Member materials and forms

• Member handbook – English (PDF)
• Social Care Network (SCN) Services – English (PDF)
• Electronic Notice Option – English (PDF)
• Member handbook – Spanish (PDF)
• Social Care Network (SCN) Services – Spanish (PDF)
• Electronic Notice Option – Spanish (PDF)
• Member handbook – Chinese (PDF)
• Social Care Network (SCN) Services – Chinese (PDF)
• Electronic Notice Option – Chinese (PDF)
• Member handbook – Russian (PDF)
• Social Care Network (SCN) Services – Russian (PDF)
• Electronic Notice Option – Russian (PDF)
• Member handbook – Haitian Creole (PDF)
• Social Care Network (SCN) Services – Haitian Creole (PDF)
• Electronic Notice Option – Haitian Creole (PDF)
• Member handbook — Hindi (PDF)
• Social Care Network (SCN) Services – Hindi (PDF)
• Electronic Notice Option – Hindi (PDF)

Directors:

Amy Ovuka - VP, CFO Medicaid
Kevin Nelson - CEO Aetna Better Health of NY
 

Assistant Secretary:

K.C. Barner - Regional General Counsel, Law Local Markets
 

Staff:

Andrea Buck – Chief Medical Officer, Aetna Better Health NY

• Appointment of representative form
• Fair hearing request form
  
• Fraud, waste and abuse form
• 2025 Auth and Appeals Metrics (PDF)

• Healthix flyer (PDF)
• Healthix patient frequently asked questions (FAQs) (PDF)
• Healthix Consent Form (PDF)
• Healthix Consent Form (Spanish) (PDF)
• Healthix Consent Form (Hindi) (PDF)
• Healthix Consent Form (Haitian-Creole) (PDF)
• Healthix Consent Form (Russian) (PDF)
• Healthix Consent Form (Chinese) (PDF)

• Advance directives – English (PDF)
• Advance directives – Spanish (PDF)
• Advance directives – Chinese (PDF)
• Advance directives – Russian (PDF)
• Advance directives – Haitian Creole (PDF)
• Advance directives – Hindi (PDF)
• Advance directives – more languages (PDF)

Health care proxy — English (PDF)

Health care proxy — Spanish (PDF)

Health care proxy — Chinese (PDF)

Health care proxy — Russian (PDF)

Health care proxy — Haitian Creole (PDF)

Authorization to Release Protected Health Information (PDF)

Authorization to Release Protected Health Information — Spanish  (PDF)

Authorization to Release Protected Health Information — Haitian Creole  (PDF)

Authorization to Release Protected Health Information — Chinese  (PDF)

Authorization to Release Protected Health Information — Russian  (PDF)

Authorization to Release Protected Health Information — Hindi  (PDF)

CDPAS MOU Form — English (PDF)

CDPAS MOU Form — Spanish (PDF)

CDPAS MOU Form — Chinese (PDF)

CDPAS MOU Form — Russian (PDF)

CDPAS MOU Form — Haitian Creole (PDF)

CDPAS MOU Form — Hindi (PDF)

• Minimum needs eligibility requirement (PDF)
• Minimum needs eligibility requirement – Spanish (PDF)
• Minimum needs eligibility requirement – Haitian Creole (PDF)
• Minimum needs eligibility requirement – Hindi (PDF)
• Minimum needs eligibility requirement – Russian (PDF)
• Minimum needs eligibility requirement – Chinese (PDF)