Plan Details

All of the health plans have special programs to help members with chronic illness such as asthma, congestive heart failure, diabetes, hepatitis C, HIV, obesity and sickle cell anemia. They also have programs for pregnant women with a high risk of problems during pregnancy and delivery. If they do not have a program in place that fits your needs, they will work with you to create one.

Eye exam (No co-pay)
$80 toward glasses or contacts (once a year) 

Dental exams and cleanings (twice a year)
Fillings and extractions
X-rays (once a year)
$500 total benefit per year*

Members can work with a case manager to access covered pain management services.

All health plans offer sponsorships and/or mini-grants for community organizations and members in need.* 

Gym membership and swim lessons for eligible members.*

All of the health plans offer rewards for healthy behaviors. Unless otherwise noted rewards are: available once a year per member; in the form of a reward debit card or gift card. 

$20 for annual well visits (birth-21) 

$15 for annual well visit

$10 for chlamydia screening, members 16-24
$15 for breast cancer screening, women 21+
$15 for cervical cancer screening, women 21–64
$25 for colon cancer screening, members 50+, one time only

$10 for each: dilated eye exam and A1C blood tests for members diagnosed with diabetes

$15 for annual asthma assessment
$15 for a follow-up after asthma related emergency room visit
$15 for other asthma care tasks*
$15-$30 for meeting weight loss goals
$5 for a flu shot

Promise Program

$25 for prenatal visit in the first 6 weeks of pregnancy or joining the plan*
$10 for each prenatal visit*

$50 for postpartum visit (3 – 8 weeks after delivery)

$50 for completing a Notice of Pregnancy form
$50 for getting all 17P shots, for eligible members 

All health plans cover newborn male circumcision.  Check with the individual plan to find out more about their rules for getting this service.

Home assessment for members diagnosed with asthma.

All health plans cover coaching and medications (with a prescription) to help members stop smoking.* 

Acupuncture for members 19+ up to $150 reimbursement

Ted E. Bear, MD Club participants get nutritional sessions and weight checks.

No copays

All health plans will set up a ride for members who don’t have a way to get to medical appointments. Stop at the pharmacy after your appointment to get medications.

Available with a prescription and co-pay.
$25 monthly benefit per household for OTC vitamins and health products.*

All health plans cover all recommended vaccinations, including: for HPV (human papilloma virus), pneumonia, the flu (influenza), chicken pox, shingles, meningitis, DTAP (diphtheria, tetanus and pertussis), MMR (measles, mumps and rubella) and hepatitis A and B.

Up to 500 MB of data or 500 minutes of talk time 

Text4Baby, Text4Kids, Text4Health, Care4Life (diabetes coaching)

www.teladoc.com 
Video chat with a U.S. board certified doctor. Many conditions can be treated with teladoc: sinus problems, bronchitis, allergies, cold and flu symptoms, respiratory infection, ear infection, and more!

Free download for members in the Apple App Store and on Google Play.

Search for Aetna Better Health:

• Find or change your provider
• View your medical and prescription claims
• View your current medications
• View your benefits
• View or request your ID card
• Create a support circle and assign tasks
• Link to health education
• Send messages to Health Plan

Community Resource and Emergency Preparedness links on website to connect members with information and resources to build a healthy and safe community.

• Ted E. Bear, M.D. Health Fair
• Community garden
• Back to school drives
• Diaper drives
• Community health fairs
• Health education events
• Food drives
• Community baby showers 

*Please contact the Health Plan for eligibility requirements and details for this benefit.