Call Member Services
You can call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
What’s covered?
We want to help you live your best life. That’s why we cover services to help you reach your health goals. We have experience that you can count on. And we’re always ready to help you on your path to better health. Check the Summary of Benefits to see an overview of benefits and services offered.
Learn more about your plan
The Evidence of Coverage is a great resource. It has everything you need to know about your health plan. You’ll also find phone numbers, addresses and much more.
More than standard benefits
Living your best life means taking care of the whole you. See all the ways we can support your health, now and in the future. You can enjoy much more than the standard benefits that Medicare and NJ FamilyCare (Medicaid) offers.
You’ll get a preloaded debit card with a $360 quarterly allowance to use toward OTC products and a $400 quarterly allowance for healthy foods and produce. Each benefit will have its own allowance that will be tracked for you.
Your quarterly OTC allowance can be used toward the purchase of covered, plan-approved items through either mail order or in a participating retail store using your preloaded debit card. Unused allowances do not rollover to the next quarter. Mail order items are shipped directly to your home with 2-day shipping. Approved food items can be purchased at approved retail locations or online to help you maintain a healthy diet.
2023 OTC catalog — English (PDF) | Spanish (PDF)
You can get nutritious meals delivered to your home after any inpatient hospital or skilled nursing facility discharge.
Enjoy peace of mind knowing that you can get help in an emergency. You’ll receive an in-home or mobile GPS device with no installation or monitoring fees, available 24 hours a day, 7 days a week.
Each year, thousands of Americans are injured or disabled due to falls at home. To lessen your risk, we’ll give you an annual allowance to purchase approved home and bathroom safety products online or by phone. Products will be delivered to your home at no cost. You may need to assemble and install your products.
SilverSneakers® is a fitness program. Members can use fitness centers and attend classes at no added cost. Find a SilverSneakers spot near you.
It’s never too late to get active with healthy exercise. Your fitness benefit can help improve your overall health. You can also learn to make healthier choices. This benefit includes:
Membership at a fitness club or exercise center through a fitness center network
Orientation to the fitness center and its equipment
Access to the SilverSneakers website and a phone number for customer service and support
At-home fitness kits for members who don’t live near a fitness center that takes part in SilverSneakers or for those who prefer to exercise at home
- Mental Fitness – Topics Include New Skills, Organization, Self Help and Staying Connected
- Health and Wellness – Topics include Cooking, Food & Nutrition, and Proactive Care
- Members can access GetSetUp classes on any device by logging in at SilverSneakers.com.
Need help with non-urgent illnesses and conditions, like allergies, minor injuries or flu? Members have the option to schedule a telehealth visit 24 hours a day, 7 days a week via Teladoc, MinuteClinic Video Visit, or other provider that offers telehealth services covered under your plan.
Members can access Teladoc at Teladoc.com/Aetna or by calling 1-855-TELADOC (1-855-835-2362) (TTY: 711).
Members can find out if MinuteClinic Video Visits are available in their area at CVS.com/MinuteClinic/virtual-care/videovisit.
Do you have questions about your health? Skip the crowded waiting rooms. You can talk to a nurse 24 hours a day, 7 days a week, at no cost to you. They can help you find local providers, understand your medicine and much more. To reach a registered nurse, you can call 1-844-362-0934 (TTY: 711), 24 hours a day, 7 days a week.
Standard benefits in your plan
Your benefits give you all the support you need to reach your health goals.
Need to see a specialist or have an emergency? You’re covered. You can also get vaccinations and services for preventive care.
We also cover Early and Periodic Screening, Diagnosis and Treatment (EPSDT) for members under 21 years of age. EPSDT covers services such as well-child care, preventive screenings, medical examinations, vision and hearing screenings and services, immunizations, lead screening, and private duty nursing services.
Need help finding a provider? You can find a provider online. Or call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
Your behavioral health needs are important to us. Mental illnesses are medical conditions that can disrupt your thinking, feeling, mood and daily functioning. The use of alcohol, some prescription medicines or other drugs may affect your health. So we offer coverage for a variety of services, such as:
Inpatient and outpatient mental health services and substance use disorder treatments
Short-term substance use disorder residential services
Mental health rehabilitation
Need to learn more? Just visit our page on behavioral health.
Under certain circumstances, there may be coverage for limited medically necessary emergency transportation needs.
Your provider may need to send medical orders or help coordinate your rides.
Need help setting up your ride? Just call us at 1-844-362-0934 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week.
Getting routine eye exams is an easy way to keep your eyes healthy. You don’t need a referral when you see a provider in our network.
MARCH Vision manages your vision benefits, including:
Routine and diagnostic exams
Eyeglasses
Contact lenses
Need help finding a provider? You can find one on the MARCH Vision website. Or call us at 1-844-362-0934 (TTY: 711). We're here from 8 AM to 8 PM, seven days a week.
LIBERTY Dental manages your dental benefits. As a member, you’ll get routine and comprehensive coverage for services, like:
Exams
X-rays
Cleanings
Fluoride treatments
Dentures (artificial teeth and gums)
Periodontal (gum disease) services
Fillings
Crowns
We also have providers that can help children who are members of the plan maintain good oral health habits and dental safety. These providers can also treat dental emergencies.
Need help finding a dentist? You can find a dentist online. Or call us at 1-844-362-0934 (TTY: 711). We're here from 8 AM to 8 PM, seven days a week.
As a member, you’ll get coverage for:
Routine and diagnostic exams
Hearing aids, fittings and accessories
Need help finding a provider? You can find a provider online. Or call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
Some conditions call for a little extra care. We can help you manage your condition and live a healthier life. You can get care for chronic conditions like these and others:
Diabetes
Chronic obstructive pulmonary disease (COPD)
Congestive heart failure (CHF)
You can learn more about caring for chronic conditions. Just visit our page on chronic disease management.
Do you need help getting care? Through our care management program, we’ll work with you to help you get the care you need. Care Managers are Nurses and Social Workers who understand your health conditions and help connect you to the right care. A Care Manager can teach you more about your health, help you find a ride to your appointments and more.
Need help or have questions? You can call your Care Manager directly. Or call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 5 PM, 7 days a week.
Need help finding a provider? Just call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
As a member, you’ll get coverage for:
Routine exams
Medically necessary foot care
Therapeutic shoes or inserts for those with severe diabetic foot disease, plus exams for fittings
Need help finding a provider? Just call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
Do you have questions about your health? Skip the crowded waiting rooms. You can talk to a nurse 24 hours a day, 7 days a week, at no cost to you. They can help you find local providers, understand your medicine and much more. To reach a registered nurse, you can call 1-844-362-0934 (TTY: 711), 24 hours a day, 7 days a week.
Need help finding a provider? Just call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
We make it easy to get the medicine you need to feel better. There are no copays or deductibles when your medicine is on our List of Covered Drugs (Formulary), also known as the Drug List. This is a list of the medicines we cover.
If you don’t see your medicine on the list, your Provider will help you find one that’s similar. You can fill your prescription at any pharmacy in our network. To learn more, just call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
Learn more about your pharmacy benefits
Download the list of medicines we cover
Need help finding a provider? Just call us at 1-844-362-0934 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week.
Managed Long Term Services and Supports (MLTSS)
Sometimes, you need extra care to feel healthy. If you meet certain clinical and financial requirements, you may be eligible for MLTSS. Get assistance with everyday tasks like taking a bath, getting dressed, making food and taking medicine. Get care where and when you need it.
Need help with your options? You can get help.
Call the state
Just call your State Health Insurance Assistance Program (SHIP) at 1‐800‐792-8820.
Call Medicare
You can also call Medicare at 1‐800‐633‐4227 (TTY: 1-877-486-2048). Someone can help you 24 hours a day, 7 days a week. Or visit Medicare.gov to learn more.
Members must use participating/network providers, pharmacies, and durable medical equipment (DME) suppliers. No referral is required to receive covered services by in-network providers. Members will be enrolled into Part D coverage under Aetna Assure Premier Plus (HMO D-SNP) and will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which they are currently enrolled.
