Benefits & Services

A summary of all the benefits and services provided can be found in your member handbook.

Our preferred lab vendor is LabCorp. You can search for locations and even make an appointment online.

Covered services include inpatient and outpatient care for psychological or psychiatric conditions.

You do not need a referral from your child’s doctor to receive covered outpatient behavioral health services. Call Beacon Health Options, a company that contracts with Aetna Better Health to provide these services at 1-844-513-4954.

All calls are confidential. A trained professional will help plan the care that is needed.

Routine dental services are not covered by Aetna Better Health but are available through the Healthy Kids program offered by a separately contracted dental vendor. If you need any information about dental services, call Florida Healthy Kids toll-free at 1-888-540-5437 Monday through Friday from 7:30 a.m. to 7:30 p.m. Eastern.

Covered services include visits to an emergency room or other licensed facility needed right away due to an injury or sudden illness when delay could lead to permanent damage to the child’s health.

Limitations:

  • Must use an Aetna Better Health facility or provider for emergency care unless the time to reach such facility or provider would mean the risk of damage to the child’s health.

Covered services provided for the medical care and treatment of a child when admitted as an inpatient to a hospital.

Limitations:

  • All admissions must be authorized by Aetna Better Health.
  • The length of stay shall be based on medical needs.
  • Room and board may be limited to semi-private rooms, unless a private room is medically necessary or semi-private rooms are not available.
  • Private duty nursing only if medically necessary.
  • Admissions for inpatient rehabilitation and physical therapy are limited to 15 days per Contract Year.

Check-ups, testing, treatment, comfort care, and other services provided in the outpatient portion of a health facility.

Limitations:

Services must be provided by Aetna Better Health participating providers or upon authorization and referral.

Covered services include care for mother and newborn. The services include prenatal and postnatal care of the mother, nursery charges, and examination of the baby.

Limitations:

  • Infant is covered for up to three (3) days following birth or until the infant is transferred to another medical facility, whichever occurs first.