And if their child has asthma, we can help them get a second inhaler to take to school.
Asthma care
If members have asthma, they can earn a:
- $10 gift card for managing their asthma by having an asthma action plan
- $10 gift card for going to a follow-up appointment with their primary care physician (PCP) after having an asthma attack
- $10 gift card for completing an in-home environmental assessment
Benefits included in our plan
At Aetna Better Health of Maryland, we take care of our members. They’re covered if they need to see a specialist, have an emergency or are planning to start a family. We also offer a wide range of preventive care services and vaccinations.
Members can skip the crowded waiting rooms and talk to a nurse 24 hours a day, 7 days a week, at no extra cost to them. Nurses can help members find local doctors, understand their medicine and much more. They just have to call Member Services at 1-866-827-2710 (TTY: 711) and say "nurse" to reach a registered nurse.
We make it easy for members to get the medicine they need to feel better. There are no copays or deductibles if their medicine is on our formulary. If they don’t see their medicine on the formulary, you can help them find one that is similar. They can fill their prescription at any pharmacy in our network.
We offer a variety of mental health benefits for our members including:
- Counseling
- Substance use disorder services
- Inpatient mental health
- Mental health drugs
They can use their behavioral health benefits by calling Optum Health at 1-800-888-1965 .
Our members get the vision care they need through Superior Vision. They're covered for:
- An Annual Vision Exam
- Frames and lenses if you're 18 or younger
- An annual $200 benefit towards the cost of prescription glasses or contact lenses.
Members can learn more about their benefits by calling Superior Vision, Monday to Friday, from 8 AM to 9 PM, at 1-800-879-6901 .
Dental care is an important part of your overall health. Dental services are provided by the Maryland Healthy Smiles Dental Program. Visit member.mdhealthysmiles.com or contact Maryland Healthy Smiles member services team at 1-855-934-9812 for assistance with finding a dental provider near you.
Our care management team is made up of care managers. They’re nurses, social workers, licensed counselors and other professionals who understand our members’ health conditions and help connect them to the right care. A care manager can teach a member more about their health, help them find a ride to their appointments and more.
Some diseases call for a little extra care. Our disease management program can help members manage chronic conditions like asthma, diabetes, chronic obstructive pulmonary disease (COPD) and more.
We offer programs that help our members get the pregnancy care and services they need, every step of the way.
Diabetes can be a lot of work to handle alone. Our Diabetes Prevention Program can help members manage their blood sugar. They can go to group meetings and learn more about eating healthy. We’ll also teach members more about exercising and dealing with stress.
To join, members must be at least 18 years old and:
- Be overweight — defined as having a body mass index (BMI) of 25 or more or, if they’re Asian, a BMI of 23 or more
- Have been diagnosed with prediabetes
- Have been diagnosed with gestational diabetes
- Not be pregnant
- Have never been diagnosed with type 1 or type 2 diabetes
If members qualify for our Diabetes Prevention Program, they can:
- Call Member Services at 1-866-827-2710 (TTY: 711)
- Or email our Diabetes Prevention Program
Members may be able to get a nonemergency ride if it’s for a medical reason, such as:
- Getting to doctor visits or physical therapy
- Picking up prescription medicines at the pharmacy
- Going to dental or vision appointments
First, members should check with their local health department to see if they cover these rides. If they don’t, members can just call us at 1-866-827-2710 (TTY: 711). They should call at least 72 business hours before they need a ride.
We make it easy for members to stay in touch with their health. If they qualify, they can get Lifeline cell service and an Android™ cell phone at no cost. This service includes:
- Data each month
- Unlimited texts
- Voice minutes each month
- Health tips and reminders by text
- Calls to Member Services that won’t count against their monthly minutes
- One-on-one texting with their health care team
If members already have Lifeline, they can easily to switch to Assurance Wireless®. This is the federal Lifeline cell phone service provider that Aetna Better Health of Maryland uses
Starting January 1, 2024, Maryland Medicaid is expanding gender-affirming health care services. Maryland Medicaid covers medically needed care that upholds the safety, dignity and respect of transgender and gender expansive people. Gender affirming care is for those who need medical care to make their body match their lived gender. “Gender-Affirming Treatments” are considered medically necessary treatments that are consistent with current clinical standards of care prescribed by a licensed health care provider for the treatment of a condition related to the individual’s gender identity. If you are a health care provider who wants to bill for your services, you must enroll as a participating provider through ePrep, Maryland Medicaid’s online Electronic Provider Revalidation and Enrollment Portal.
How do I get care?
To get Medicaid gender affirming services, you must:
- Be enrolled in Medicaid
- Talk to your health care provider about a diagnosis for care.
- Be able to make fully informed decisions and consent to treatment.
What gender affirming services does Medicaid cover?
- Hormone therapy and lab testing
- Voice surgery, therapy and lessons
- Hair removal and transplants
- Fertility preservation services
- Facial surgery
- Top surgery
- Gender affirming surgery
- Preventative care after transition
- Revision or reversal of prior gender-affirming procedures
Please visit Pages - gac-providers (maryland.gov) for more information.
Population health management programs
Our population health programs can help you live your healthiest life possible. You can get the care you need from our special programs. And get help preventing health issues in the future.
Other language and format needs
Interpreter services are provided free of charge to members during any service or grievance process. This includes American Sign Language and real-time oral interpretation. If members need something translated into a language other than English, they can call us. We can also provide materials in other formats, too. Like braille, audio CD or large print. And if members need an interpreter for their medical appointment, they can call Member Services 48 hours before their appointment, and we’ll arrange for one to be there.
Teladoc is a trademark of Teladoc Health, Inc.
Android is a trademark of Google LLC.