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What’s covered?
This is Oklahoma SoonerSelect coverage. As a member, you’ll enjoy all the benefits you’re used to plus extras to keep you healthy. Why extras? Because we take care of the whole you. And healthier happens together™.
To learn more, check your member handbook:
The Aetna Better Health®of Oklahoma 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. Learn more about extra benefits. Call us at 1-844-365-4385 (TTY:711).
You can get $150 every two years to cover glasses or contacts. You can also get $75 toward an annual exam.
More about vision
More about vision
You should have everything you need to help you feel your best. That’s why we’re working with CVS Health® to give you $25 of over-the-counter (OTC) health supplies and products. And we'll send it to you every month at no extra cost.
More about your OTC benefit
Alternatives to opioids
Members ages 21 and older with a diagnosis of chronic pain can get $500 to use for:
Acupuncture
Massage therapy
Dry needling
- Yoga
Behavioral health follow-up visit
Members ages 6 and older can get a $20 reward for each follow-up visit completed with a mental health practitioner. Each visit happens within 7 days of an acute behavioral health inpatient hospital stay.
"Keeping Kids Safe" opioid lockbox program
This intervention supports safety with a lockbox to secure medications. It’s for members who have children at home.
MyStrength® Plus program
This program aims to strengthen emotional health in members ages 13 and older through an online platform. The program provides tools and supports for:
Depression
Substance use
Tobacco cessation (quitting)
Pregnancy
Emotional support with Pyx Health®
Pyx Health provides 24/7 digital companionship and support with a mobile platform. Members have direct access to the Pyx Health compassionate support center. Staff have training to support members one-on-one when they show a social need or screen as:
Lonely
Depressed
Anxious
Technology for substance use disorders (SUDs)
This technology platform supports members with mental health conditions and SUDs.
More about mental and behavioral health care
Are you planning to start a family or expecting a child? We’ll help you stay healthy during your pregnancy. Our programs can help you get the care and services you need. And you can earn rewards for making healthy choices.
We want to make sure that women have healthy births. And that new moms get the best care during their pregnancy through extra benefits and rewards.
More about pregnancy care
Get a monthly gift card for up to $45 in diapers for each child in your household up to age 2 and a half.
GO (Get Outside) Initiative
We want to encourage children, youth and families to get outside with the GO/Get Outside initiative. You get $40 each year to use for:
The Oklahoma City Zoo
The Tulsa Zoo
- An Oklahoma state park pass
After-school engagement
Children and youth ages 5 to 18 get up to $50 per year for activities through:
YMCAs
Boys and Girls Clubs
Boy Scouts or Girl Scouts
Sports and after-school programs
Healthy living for children
Children and youth ages 8 to 16 with a diagnosis of obesity can get $50 for:
Home exercise
Sports supplies
After-school programs
They can also get two family nutritional counseling sessions. After completion, you earn a $20 reward for each session. Plus, you qualify for an annual $100 allowance for youth sports and fitness program fees.
Ted E. Bear, M.D.® Cub Club
Our goal is to improve health outcomes through health education and healthy activities. The club provides children up to age 13 with health education about:
Diet
Exercise
Daily hygiene
We create materials for children and offer rewards (such as blankets or dental kits) when they complete:
Challenges
Activities
Program graduation
You have a standard nonemergency medical transportation benefit. This is for rides to your doctor appointments. Your added benefit includes up to 10 round trips per year for other things, like:
Job interviews and training
Shopping for work clothing
Grocery shopping
Senior services
- Other community health services otherwise not covered
Did you know that you can get rewards for taking care of your health? Complete certain healthy steps to claim your rewards. We’ll show you how it works.
More about rewards
Asthma home care
Members with a diagnosis of asthma can get one set of hypoallergenic bedding every year.
Members can also get up to $150 each year for:
Deep carpet cleaning
Pest-control services
Career and GED support
Members age 16 and older can use a job skills training platform to:
Discover career paths
Earn credentials and certifications
Highlight skills to employers
You can also develop trade skills or get your General Equivalency Diploma (GED).
Traditional healing practices
Enjoy up to $400 each year for traditional healing practices if you’re an American Indian or Alaska Native (AI/AN). This is for members who choose these healing methods.
Short-term housing support
Upon discharge from an inpatient treatment facility for substance use, a member may be eligible for funding for short-term housing.
Post-discharge meals
Eligible members can receive medically appropriate meals post-discharge.
Benefits in your plan
Benefits in your plan
Learn about all your plan benefits, from maternity care to mental health. Plus, help to stop smoking and much more. You can learn more about all these topics in your:
You can see any provider in our network. You may be able to keep seeing a provider who isn’t in our network in certain situations:
- For family planning services
- For providers you started seeing before joining our plan
Questions? Call us at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.
SoonerSelect coverage
There are certain services we don’t cover, like acupuncture, chiropractic care or cosmetic surgery. Questions? Check your member handbook. Or call Member Services.
Copays
Some members may have copays for certain health care services or prescription medicines. Services for Early Periodic Screening, Diagnostic, and Treatment (EPSDT) don’t have copays. Questions? Check your member handbook. Or call Member Services.
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
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 have unlimited visits, so you can see your primary care provider (PCP) as many times as you need to — at no cost.
You can also get a wide range of preventive care and vaccines. Start by finding a provider today.
Children have coverage for routine eye exams up to age 21. They can also get two eyeglass frames each year.
Adults over age 21 and under the alternate benefit plan (ABP) have no coverage for routine eye exams. You have coverage to treat medical and surgical conditions only.
Your dental benefits are part of a separate plan. The Oklahoma Health Care Authority has more info about these benefits.
We make it easy to get the medications you need to feel better. You may have a copay for those on our preferred drug list (PDL). 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. You or your child can go to any behavioral health provider in our network.
Help in a crisis
Call 988 if you have a mental health crisis. This is the new number for the National Suicide Prevention Lifeline. Do you have thoughts of harming yourself or someone else? Their trained counselors can help you, 24 hours a day, 7 days a week. You can also chat online with a counselor through their Lifeline Chat service.
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 us at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.
We can help you and your baby be as healthy as possible. We cover routine prenatal services and 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 1-844-365-4385 (TTY: 711) to choose a family planning provider.
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 cover certain nicotine replacement therapy (NRT) products, like:
- Patches
- Gum and lozenges
- Inhalers
- Nasal spray
We also cover eight counseling sessions to help stop tobacco use. To learn more, check your member handbook. Or call Member Services.
If it’s late at night or you can’t reach your PCP, you’re not alone. You can speak with a nurse 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 1-844-365-4385 (TTY: 711). Then, choose the option for Nurse Line.
These are services that help people with everyday activities, like:
Bathing and grooming
Getting into and out of bed
Toileting
Eating
Shopping and errands
Doing laundry
Housekeeping
More about state plan person care services
Children need certain immunizations (shots) to stay healthy. The EPSDT program covers these shots. You’ll want to follow the schedule to stay on track with your child’s health. Call your doctor to ask about which shots your child needs next.
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, chronic obstructive pulmonary disease (COPD) and more.
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
Other language and format needs
Need language help? Just call us at 1-844-365-4385 (TTY: 711). We’re here for you 24 hours a day, 7 days a week. 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, 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.