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What’s
covered?

We offer a Managed Long-Term Care (MLTC) plan. MLTC covers services for adults (age 21 and up) who need a nursing home level of care. For details, you can check our list of covered services (PDF). Or check your member handbook.

 

Ready to enroll?

The Aetna Better Health® difference

You deserve to get the care you need, no matter what health challenges you face. You can count on our experience and range of benefits for your long-term health needs. You’ll also get your own care management team. They will make sure you get the personal attention and support you need to live safely at home. 

MLTC benefits let you get health care services at home. Depending on your needs, those services can include: 
 

  • Nurse care
  • A home health aide 
  • Nutritional services
  • Social work services
  • Physical therapy
  • Occupational therapy
  • Speech or language therapy

 

To learn more, call Member Services at 1-855-456-9126 (TTY: 711). We’re here for you 24 hours a day, 7 days a week. 

You’ll be assigned a care management team to make sure you get the right care. Your team will include a care manager, a social worker and a care management associate. They’ll know your health conditions and help you with your daily needs.

 

Learn more about care management

Your benefits help you continue to live at home, but you don’t have to be alone. Social day care programs offer a space for regular social time with other adults. You can also get health care, nutrition help, and more while you’re there. 

 

To learn more, just call us at 1-855-456-9126 (TTY: 711). 

You’re covered for any DME needed to treat your health condition(s). This includes devices and other items like:

 

  • Prosthetics and orthotics 
  • Medical supplies like a cane or walker
  • Orthopedic footwear
  • Hearing aid batteries
  • Surgical supplies

You’re covered for routine eye exams, dental checkups and more. Be sure to make regular visits to your dentist and vision care provider. That way they can catch any problems before they become bigger health issues. 

 

Learn more about vision and dental benefits

Benefits in your plan

Benefits in your plan

Learn about all your plan benefits, from vision and dental care to rides and home health services. You can also learn more about all these topics in your member handbook.

 

Spenddown or surplus income program

 

Do you have a Medicaid surplus (also known as a spenddown)? If yes, then you know it is because your monthly income is over the Medicaid income limit. If you have a surplus/spenddown, we’ll send you a letter with more details. We’ll also tell you where to send your payments. 

 

To learn more, just call us at 1-855-456-9126 (TTY: 711).

 

Approval for services

 

All 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

 

Learn more about prior authorization

We’re here to make sure you get the care that’s right for you. Your MLTC plan covers you for certain medical services not covered by regular Medicaid. Depending on your needs, that may include services like:

 

  • Physical therapy
  • Occupational therapy
  • Podiatry (foot) care
  • Outpatient rehabilitation
  • Respiratory (breathing) therapy

 

Find a provider

Vision and dental care are important to your overall health and well-being. That’s why you’re covered for a wide range of vision and dental services. Don’t forget to get regular checkups with your dentist and vision care provider. Just be sure to show your member ID card at every visit.

 

Learn more about vision and dental care 

 

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. They 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 also help you manage chronic conditions including: 

 

  • Asthma 
  • Chronic obstructive pulmonary disease (COPD) 
  • Congestive heart failure (CHF) 
  • Coronary artery disease (CAD) 
  • Diabetes
  • Electrolyte imbalance 
  • High blood pressure 
  • HIV
  • Sepsis (a life-threatening infection) 
  • Urinary tract infection (UTI)

 

Learn more about chronic disease management

 

Special programs

 

These programs can help you live life as healthy as you can. We have special programs and services to help you get the care you need. And prevent health issues in the future.

 

Learn more about special programs

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