Prevention and Wellness Programs

Quality is in all we do at Aetna Better Health

You can join our prevention and wellness programs. You'll learn how to get the care and service you need to live a healthier life. To learn more about our quality improvement programs and performance, read our quality management program evaluation.

You can also help us understand where we need to improve our processes. Your satisfaction with us as your health plan is our goal. Some things we do for our members are:

  • Educating on prevention and wellness care through telephonic and other outreach for:
    • Visitas al médico y al dentista
    • Examen para detectar plomo
    • Immunizations for Children and Adolescents
    • Women's health screenings like mammograms and cervical cancer screenings
    • Cuidado durante el embarazo
  • Surveying members and providers to measure satisfaction (CAHPS survey)
  • Working with members who have serious health issues through case management
  • Giving members information on the website about what health care costs
  • Evaluar estándares, como cuánto tarda un miembro en conseguir una cita.
  • Supervisar las llamadas telefónicas para asegurarnos de que le respondan lo más rápido posible y de que le den la información adecuada.
  • Working with your PCP or provider to get them all the information to provide you or your child the care you need
  • Revisar llamadas y quejas de los miembros.
  • Revisar todos los aspectos del plan de salud a través de comités compuestos por el personal, los proveedores y los miembros del plan de salud.

This list is just some of our quality programs. Call us at 1-866-638-1232 or TTY 7-1-1 to fid out more about our quality programs. You can always call us if you need help finding a doctor. You can also ask for a written description of our Quality Management Program.

HEDIS® stands for Healthcare Effectiveness Data and Information Set. HEDIS® is a tool that looks at how well members of the plan complete services for items such as:

  • Well-child and adolescent PCP visits
  • Shots given on time
  • Pregnancy visits 
  • Dental visits
  • Diabetes care

Members complete the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey to tell us how you feel about your doctor and your health plans services.

We use HEDIS® rates and the results of this survey to improve care and services for you.

EPSDT services help children up to 21 years old. Medically necessary services are covered for children and adolescents under 21 even if some of these services aren’t part of the HealthChoices benefits program. EPSDT services are at no cost to members. EPSDT standard services include:

  • Medical checkups
  • Dental checkups
  • Visit reminders
  • Disparos
  • Blood and lab tests
  • Vision checkups
  • Hearing checkups
  • Appointments
  • Help getting to appointments
  • Health education
  • Developmental delay and Autism Spectrum Screening at specific ages
  • Lead poisoning testing
  • Other services as needed to treat conditions found during your well visit

Well checkups are not just for young children. They’re important at every age including adolescents. Help your child/adolescent stay healthy by scheduling well checkups for them. Check out the timeframes for when your child/adolescent should get their checkups.

Get rewarded for attending and completing certain preventive care appointments

Member Rewards Program