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    • Aetna Better Health® Kids

    What's covered?

    Apply or renew

    For members

    Health and wellness

    What’s covered?

    This is Aetna Better Health® Kids coverage. As a member, you’ll enjoy benefits and services that can help you reach your health goals. To learn more, check your member handbook:

     

    Member handbook – English (PDF)

    Member handbook – Spanish (PDF)

    Ready to enroll?

    The Aetna Better Health Kids® difference

    You deserve to be as healthy as you can be. That’s why we offer the support and tools you need to be your healthiest, bringing together what matters most to your health. It’s care you can trust. And experience you can count on — with extra 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 the year. 
       

      Go Get Active: $100 for programs and activities
       

      Receive $100 on a reloadable card to use toward healthy programs and memberships for children. You can use the money on the card to pay for activities and places, like:

      • After-school programs and sports

      • Clubs and memberships, like Boy and Girl Scouts

      • Gyms, bowling alleys, dance studios and the YMCA 

      • Parks, aquariums, museums and tourist attractions

      How to ask for your reloadable card: Call us at 1-800-822-2447 (TTY: 711). You can also call your care manager at 1-855-346-9828 (TTY: 711).

       

      More about Go Get Active (PDF)
       

      $30 over-the-counter (OTC) monthly benefit
       

      You should have everything you need to help you feel your best. That’s why we’re working with CVS Health® to give you $30 of OTC health supplies and products. And we'll send it to you every month at no extra cost.  

       

      More about your $30 OTC benefit
       

      Maven: 24-hour pregnancy and postpartum support  
       

      Whether you are pregnant or a new mom, this program is here for you. At any time, you can get help with:

       

      • Unlimited online appointments and messages with doctors

      • Providers and how to find the right one

      • Trusted resources like articles and parenting classes 

       

      The program also offers you support and answers for other things, like:

       

      • Your mental health

      • Concerns about your pregnancy 

      • Questions as you recover from birth

      • Learning more about your baby’s milestones

      • Breastfeeding or formula feeding

       

      Join Maven now
       

      Nonemergency rides  
       

      Need help with getting transportation (rides) to and from appointments? We work with Modivcare to give you nonemergency rides to health care visits. 

       

      More about rides
       

      Medically tailored meals
       

      We work with MANNA to offer medically tailored meals to children who have chronic conditions, like diabetes, hypertension and obesity. This benefit includes support and guidance from a dietitian and meal delivery to wherever you live. For more info, you can talk with a care manager from our Special Needs Unit. Call 1-855-346-9828 (TTY: 711).

       

      More about MANNA meal delivery (PDF)
       

      Pyx Health: support for mental health and loneliness  
       

      If you’re feeling lonely, anxious or depressed, you can turn to Pyx Health for help. This app will connect you to trained staff who can offer you resources and judgement-free support. 

       

      You can download the Pyx Health app for iPhone® or Android™.

      Medication lockbox

      Having a medication lockbox allows you to store your medicines safely and securely, which can help prevent overdoses. To find out how you can get your lockbox, call us at 1-800-822-2447 (TTY: 711).
       

      Sports physicals

      A sports physical is different from a regular physical. It focuses on reviewing your child's current health status and medical history to ensure they’re healthy enough to play their sport. Each child can get one sports physical each year in addition to their covered benefit of an annual physical for each member. 
       

      Enhanced dental benefit

      This enhanced benefit goes beyond your standard dental benefits. We offer 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 smile. For more info, you can ask your dentist or call us at 1-800-822-2447 (TTY: 711).

      Enhanced vision benefit

       

      Members can get up to $180 applied toward the purchase of fashion frames. Just ask your child’s eye doctor for details. You can use this extra benefit once each calendar year.

    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.

     

     

    CHIP costs

     

    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.   

     

    More about CHIP costs

     

    Copays

     

    You may have a small copay for some services or prescriptions. If you’re unsure, you can check with Member Services. Just call us at 1-800-822-2447 (TTY: 711).  

     

    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
    • Covered

    More about PA

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    • We take care of the whole you. That means you’re covered if you need to see a specialist, have an emergency or plan to start a family.

       

    • You can get a wide range of shots and vaccines. Not only are they a covered benefit, but they can help keep you healthy. 

       

      Flu

      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.

       

      COVID-19

      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.

       

      Find a provider

       

      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.

       

      More about dental care

    • 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 $180)

      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 medicines you need to feel better. You may have a copay for those on the  formulary. This is a list of medicines we cover. Don’t see yours on the list? Ask your provider to find a similar medicine. And you can fill your prescription at any pharmacy in our network. 

       

      More about pharmacy benefits

    • 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

       

      No matter what time of day, you’re not alone. We have resources in place to help you in a crisis or mental health emergency. This includes thoughts of harming yourself or others. Here are some options for help:

       

      • Call our Special Needs Unit at 1-855-346-9828. We’re here for you Monday through Friday, 8 AM to 5 PM. And we can help connect you to the right resources. 

      • Call 911 or go to the nearest hospital.

       

      You can use any hospital for emergency care, even if it isn’t in our network. Just show your member ID card.  

      More about mental and behavioral health care

    • 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:

       

      • Annual checkups
      • Dentist appointments
      • 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.

       

      Questions about this program? Call us at 1-800-822-2447 (TTY: 711).

    • 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  

       

      More about pregnancy care

    • We’ll help you get birth control counseling and supplies. You can see any in-network or out-of-network provider. Any family planning care that you get is private. You can call us at 1-800-822-2447 (TTY: 711) to choose a family planning provider.

       

      More 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

       

      Questions? Call 1-800-822-2447 (TTY: 711).

       

      More resources for stopping nicotine use

       

       

       

    • 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.   

       

      More about care management

       

      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.  

       

      More about chronic disease management

       

      You can decide to take part or not take part in care mangement or chronic disease management at any time. Just let your care manager know. Or call us at 1-800-822-2447 (TTY: 711).

    • 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.

       

      Call us at 1-800-822-2447 (TTY: 711). Then, choose the option for Nurse Line.

    • 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

     

    Other language and format needs

     

    Need language help? Call us at 1-800-822-2447 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM. You can get:

     

    • Interpreter services at no cost during any service or complaint process, including American Sign Language and real-time oral interpretation
    • Interpreter services for your health care visit (be sure to call 48 hours before your visit)
    • Info in another format, like audio, large print and braille
    • Materials in other languages if your primary language isn’t English

    Legal notices

    Aetna is part of the CVS Health® family of companies.

    All trademarks are the property of their respective owners.

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