What’s covered?
This is HealthChoice Illinois 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:
The Aetna Better Health® 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.
In 2024, we've added free meal delivery programs with personal nutrition and dietitian services when you qualify. Eligible members may qualify for baby supplies, too. Enjoy $45 each month to spend on things, like diapers, a car seat, portable crib or highchair.
Aetna® Better Care Rewards
You can earn rewards by being healthy. We’ll reward you when you do things like going to your yearly wellness visit or telling us if you’re pregnant. You can learn more about our Aetna Better Care Rewards below.
FREE fitness and weight management tools
Eligible members can get a voucher for monthly memberships at participating gyms. Ages 13 and up can receive a digital membership, ages 18 and up can receive a digital or in-person membership.
Eligible members ages 18 and up can receive a voucher to cover weight management app membership. To qualify for gym and weight management benefits, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Fill out a member marketing consent
Eligible members ages 18 and up can get personal nutrition counseling services. You may also get food assistance. To qualify, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Have a diagnosis of either Diabetes Mellitus (type 2), congestive heart failure or chronic kidney disease (stage 3-5)
Free kids clothing
Need new clothes for school? Eligible members in grades K through 12 (ages 5 through 18) can get a voucher for clothing through select online retailers. To qualify, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Be up-to-date on all immunizations
Free educational support
Eligible members ages 18 and up can receive career training, skill building and GED support through CampusEd. To qualify, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Fill out a member marketing consent
Reminder: The after-school care benefit was discontinued effective December 31, 2023.
Free behavioral health wellness app membership
Eligible members ages 12 and up can receive a voucher to cover behavioral health wellness app membership. To qualify, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Fill out a member marketing consent
Free baby essentials
Eligible pregnant members can receive a car seat or highchair OR play yard, plus a diaper bag. To qualify, members need to:
- Complete a health risk screening
- Complete 1 prenatal appointment within first four months of pregnancy; or for new enrollees, 1 prenatal visit within 42 days of enrollment
Eligible members can receive a voucher for up to $45 a month to spend on diapers for each child ages 2.5 years (30 months) and under. To qualify, members need to:
- Complete a health risk screening
- Complete an annual wellness visit
- Be up-to-date on all immunizations
Benefits included in your plan
At Aetna Better Health of Illinois, we take care of the whole you. No matter where you are on your path to better health, we’ve got your back. That means you’re covered if you need to see a specialist, have an emergency or are planning to start a family. We also offer a wide range of preventive care services and vaccinations.
Do you have questions about your health? Skip the crowded waiting rooms. You can talk to a nurse 24 hours a day, 7 days a week, at no extra cost to you. They can help you find local doctors, understand your medicine and much more. Just call your local Member Services number, and they’ll connect you with a registered nurse. To reach a nurse, you just need to call 1-866-329-4701 (TTY: 711) and press #2 then press #6 in order to get to the nurse line.
A healthy smile goes a long way. Dental care is an important part of your overall health. Your dentist can prevent unwanted pain and infections when you go to your covered checkups twice a year.
Oral care tips — Adults (PDF) Spanish (PDF) | Children (PDF) Spanish (PDF)
With Aetna Better Health of Illinois, you’re covered to see DentaQuest providers in our network. If you need help finding a dentist, you can call Member Services. Or search for one with our find a provider tool.
Don’t lose sight of what matters most. Going to routine eye exams is an easy way to keep your eyes bright and healthy. We cover one vision exam each year. If you need glasses, we’ll cover your frames and lenses. We’ll even help you pay for contact lenses if you prefer them. Get the most from our vision services for children and adults. If you need help finding a vision provider, you can call Member Services. Or search for one with our find a provider tool.
We make it easy for you to get the medicine you need to feel better. There are no copays or deductibles when you see your medicine on our preferred drug list. A preferred drug list is a list of covered medications. And if you don’t see your medicine on our preferred drug list, your doctor will help you find one that is similar. You can fill your prescription at any pharmacy in our network. Or we can conveniently mail your medicine to you.
When you’re not quite feeling like yourself, we’re here for you. Your mental health is important for your overall health. That’s why we cover a variety of mental health services. We have great benefits that extend to people who need:
Counseling
Substance use disorder services
Inpatient mental health
Mental health drugs
Sometimes, you need a little extra help getting to and from your doctor appointments. We can help you get a ride. Ambulance rides are always covered in an emergency. We also cover rides to doctor appointments and pharmacies. To schedule a ride, call Member Services at least two (2) business-days in advance.
Transportation benefits — English (PDF) Spanish (PDF)
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
- 4.5 GB of data each month, all on the T-Mobile Network
To see if you’re eligible for Assurance Wireless, go to Apply for your smartphone.
Apply for your smartphone
We can help you get the care you need over the phone or at your home. Our Community Health program can help you with things like:
Choosing a doctor
Using your benefits
Getting preventive care and screenings
Accessing community social services programs for food, housing or clothes
Are you expecting a child? We’ll help you stay healthy during your pregnancy. Our programs will help you get the care and services you need. You can read more about our pregnancy program on our website. Or call Member Services.
The EPSDT program helps you and your loved ones 21 years or younger get care. It covers preventive health and wellness visits — like doctor and dentist appointments — at no cost to you. The EPSDT program also covers the following treatment of any problems found during a visit:
• Medical checkups
• A general physical exam and assessment of your child’s growth and development
• An assessment of your child’s mental/behavioral health
• An assessment of your child’s nutrition
• Lab tests, including testing for lead
• Vaccines when they are needed
• Vision screenings, diagnosis and treatment, including eyeglasses
• Hearing screenings and services, diagnosis and treatment, including hearing aids
• Referrals for other medically necessary services
• Dental services, including treatment for pain and infections, restoration of teeth and maintenance of dental health
• Medically necessary treatment to treat any problems found during a well- child visit (some of these services may require prior authorization)
You can learn more about EPSDT benefits in the Member Handbook or call Member Services with any questions 1-866-329-4701 (TTY:711).
Get everyday health care products at no cost. As part of your Aetna Better Health® of Illinois plan, your household has a $25 monthly allowance to spend on over-the-counter (OTC) health care products.
Vaccines help prevent many illnesses and certain types of cancer. A vaccine works with your body’s natural defenses to build immunity against a virus or another source of illness.
Vaccines should be part of wellness checkups at your doctor’s office. Many vaccines can also be given at an in-network pharmacy.
Learn about the vaccines children and adults should have. Ask your doctor about getting up to date. Remember that recommended vaccines are covered at no cost to our members — from early childhood to adult.
Do you qualify for more services?
Do you qualify for more services?
Do you or a loved one need extra care to feel healthy? You may be eligible for our long-term care program. Get care where and when you need it. Our care managers will be there to help you every step of the way on your path to better health. You can learn more about our wide range of long-term care services, like assisted living, meals and rides. We also offer long-term care services for children with special needs. They may even be able to keep going to the doctor they see now. You can learn more about these programs below.
Waiver services
Waiver services
Waivers help you get more benefits and let you live more independently. If you’re elderly, had a recent accident or have a chronic condition, you may qualify for waivers. You can learn more about waiver services below.
How to use your benefits
As an Aetna Better Health of Illinois member, you can choose who you see for your health care needs. You can choose anyone from our strong network of providers. You can find a provider near you online. Or call Member Services for more information.
Other language and format needs
Interpreter services are provided free of charge to you during any service or grievance process. This includes American Sign Language and real-time oral interpretation.
If you need something translated into a language other than English, please call Aetna Better Health of Illinois. We can also provide materials in other formats, such as braille, audio CD or large print.
If you need an interpreter for your medical appointment, contact Aetna Better Health of Illinois 48 hours before your appointment. We will arrange for one to be at your appointment. Just call Member Services.