What’s
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 physician (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. 

Find a provider

Vision care

Routine eye exams are an easy way to keep your eyes healthy. You don’t need a referral to see a provider in the network. Just be sure to show your member ID card at every visit.
 

Dental care

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.

More about vision and dental care benefits

We make it easy to get the medications you need to feel better. The preferred drug list (PDL) 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.

Learn more about pharmacy benefits

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 and behavioral health.
 

Help in a crisis

Call 911 or go to the nearest hospital if:
 

• You have thoughts of harming yourself or someone else  
• You have an emergency and need help right now  
  

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:
 

• Our crisis line: 1-866-827-8704 (TTY: 711). We’re here for you 24 hours a day, 7 days a week.
• 988 Suicide & Crisis Lifeline: Call or text 988. 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.
  

Learn about mental and behavioral health care

The Pyx Health® app

Dealing with loneliness? The Pyx Health app can help. You can connect with a friendly, non-judgmental chat robot named Pyxir. Pyxir is a good listener who offers support, jokes and links to other people and support services. The Pyx Health app is free. And you can use the services 24 hours a day, 7 days a week. 

We can help you and your baby be as healthy as possible. When you take part in our program, here are some benefits you’ll get:
 

• A new mom welcome kit and baby bundle with diapers, diaper bag and other items
• Info about healthy pregnancies, labor, delivery and baby care
• Support from doulas and midwives
• Referrals for maternal infant health programs (MIHP)
• Help from a care manager
• Dental services
• 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 

Learn more about pregnancy care

Both men and women can get this care. You can see any in-network or out-of-network provider. Any family planning care that you get is private.
 

Family planning services include:
 

• Counseling to help you decide when to have children
• Help to decide how many children to have
• Birth control services and supplies (it’s recommended to get a Pap test and chlamydia test before getting birth control)
• Sexually transmitted disease testing and treatment
• Testicular and prostate cancer screening

You can call us at 1-866-316-3784 (TTY: 711) to choose a family planning provider. Or you can read more about family planning.

Children’s Special Health Care Services (CSHCS) is a state program that serves children and some adults with special health care needs. Those who are eligible can get the support they need at no extra cost.
 

More about CSHCS

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 these services without prior authorization to help you quit:
 

• Group and individual counseling and coaching
• Prescription inhalers or nasal sprays
• Non‑nicotine drugs
• Over‑the‑counter items to help stop smoking
  • Patches
  • Gums
  • Lozenges

Other resources to help you quit:
 

• Michigan Tobacco Quitline: 1‑800‑QUITNOW (1‑800‑784‑8669)
• Smokefree.gov
• Cancer.org

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), sickle cell disease and more.

Learn more about chronic disease management

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 1-866-711-6664 to reach the Nurse Line.

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

If you have no way to get to the hospital during an emergency, call 911. We cover ambulance rides on the ground in a medical emergency for all members. 

If you don’t have a ride to your appointment, we’ll help you get one. These rides are for the medical services we cover, like:
 

• Doctor visits
• Dental care
• Other covered services

More about rides

Get help staying active by joining the Active&Fit Enterprise™ program. Through this program, you can enjoy:
 

• Membership at some fitness centers
• Workout plans to help you start an exercise routine
• Live workout videos
• The Active&Fit Connected!™ tool for tracking workouts
• Many other online resources

Be sure to talk with your doctor before starting or changing your exercise routine.

More about Active&Fit

We provide other programs and services that extend beyond the list of standard benefits. These include programs and services, such as:

• Disease management sessions
• Tobacco cessation
• Wellpass text messaging (two-way communication with your care manager by text)

Need to learn more? Just call us at 1-866-316-3784 (TTY: 711).

Here’s a list of services Aetna Better Health of Michigan does not cover:
 

• Elective abortions and related services
• Experimental/investigational drugs, procedures or equipment
• Elective cosmetic surgery
• Services provided by any out-of-network doctor (other than emergency services or services with prior approval by plan)
• Any costs incurred in connection with services that are not covered
• Services that are not medically necessary as determined by the plan or a third party used by the plan to perform utilization review services
• Services and supplies necessary to diagnose or treat any condition resulting from the member's attempt to commit a crime or participate in illegal activities
• Charges for member's failure to keep appointments
• Except as required by law, care provided in a government hospital or by a government-related health care provider
• Payment for services performed before the enrollment effective date or after the enrollment termination date
• Services paid by or provided for under worker's compensation, no-fault or other automobile insurance, any other insurance plan, any educational program, Medicare, CHAMPUS and some other third-party payors
• Employment-related examinations
• Court-order examinations, tests, reports or treatment for mental health and chemical dependency/substance misuse or for parole/probation evaluations
• Cognitive services
• Infertility treatment and related services
• Services related in any way to surrogate parenthood
• Cosmetic services or any services performed for cosmetic purposes
• Food and dietary supplements, vitamins, minerals and infant formula
• Long-term rehabilitative treatment provided through day treatment programs and residential/transitional facilities
• Fees, costs, and expenses incurred by a person who donates an organ or tissue, unless the recipient is a member of the plan and the donor's own health plan does not cover the expenses
• Reversal of sterilization
• Testing to determine parentage or DNA testing
• Autopsies, except when provided because the member died while in the hospital