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Special programs

You have access to special programs to help you get the care you need. And prevent health issues in the future. Read on to learn more about these programs.  

Learn more about your benefits

These programs can help you manage conditions, prevent health problems and stay as healthy as you can. Just check out the topics that interest you.

Need help using your benefits? 

Just contact us. Then, ask to speak with a care manager.

Are you expecting a child? We’ll help you get the care you need through pregnancy and after birth by: 

 

  • Providing screenings 
  • Offering proven treatments  
  • Working closely with your providers  

Did you know that you can earn rewards for pregnancy and birth care? Check it out.

 

Earn rewards

 

Learn more about pregnancy care

 

Get tips on staying healthy while pregnant 

Some medicines pass through the mother’s bloodstream to the baby’s blood. Severe drug withdrawal symptoms can happen after the baby is born. NAS is the medical name for this condition.

 

Do you use alcohol, street drugs or even prescription medicine? These can harm you and your baby. Stopping suddenly can also cause harm. So be sure to get help from your doctor. You can get help right away.

 

Get help from a care manager

 

Baby and you: drug withdrawal in newborn babies (PDF)

Some members have special health care needs and medical conditions. Our care managers include nurses who can:

 

  • Work with different providers, agencies and groups to help you get the care you need
  • Help you make appointments
  • Talk about your care with your doctor

Care managers can also help members with:

 

  • High-risk pregnancy
  • Neonatal intensive care (NICU) for babies after birth
  • Care and treatment of substance use for women and their babies after birth

If you think you need help from a care manager, contact us. Call the number for your health plan. Then, ask for a care manager.

 

Your doctor or caregiver can also call to get you started with care management. And you can choose to stop taking part anytime. Just contact us.

 

Learn more about care management 

We help our members with chronic conditions be as healthy as they can. We’ll mail you health info to help you manage your condition. You may also get a call from a care manager, who can help you or your child manage chronic conditions like:

 

  • Asthma
  • Diabetes
  • COPD (chronic obstructive pulmonary disease)
  • CAD (coronary artery disease)
  • CHF (congestive heart failure)
  • Mental health/depression

Your doctor or caregiver can also call to get you started with chronic condition management. And you can choose to stop taking part anytime. Just contact us.

 

Learn more about chronic condition management

 

Want to learn more about managing your condition? Just register for MyActiveHealth℠. You can get healthy living tips, watch videos about wellness, learn about a healthy lifestyle and more.

It can be hard to figure out the type of care you or your family members may need. We can help you decide whether to go to the ER or urgent care. 

 

24-Hour Nurse Line

This doesn’t take the place of your PCP. But if it’s late at night or you can’t reach your PCP, a nurse can help you decide what to do.

 

Telehealth options

MDLIVE lets you talk to a doctor or specialist from the comfort of your home or work. Skip the waiting room and get the help you need.

 

Behavioral health crisis

Mental and behavioral health are part of your whole health. Call 911 or go to the nearest hospital if:

 

  • You’re thinking about hurting yourself or someone else
  • You have an urgent behavioral health emergency

You can use any hospital for emergency care, even if it’s not in our network. Just show your member ID card.

 

24-Hour Nurse Line and behavioral health hotline: choose options for nurse line or mental health crisis

 

  • 1-800-248-7767 (TTY: 711) for STAR members in the Bexar service area
  • 1-800-306-8612 (TTY: 711) for STAR members in the Tarrant service area
  • 1-844-STRKIDS (1-844-787-5437) (TTY: 711) for STAR Kids members in Tarrant or Dallas service areas
  • 1-866-818-0959 (TTY: 711) for CHIP members in the Bexar service area
  • 1-800-245-5380 (TTY: 711) for CHIP members in the Tarrant service area

 

Care management after acute care

Have you or your child had a hospital stay recently? If so, you may get a call from our care management team. They’ll ask if you:

 

  • Scheduled a follow-up appointment with a PCP or specialist
  • Were able to get any prescribed medicine
  • Understood the discharge instructions
  • Have any other needs, so they can refer you to one of our care managers

 

Check out some of these articles to learn more about getting the right care at the right time:

 

Flu

 

Most members 6 months and older can get a flu shot every year. Studies show which flu viruses may be the most common during the upcoming season. Seasonal flu shots protect against those three or four flu viruses. Just ask your doctor about getting the shot.

 

Protect yourself from the flu

 

COVID-19

 

Members 12 years and older can get the vaccine for the coronavirus (COVID-19). You can ask your doctor about getting this shot. Or check this COVID-19 vaccine information from Texas Health and Human Services.

Autism spectrum disorder is a developmental disorder. Symptoms generally appear in the first two years of life. Autism may not be recognized or diagnosed until much later. It can be diagnosed at any age. A person with autism has a brain that works differently. The way they respond to things may be different. It can affect the way a person gets along and communicates with others. It can affect how a person behaves. It can make it difficult for a person to do the things that others do easily. People with autism can be very sensitive to certain things.

 

Autism can affect someone a little, a lot, or somewhere in between. The term ‘high functioning’ means mild challenges. ‘Low functioning’ means a person has severe challenges. That’s why it’s called a ‘spectrum’ disorder. The challenges of autism affect people in different ways.

 

If you have any questions about ASD, or what Aetna Better Health of Texas can do to help you or your child, call the Member Services phone number on your child’s ID card and ask to speak with a Case Manager. We want to walk through this journey with you.

 

Learn more about autism English | Spanish

 

Autism Spectrum Disorder Booklet English | Spanish

Care and safety

 

  • A $25 gift card:Complete an ATV rider safety and training course

Starting Sept. 1, 2022, Aetna Better Health of Texas will provide case management for children and pregnant women (CPW) services

 

What is case management for children and pregnant women (CPW)?

 

CPW is a program that connects a social worker or nurse with a member in order to help that member get community resources that they need and get services that are not covered by Medicaid. The case manager will work to coordinate services and be an advocate for you.

 

Who may need a CPW case manager?

 

Children, teens, young adults (birth through age 20) with certain health conditions or health risk conditions and high-risk pregnant women who get Medicaid.

 

Who are CPW case managers?

 

A CPW Case Manager is a licensed nurse or social worker approved by the Texas Health and Human Services Commission (HHSC) to provide services.

 

If you qualify for CPW case management services, an Aetna Better Health of Texas case manager will work with a CPW case manager to make sure your needs are met. The member, parent or guardian have to agree to the CPW Case Management services.

 

What do CPW case managers do?

 

A case manager will visit with you and then:

 

  • Find out what community resources/services you need.
  • Find community resources/services near where you live.
  • Provide follow-up visits to make sure you are getting the services you need.

 

What kind of help can you get?

 

Case managers can help you:

 

  • Work on school or education issues.
  • Assistance with transition to adulthood, guardianship.
  • Accompany member/parent/guardian to advocate at appointments (court, Social Security).
  • Get medical and dental services that are not covered by Medicaid.
  • Work on other problems.

 

If you need CPW services after Sept. 1, 2022, call Aetna Better Heath of Texas

 

Aetna Better Health of Texas will help decide who will provide you with case management services. Call Aetna Better Health of Texas by using the phone number on the back of your ID card.

 

 

You can also call Texas Health Steps at 1-877-THSteps (1-877-847-8377).

 

Aetna Better Health of Texas will help ensure a smooth transition

 

If you currently get CPW services through a traditional Medicaid provider or the Department of State Health Services (DSHS) then starting Sept. 1, 2022, CPW services will be provided by Aetna Better Health of Texas.

 

 Your DSHS regional case manager or current CPW provider will work with Aetna Better Health of Texas to transition your services:

 

  • Aetna Better Health of Texas will help decide who will provide you with case management services.
  • You may receive services from a CPW provider contracted with Aetna Better Health of Texas or from Aetna Better Health of Texas service coordination staff.
  • If you currently get CPW services through a traditional Medicaid provider then you can keep your current CPW provider for up to 90 days after Sept. 1, 2022.
  • If you currently get CPW services through DSHS then your DSHS regional case manager may need to transfer your case files to Aetna Better Health of Texas.

Connecting you to support and resources for a healthier and happier life.

 

Life can be challenging. It's hard keeping your mind and body healthy every day. That’s why we’re bringing you the Pyx Health program at no cost.

 

  • Chat with Pyx Health staff for support and guidance
  • Find tips and tools to help your physical and mental health
  • Access to health plan benefits and community resources
  • Improve mood, stress levels, motivation and more

 

Pyx Health makes it easy to get the right help, in the moment you need it.

 

Connect via the app or with a phone call.

 

  • Adults 18+ (PDF): Tools and activities to improve mindset and manage stress. You can also get help with things like food, transportation and rent
  • Teens 13–17 (PDF): Safe, private access to trained peer support and resources for school, work, social media and relationship challenges
  • Guardians (PDF): Support for the challenges of being a guardian: understanding staff, plus connections to support groups, help lines and more

 

Ready to get started?

 

Adults and teens with guardian consent: download the app now and sign up with your health plan ID. Or call Pyx Health’s friendly team at 1-855-499-4777.

 

Guardians: download the app now and sign up with partner code aetnatx. Or call Pyx Health’s team at 1-855-288-1651.

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