Helping people find the ideal Medicaid plan for their needs

Not all Medicaid plans are created equal. But according to health care expert Philip Moeller, the options available for Aetna Better Health^® members include “a lot of great choices.”

Aetna Better Health^® Medicaid and duals plans currently serve over 2 million people in 15 states across the country: California, Florida, Illinois, Kansas, Kentucky, Louisiana, Maryland, Michigan, New Jersey, New York, Ohio, Pennsylvania, Texas, Virginia and West Virginia. Every state has different benefits, and we take pride in ensuring that we support local communities with the resources that fit their specific needs. No matter where our members live, Aetna Better Health^® is committed to improving and encouraging the health journeys of those we serve.

Here are a few ways that Aetna’s Medicaid plans are designed to help members get healthy and — just as importantly — stay healthy.

Expansive provider network 

Their care team matters. When making the transition to Medicaid, many members may already have a network of health care providers that they’ve learned to trust and rely upon. And there’s no guarantee that their care team of choice is covered by Medicaid. 

We know that members want to take an active role in choosing who treats them. Each state has detailed provider directories, like this one for New Jersey, which empower new members to become more than passive recipients of their own care. We know the importance of care that is coordinated and close to home, which is why we ensure a provider network that includes an extensive statewide group of doctors, hospitals, medical facilities, federally qualified health centers and urgent care centers, to ensure the right care at the right time for our members. It’s their doctor; they should have a say.

Covered out-of-pocket costs 

Many individuals are rightly concerned about out-of-pocket costs, such as what they pay up front for a doctor’s visit. It’s especially worrying during the COVID-19 pandemic, when individuals, including those without complications or comorbidities, can expect to pay an average of $1,300 in out-of-pocket costs to treat the virus, according to an analysis by the Kaiser Family Foundation.

Fears about medical bills, even with insurance, have kept some people from seeking treatment. According to a recent Gallup and West Health study, one in seven individuals say they avoid seeking medical care because of concerns about costs.

But these costs are usually covered by Aetna Better Health^® plans in most states. “Copays for office visits and drugs are anywhere from zero to a few dollars,” Moeller says. “There is no annual deductible for Medicaid, so you don’t have a big out-of-pocket expense.”

Preventative and wellness benefits 

Many of our plans offer benefits that keep Medicaid members healthy year-round and help them get more out of life. “These are benefits that basically give patients opportunities for wellness and preventative behavior,” says Renee Dua, MD, a physician in Northridge, California, within Aetna’s network of doctors. They could include everything from free or discounted gym memberships to free enrollment in weight-loss programs, home-delivered meals and even nutritional coaching through our partnership with the Metropolitan Area Neighborhood Nutrition Alliance in some states.

“Medicaid is not just about treating you when you’re sick,” says Dr. Dua. “It’s about giving folks the incentives and the tools to stay healthy.” Aetna Better Health^® understands this and provides a variety of options, which vary by state.

Mental health

Whether it’s depression or stress from losing a job, mental health can be a serious concern. But there are Aetna Medicaid benefits that can help. There is a variety of online self-assessment tools, including an Anxiety Check and a Depression Check. These tools can identify the warning signs of mental distress and suggest next steps. And if professional help is needed, members in many states have access to various behavioral health resources, case managers and coverage options, including inpatient, residential and outpatient mental health services. Though coverage and benefits can vary by state, Aetna Better Health^® Medicaid offers a wide range of services for members to address their emotional well-being.

The Aetna Better Health^® website for each state is also a great resource for members to find alternative therapy services available to them. For example, the “Expanded Benefits” for Florida Medicaid members include art therapy and equine (horse) therapy.

Telemedicine and virtual care 

One of our most exciting Medicaid benefits is telemedicine. Especially with the coronavirus, which has caused many people to cancel nonessential medical appointments, telemedicine allows individuals to continue down a path of great health without leaving the comfort and safety of their homes.

Telemedicine even gives Medicaid members more incentives to make smart health choices. “We’re able to do remote monitoring,” says Dr. Dua. She’s the chief medical officer of a company that provides doctor house calls through an app. 

Without leaving their living rooms, members can have a doctor evaluate blood sugar levels, blood pressure, weight and oxygenation levels, among other vital signs. And our 24-hour nurse health line is available to members at no extra cost, so they have access to help any time they need it.

Choosing a Medicaid insurance plan can be confusing and scary, especially in these uncertain times. But Aetna Better Health^® makes it easier for families and individuals to sign up, and also encourages them to make healthier choices in their lives.