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COVID-19
We know you have lots of questions about COVID-19. We’re here to support you with answers. Just check these resources to learn more:
General questions
CHIP is a government program that provides no-cost or low-cost health care for children and teens (under age 19) who aren’t eligible for Medicaid. Aetna Better Health® Kids is a managed care organization (MCO) taking part in CHIP. An MCO is the health plan that provides your benefits. MCOs provide health coverage and standard benefits.
People who qualify for CHIP are covered for many benefits and services, like:
- Preventive care
- Vaccinations
- Vision care
- Dental care
- Medications
- Disease management
- Behavioral health services
Learn more about what’s covered
Before you can get coverage, be sure you qualify for CHIP.
After you qualify for CHIP, you can choose Aetna Better Health Kids as your health plan.
Yes, you must renew your CHIP coverage every year. You can find out how to do it.
We want you to be happy with the care you get. So if you’re ever unhappy with your health plan or a provider, you can file a complaint or grievance. To learn more about complaints and grievances, see your member handbook. Or call us at 1-800-822-2447 (TTY: 711).
Tell us. You have the right to report anyone you believe is committing fraud or abuse.
Member Services
You’ll find your health plan summary and benefits info in your member handbook or on your Member Portal or Aetna Better Health app.
Learn more about your Member Portal and app
We’re here for you Monday through Friday, 8 AM to 5 PM. Just call us at 1-800-822-2447 (TTY: 711).
You can also use the Contact us page to get in touch. Or log in to your Member Portal or Aetna Better Health app.
Yes. All members get an Aetna Better Health Kids member ID card in the mail. It’ll be printed with your name and special ID number. It’ll also show your primary care provider’s (PCP) name and phone number.
You have some options if you lose your member ID card. First, log in to your Member Portal or Aetna Better Health app. There, you can:
- Ask us to mail you a new ID card
- Find the electronic version of your ID card — as long as you have your smartphone, you’ll always have your ID card with you for health care visits
Or call us at 1-800-822-2447 (TTY: 711).
My health care providers
Your PCP is a medical provider who will manage your health care. They’re the doctor, nurse practitioner, physician assistant or clinic that provides your main health care. They’ll help you get all the covered services you need.
You can change your PCP through your Member Portal or Aetna Better Health app. You can also call Member Services at 1-800-822-2447 (TTY: 711). This is the number on your ID card.
You can also learn more about choosing a PCP.
Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
Specialists are providers who treat specific conditions. Your PCP might refer you to a specialist in our network. Or they may recommend you see one. Need help finding a specialist? Just call us at 1-800-822-2447 (TTY: 711).
Call the provider’s office and let them know you have Aetna Better Health Kids. This means you shouldn’t get a bill if the service was medically necessary. If you keep getting bills, just call us at 1-800-822-2447 (TTY: 711).
Coverage and care
Whether it’s day or night, your PCP or on-call provider can tell you what to do. If they’re not in the office, leave a message. They’ll return your call. Your provider must see you within 24 hours if you need urgent care.
If you're having an emergency, call 911 or go to the closest hospital.
You’ll only need emergency care if you think your health is in serious danger. Emergencies may include:
- Severe pain
- Serious injury
- Sudden illness
- Illness that is quickly getting much worse
- Heavy bleeding that doesn’t stop, especially if you’re pregnant
If it’s not an emergency, but you need medical advice, call us at 1-800-822-2447 (TTY: 711). Then, choose the option for the 24-Hour Nurse Line. A nurse can help you decide if you need to go to the ER or urgent care.
If you have no way to get to the hospital during an emergency, call 911. We cover ambulance rides on the ground in a medical emergency.
Need a ride to your doctor visits? You can get help with rides to medical services we cover.
We cover rides for your nonemergency medical needs. You can get a ride for visits to your:
- Health care provider
- Dental or vision provider
- Mental or behavioral health care provider
- Pharmacy
If you’re away from home and have an emergency, go to the closest hospital or call 911. The hospital doesn’t have to be in our network for coverage and care.
You can use the provider search tool to find a hospital. Or you can call us at 1-800-822-2447 (TTY: 711) for help.
Post-stabilization services are non-emergency medical services. We provide these services after some medical emergencies. These services can help to stabilize, improve or recover from your condition.
Services are covered both in network and out-of-network. You do not need prior approval (PA).
Pregnant women need special care. Aetna Better Health Kids can assist in scheduling an appointment after a positive pregnancy test (home or lab). Just call us as soon as you can at 1-800-822-2447 (TTY: 711).
You can also visit our health and wellness library to learn more about pregnancy, women’s health and other topics to help keep you healthy.
You’ll want to make sure your baby has medical coverage. If you don’t have insurance when your baby is born, enroll them in CHIP. You can do so by contacting the Pennsylvania Department of Human Services.
If you have questions or need help, just call us at 1-800-822-2447 (TTY: 711).
When you have a condition, you’ll work with your health care provider to set up a treatment plan. The plan will likely include certain steps, like:
- Taking medication
- Making lifestyle changes, like eating and exercise
- Finding emotional support
Some conditions can benefit from disease management, like:
- Asthma
- Attention-deficit/hyperactivity disorder (ADHD)
- Depression
- Diabetes
- High blood pressure
- Nicotine addiction
- Obesity
Do you have one of these conditions? If yes, you may be able to get help from a care manager. You can learn more on our page about disease management. Or call us at 1-800-822-2447 (TTY: 711).
Pharmacy
A formulary is a list of covered medications. The list may come from your state or health plan. These medications treat a variety of conditions. You can learn more on our pharmacy benefits page.
You can ask your provider to:
- Give you a similar medication that is preferred on the list
- Get prior authorization (PA) to cover this medication if they think it’s necessary to treat your medical condition
First, your provider will contact us. Then, our pharmacy staff will review the info your provider gave us. Finally, we’ll make a decision.
Some health care services and supplies need approval before you can get them. We follow nationally recognized guidelines to make these decisions. Before providing a service, your provider must check the list. It may change from time to time. You can learn more about PA.
You don’t need a referral to see in-network providers for routine and preventive health care services.
You do need PA for some health care services and supplies before you get them. We use nationally recognized guidelines to make PA decisions about care your provider suggests.
Your provider must check to see if your service requires PA before they provide it. You can learn more about PA.
We work with the state to set quantity limits for different reasons. Some medications have a maximum limit or dose for safety reasons. Our clinical staff sets the limits based on proven standards of care, such as the U.S. Food and Drug Administration (FDA) guidelines. In some cases, we make exceptions. Have your provider contact us. We’ll review the info from your provider and make a decision. You can learn more about pharmacy benefits.
These types of medications aren’t covered on the formulary:
Cosmetic
Hair growth
Infertility or erectile dysfunction
Experimental or investigational
Your health
Staying active is one of the best things you can do for your health. It can:
- Give you more energy
- Help you feel better
- Prevent some health problems that go along with aging
Some physical activity is better than none at all. But check with your doctor before you start — just to be sure it’s safe. Want to learn more about staying active?
You can learn more about health goals, info and coaching.
You’re not alone. During the COVID-19 pandemic, many people have felt more stress and anxiety than ever. They need more help than usual coping with everyday pressures. Things like job loss, child care issues and other challenges are very real.
Did you know that stress can affect your health? It’s common during times of stress to pick up some unhealthy habits. Don’t be too hard on yourself. It’s not always easy, but you can learn ways to:
- Eat healthy
- Exercise regularly
- Start other healthy habits
Learn more about healthy habits:
- Healthy living resources
- 4 ways to take care of physical and mental well-being during unsettled times
- Staying mentally healthy in tough times
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. Or you can find this info on your Member Portal or Aetna Better Health app.
It may not be easy, but you can stop using nicotine — whether it’s smoking, vaping, chewing or another form. Let’s quit together.
Find more support
You can also learn more about quitting from the:
- American Cancer Society’s guide to quitting smoking
- Great American Smokeout® event
- Centers for Disease Control and Prevention at 1-800-QUIT-NOW (1-800-784-8669)
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
Learn more about substance use and mental health issues from the:
- Alcoholics Anonymous® website
- Substance Abuse and Mental Health Services Administration (SAMHSA) website
And be sure to check out even more mental and behavioral health resources.
Your PCP can give you more personal help and treatment. Be sure you know who your PCP is and make an appointment today. Your ID card will have your PCP’s name and phone number. You can also find this info on your Member Portal or Aetna Better Health app.
If you have thoughts of harming yourself or others, get help right away. You can call:
- Our crisis line: 1-800-822-2447 (TTY: 711)
- The National Suicide Prevention Lifeline: 988
And be sure to check out even more mental and behavioral health resources.
The Great American Smokeout is a registered trademark of the American Cancer Society, Inc.
Alcoholics Anonymous is a registered trademark of Alcoholics Anonymous World Services, Inc.
Questions?
Just call Member Services at 1-800-822-2447 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.