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What does CHIP cover?
Children’s Health Insurance Program (CHIP) and CHIP Perinatal are for members living in the Tarrant and Bexar service areas. CHIP offers coverage for families that earn too much money to use Medicaid, but can’t afford to buy private health insurance. CHIP Perinatal offers coverage for mothers-to-be. As a member, you’ll enjoy benefits and services that can help you reach your health goals.
Ready to enroll?
Questions? You can contact our helplines. For the 24-Hour Nurse Line, just call 1-800-556-1555 (TTY: 711).
For Member Services, behavioral health and more, call the number for your service area:
Tarrant: 1-800-245-5380 (TTY: 711)
Bexar: 1-866-818-0959 (TTY: 711)
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.
Check this flyer for a complete list of benefits:
Pregnancy and newborn care
Are you expecting a child? We’ll help you stay healthy during and after your pregnancy. Our programs can help you and your baby get the care and services you need, such as breastfeeding support (visits from a lactation consultant), info for new moms and more. You can even earn rewards for making healthy choices.
Rewards you can earn
Get rewards for taking care of your child’s health. Complete a preventive care activity, such as a well-child checkup, and you can earn a $25 gift card. We’ll show you how it works.
$25 for over-the-counter (OTC) products
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 OTC health supplies and products. And we'll send it to you every month at no extra cost.
24-Hour Nurse Line
Have questions about your health? You can talk to a nurse 24 hours a day, 7 days a week. They can help you find doctors, understand your medicines and much more.
Extra help with rides
Need help with getting rides to local resources, services or events? You can get daily bus passes for rides to:
- WIC offices
- Health plan community events or classes
- Member Advisory Group meetings
We’ll also cover the cost of rides for the member’s:
- Legally authorized representative (LAR; parent or guardian)
- The member’s siblings if the LAR can’t make other child care arrangements
Just contact us to learn more about extra help with rides. This extra help goes beyond the standard rides benefit. You can learn more about the standard benefit on the rides page.
Even more benefits
- Dental care: Members who are pregnant or ages 21 and older are eligible for a cleaning (every six months), X-rays (once a year) and other services such as limited fillings, simple extractions and fluoride treatments
- Vision care: One eye exam every other year (ages 21 and older) and $175 toward glasses (frames and lenses) or contact lenses every year (ages 21 and under) or every other year (ages 21 and older)
- Help stopping nicotine use: Counseling and stop-smoking products (up to $200/year for members 18 and older)
To learn more, scroll down the page.
Benefits in your plan
Benefits in your plan
Learn about all your plan benefits, from vision and dental care to telehealth, maternity care and early childhood intervention (ECI).
Copays
Members don’t have any copays for the services we cover. You only have copays for medicines. If a provider bills you, don’t pay the bill. Just contact us.
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 check your member handbook. Or 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. You have unlimited visits, so you can see your primary care physician (PCP) as many times as you need to — at no cost. You can also get a wide range of preventive care and 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:
- DentaQuest:
- CHIP (Excluding CHIP Perinatal): 1-800-508-6775
- CHIP Perinatal: 1-833-493-0635
- MCNA Dental: 1-844-350-6262
- UnitedHealthcare Dental: 1-877-901-7321
Routine eye exams are an easy way to keep your eyes healthy. We work with Superior Vision to provide you with vision care and eye health services. Have questions? Just call 1-800-879-6901.
We make it easy to get the medications you need to feel better. You can find the medications we cover on the preferred drug list (PDL). If you don’t see yours on the list, ask your provider to help you find one that’s similar. And you can fill your prescription at any pharmacy in our network.
Mental and behavioral health includes services for mental health and substance use. If you need help, we’re here for you. We’ll also connect you with local resources for more support.
What to do if you’re having a mental health 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 or text the 988 Suicide & Crisis Lifeline at 988. Trained counselors can help you 24 hours a day, 7 days a week. Chat online with a counselor through their Lifeline Chat service.
- Call our behavioral health hotline:
- Tarrant: Call 1-800-245-5380 (TTY: 711)
- Bexar: Call 1-866-818-0959 (TTY: 711)
Our team helps you and your baby be as healthy as possible. Some benefits include:
- Info about healthy pregnancies and baby care
- Rewards you can earn for completing certain goals
- Help from a care manager
- Breastfeeding support
- Text4baby™, a text service that sends health tips and reminders
- Local community programs and resources
- Info about family planning
- Coverage of long-acting birth control
ECI services help children from birth to age 3 who have developmental delays or disabilities. These services support families as their children learn and grow. You can check with the Texas Health and Human Services Commission to see if your child qualifies.
You can get birth control counseling and supplies. And see in-network or out-of-network providers.
Any family planning care that you get is private. You can contact us to choose a family planning provider. Or you can read more about family planning.
Care management
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 health care visits and more.
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.
If you have asthma, we can help you take care of yourself year-round. You can get these supplies or services (up to $100/year) when you join our chronic disease management program:
- Hypoallergenic bedding
- Pest control services
- Vent cleaning services
- Deep cleaning services for your carpet
You can contact us to learn more about asthma care.
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 though, so be sure to follow up later.
To reach the Nurse Line, just call 1-800-556-1555 (TTY: 711).
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.
Through secure video on your computer, you can meet with a doctor for treatment of behavioral health and other common health conditions. Cold or flu? Great reasons to use telehealth. You can also get help with allergies, sinus problems and more.
If you have no way to get to the hospital during an emergency, call 911.
If you don’t have a ride to your health care visit, we’ll help you get one. Nonemergent medical transportation (NEMT) services provide rides to normal health care visits, like:
- Medical care
- Dental care
- Behavioral health care
These rides are not for emergencies. You can contact Access2Care at 1-866-411-8920 (TTY: 711) 24 hours a day, 7 days a week. Be sure to set up rides as early as you can, and at least:
- Two business days before you need it for regular trips
- Five business days for long-distance trips (more than 90 miles)
Members who qualify for Texas Health Steps can get free preventive care from birth to age 20. This includes medical and dental checkups, as well as vaccines/immunizations.
Physical exams for school and sports
We also cover physical exams for members (ages 19 and younger) who need them to attend school or play sports. Exams must be medically necessary. Members will need to complete their Texas Health Steps wellness checkup beforehand.
Check our member Texas Health Steps page to learn more.
Health programs
These programs can help you live life as healthy as you can be. We have special programs and services to help you get the care you need. And prevent health issues in the future.
Other language and format needs
Need language help? Just contact us. 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 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.
