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What’s
covered?

This is Aetna Better Health® Kids, a Pennsylvania Children’s Health Insurance Program (CHIP) provider. As an Aetna Better Health Kids member, you’ll enjoy benefits and services that can help you reach your health goals. To learn more, check your member handbook — English (PDF) | 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 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

 

Aetna Better Health Kids members can purchase $30 worth of eligible OTC products each month (that's $360 every year).


You can order online, by phone or in most CVS Health® stores across Pennsylvania.

 

 

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.  

Just call 1-855-346-9828 (TTY: 711).
 

More about MANNA meal delivery (PDF)

Keeping kids safe medication lockbox
 

Locking up medications benefits everyone's health and well-being and can save lives just like helmets and seatbelts. Parents can request a lockbox to secure medication which can help prevent overdoses.  

To find out how you can get your lockbox, just call us at 1-800-822-2447 (TTY: 711).

Sports Physicals

Sports physicals are different than a regular physical. It focuses on reviewing your child's current health status and medical history to ensure that your child is healthy enough to play his or her sport.

 

Each child can get one Sports Physical each year in addition to their covered benefit of an annual physical for each member. Call us to learn more. 

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).

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

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).

 

Costos de CHIP

 

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

You can learn more about PA. Just visit our PA page.

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.

 

Buscar un proveedor

 

Learn about telehealth services

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.

 

Buscar un proveedor

 

More info on vaccines

 

Vaccines for infants and toddlers (PDF)

 

Vaccines for kids and teens (PDF)

 

More about children’s health and wellness

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 $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.

 

Buscar un proveedor

 

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. 

 

Learn 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

 

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: 

 

 

Learn 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? Just 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  

 

Learn 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. Or you can read 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? Just call 1-800-822-2447 (TTY: 711).

 

More resources for stopping nicotine use

 

SmokefreeTXT 

 

The American Lung Association 

 

Guide for stopping nicotine use (PDF)

 

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.   

 

Learn 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.  

 

Learn more about chronic disease management

 

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.

 

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

It’s important to stay in contact with your health care team. And to be able to receive health tips and reminders by text. Need a smartphone? You can get one through Assurance Wireless® Lifeline at no cost to you. Your smartphone will include services, like:
 

  • Unlimited texts
  • 1,000 talk minutes
  • 5GB of data each month
     

To see if you’re eligible for Assurance Wireless, go to Apply for your smartphone.

Apply for your smartphone

 

Other language and format needs

 

Need language help? Just 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 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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