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The Aetna Better Health Kids® difference
You deserve to be as healthy as you can be. That’s why we offer enhanced benefits that take care of the whole you. We have experience you can count on — with a range of services to help you on your health journey. We’ve added some benefits that go beyond your standard health coverage.
We’re excited to share details about your enhanced member benefits for you or your child. Check here often as we’ll continue adding new enhanced benefits throughout 2023.
No-cost over-the-counter (OTC) benefit
Transportation benefit for medical appointments
Need transportation (rides) to and from appointments? We’re here to help. Aetna Better Health Kids has teamed up with Modivcare, a leader in non-emergent medical transportation to better connect you with care at times when you need it most.
More about rides
Tailored meals for children with medical conditions
Aetna Better Health Kids has partnered with MANNA to provide a series of meals that are designed for children and adolescents who can benefit from a medically tailored diet based on certain diagnoses. Some examples are diabetes, hypertension and obesity.
This benefit includes a dietician consultation, dietary education and meal delivery no matter where you live. For more info, call our Special Needs Unit to speak with someone from care management today.
Keeping kids safe medication lockbox
Enhanced dental benefit
In addition to your regular dental benefits, Aetna Better Health Kids now offers members esthetic caps (that look like a real tooth) for children with dental caries of their baby teeth. This can help your child feel better about their appearance. For more info, you can ask your dentist or call us at 1-800-822-2447 (TTY: 711).
Benefits in your plan
Benefits in your plan
Learn about all your plan benefits, from vision and dental care to telehealth, maternity care and help stopping nicotine use. You can learn more about all these topics in your member handbook — English (PDF) | Spanish (PDF).
Those who are eligible for CHIP may enroll in one of three types of coverage: free, low cost or full cost. The coverage type that you’re eligible for will depend on your family’s size and income. You can learn more about your coverage options, premiums and how to pay them, if needed.
Approval for services
Some 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
You can learn more about PA. Just visit our PA page.
You can get a wide range of shots and vaccines. Not only are they a covered benefit, but they can help keep you healthy.
Most members (6 months and older) can get a flu shot every year. Studies show which flu viruses may be the most common during the upcoming season. Seasonal flu shots protect against those three or four flu viruses. Just ask your doctor about getting the shot.
Members can get the recommended vaccine and boosters for the coronavirus (COVID-19). You can ask your doctor about getting this shot. Or check with the Centers for Disease Control and Prevention (CDC) for more info about the COVID-19 vaccine.
More info on vaccines
A healthy smile goes a long way. Dental care is part of your overall health. That’s why you should see your dentist every six months.
Check your member ID card from your dental plan. Then, call your plan for answers to questions about care and coverage.
Routine eye exams are an easy way to keep your eyes healthy. We work with Superior Vision to offer you these covered services:
- One routine eye exam every year
- One pair of glasses or contact lenses every year
- Frames (up to $130)
You don’t need a referral to see a provider in the network. Just be sure to show your member ID card at every visit.
Find a provider
To find a vision provider, just visit the Superior Vision website.
We make it easy to get the medications you need to feel better. You may have a copay for those on the formulary. This is a list of medications we cover. If you don’t see yours on the list, ask your provider to find one that’s similar. And you can fill your prescription at any pharmacy in our network.
You deserve to be healthy in body and mind. Your plan covers health for you as a whole person. That includes help with your mental health or substance use. Any covered member can go to any behavioral health provider in our network.
Help in a crisis
Call 988 or go to the nearest hospital emergency room if:
- You have thoughts of harming yourself or someone else
- You have an emergency and need help right now
You can use any hospital for emergency care, even if it isn’t in our network. Just show your member ID card.
You can also call:
- Our Special Needs Unit at 1-855-346-9828 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM. And we can help connect you to the right resources
- The National Suicide Prevention Lifeline: 988
Through this program, children (under age 19) can get full preventive health care services at no cost. This includes preventive health and wellness visits, like:
Eye doctor appointments
Why do these visits matter? They can help doctors treat symptoms before they get worse. And in some cases, they can help prevent health issues before they start.
We can help you and your baby be as healthy as possible. When you let us know you’re pregnant, here are some benefits you’ll enjoy:
Info about healthy pregnancies and baby care
Help from a care manager if you have a high-risk pregnancy
Text4baby™, a text service that sends health tips and reminders
Local community programs and resources
Info about family planning
Stopping nicotine use is hard, whether you smoke, chew, vape or use another method. Most people need help to quit, and we’re here for you.
We offer coverage and extra support toward quitting, including:
- Therapy and/or counseling services
- Medication and products to help you quit
- Info and tools for stopping nicotine use
More resources for stopping nicotine use
- Pennsylvania Free Quitline
- CVS MinuteClinic® Start to Stop® quit program (PDF)
- Asian Smokers’ Quitline
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. A care manager can help you learn more about your health, find a ride to your appointments and more.
Chronic disease management
Some health issues need more care. Our care managers can help you manage chronic conditions like asthma, diabetes, attention-deficit/hyperactivity disorder (ADHD) and more.
If it’s late at night or you can’t reach your PCP, you’re not alone. You can speak with one of our nurses about your health care questions 24 hours a day, 7 days a week. Not sure if you should find urgent care or go to the emergency room? The Nurse Line can help. It doesn’t take the place of your PCP, so be sure to follow up later.
If you are age 18, you may be eligible to get a smartphone with an Android™ platform and Assurance Wireless Lifeline cell service at no extra cost. If you already have Lifeline, you can switch to Assurance Wireless. You’ll get:
- A smartphone with an Android platform
- Data each month
- Unlimited texts
- Voice minutes each month
- Health tips and reminders by text
- One-on-one texting with your health care team
- Calls to Member Services that won’t count against your monthly minutes
Other language and format needs
- Interpreter services at no cost during any service or complaint process, including American Sign Language and real-time oral interpretation
- Interpreter services for your medical visit (be sure to call 48 hours before your visit)
- Info in another format, like audio CD-ROM, large print and braille
- Materials in other languages if your primary language isn’t English
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