What’s covered?

If you have a qualifying chronic condition, you may get a monthly allowance. You can use it to help pay for everyday needs, including:

• Healthy food
• Over-the-counter (OTC) items
• Rides
• Utility bills, like gas, electric or water  
• Personal care items

Your monthly allowance for 2026 is: $220 each month

Visit  CVS.com/Aetna to manage your Extra Benefit Card. You can use the website to:

• Activate your card
• Check your allowances and balances
• Find stores where you can shop and items you can buy
• Order items online
• Ask for a new card

If you don't have a qualifying chronic condition, you can use your allowance to buy OTC items. Your benefit is added to your card on the first day of each month. Be sure to use all of it each month. Any unused amount does not roll over.

See the Member Handbook (PDF) for a list of chronic conditions.

Note: Your plan doesn’t cover lost or stolen cards. Also, you must pay any fees for late utility bills.

You can get up to 28 home-delivered meals over a 14-day period after you leave one of these care settings:

• Inpatient acute hospital

• Inpatient psychiatric hospital

• Skilled nursing facility to home 

Upon discharge, NationsMarket® will reach out to you to schedule your delivery. 

Are you at risk of falling? You can get help moving around your house. This includes up to $100 each year for approved safety items for your home or bathroom.

SilverSneakers® is a fitness program included with your plan. You can visit fitness centers and take classes at no cost to you. Find a SilverSneakers location near you.

It’s never too late to get active. Your fitness benefit can help improve your health. You can also learn healthier habits. Your benefit includes:

• Live online classes

• Membership to a gym or fitness center 

• Help getting started with equipment use

• Access to the SilverSneakers website and customer support 

• At-home fitness kits if you exercise at home 

• Mental fitness classes on skills, organization, self-help and staying connected  

• Health and wellness classes on food, nutrition, cooking and healthy habits 

• GetSetUp classes you can use through your SilverSneakers account 

This service helps you stay active from home or on the go. You can choose workouts and meditations that fit your needs. Sessions range from 5 to 45 minutes.

To activate your subscription, use:

• Your SilverSneakers member account

• The SilverSneakers GO™ mobile app

After you activate, you can use Apple Fitness+ on

• iPhone®

• iPad®

• Apple TV®  

• Apple Watch®

With Apple Watch, you can:

• Track your stats in real time

• Try guided walks, runs and meditations 

Apple, the Apple logo, Apple Fitness+, iPhone, iPad, Apple TV and Apple Watch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple, Inc.

Through secure video on your computer or other device, you can meet with a provider for treatment of common health conditions. Cold or flu? Great reasons to use telehealth. You can also get help with allergies, sinus problems and more.

Schedule a telehealth visit 24 hours a day, 7 days a week via Teladoc® or Minute Clinic Virtual Care®. You can also see other providers that offer telehealth services covered under your plan.

To schedule a telehealth visit, go to Teladoc. You can also call 1-855-TELADOC 1-855-835-2362 (TTY: 711).

Or schedule a visit through MinuteClinic Virtual Care

Need help finding a provider? You can find a provider online. Or call us at 1-855-676-5772  (TTY: 711). We’re here for you from 8 AM to 8 PM, 7 days a week.

Questions about your health?  Skip the crowded waiting rooms. You can talk with a nurse 24 hours a day, 7 days a week, at no cost to you. They can help you find local providers, understand your medicine and much more. To reach a registered nurse, call 1-855-493-7019 (TTY: 711) anytime.

If you lose hair due to chemotherapy, this benefit can help. It only covers this type of hair loss.

You can get up to $400 each year for a wig. You’ll pay any costs above this amount.

We cover emergency and urgent care worldwide.

Go to any emergency room if you think you need care right away. You don’t need prior authorization or approval first. And you can use any provider including those not in-network.

Your yearly limit is $250,000 for emergency care. You may need to pay first at the visit and then ask for reimbursement (payment). We pay up to the limit after any copay or cost share.

Your plan covers a personal emergency response system (PERS) through LifeStation®. This service gives you access to emergency help 24 hours a day, 7 days a week. Here’s what it includes:

• Equipment (in‑home, mobile with GPS, or smartwatch)

• Shipping

• Fulfillment 

• Monitoring

• Customer service

You pay a $0 copay for each item.

Need to see a specialist or have an emergency? You’re covered. You can also get vaccinations and services for preventive care. 

Need help finding a provider? You can find a provider online. Or call us at 1-855-676-5772  (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week. 

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 or substance use. You can go to any behavioral health provider in our network. 

We offer coverage for a wide range of services, including: 

• Inpatient and outpatient mental health services and substance use disorder treatments

• Short-term substance use disorder residential services

• Mental health rehabilitation  

Help in a crisis

There are resources in place to help you in a crisis or mental health emergency. If you have thoughts of harming yourself or others, get help right away. Here are some options:

• Call or text the Suicide & Crisis Lifeline at 988. Trained counselors can help you 24 hours a day, 7 days a week. Chat online with a counselor through their Lifeline Chat service.

• Call 911 or go to the nearest hospital. 

One way to support your health is to schedule a well-woman checkup each year. Routine women’s health care may include:

• Breast exams

• Mammograms

• Pap tests

• Prenatal care

You don’t need a referral or prior approval to see a women’s health specialist. You can choose any of these providers in our network for routine women’s health care:

• Obstetricians

• Gynecologists

• Certified nurse midwives

You may not have any signs or symptoms of certain health conditions. These visits can help find problems early. Your health can change quickly, so it’s important to schedule a well-woman checkup each year.

Questions? Or need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week. 

Your health needs can change over time. A yearly checkup is a good time to ask questions, review concerns and plan your care.

Your provider can help you stay up to date on:

• Screening tests

• Vaccines

• Health counseling

• Care for ongoing health conditions

• Healthy changes you want to make

Some health problems may not have signs or symptoms at first. Regular checkups can help find problems early. They also give you time to talk about your physical, mental and emotional health.

Ask your provider what care is right for your age, health history and needs.

Questions? Or need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week. 

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. And you don’t need prior approval in an emergency.

If you don’t have a ride to your health care appointment, we’ll help you get one. You can get rides to and from plan approved locations. And these rides are for any of the services we cover, like: 

• Doctor visits

• Dental care 

• Behavioral health care

How to schedule a ride

You can contact MTM Health at 1-855-814-1699  (TTY: 711) Monday through Friday, 7 AM to 8 PM. Be sure to schedule rides at least two business days before you need them. You can change or cancel rides up to one business day before your pickup time. 

Getting routine eye exams is an easy way to keep your eyes healthy. You don’t need a referral when you see a provider in our network. 

VSP manages your vision benefits, including:

• Routine and diagnostic exams

• Eyeglasses

• Contact lenses

Need help finding a provider? You can find one on the Vision Service Plan website. Or call us at 1-855-676-5772 (TTY: 711). We're here from 8 AM to 8 PM, 7 days a week.

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. 

DentaQuest® manages your dental benefits. As a member, you’ll get routine and comprehensive coverage for services, like:

• Exams

• X-rays

• Cleanings

• Fluoride treatments

• Dentures (artificial teeth and gums)

• Periodontal (gum disease) services 

• Fillings

• Crowns 

Need help finding a dentist? Call us at 1-855-676-5772 (TTY: 711). We're here from 8 AM to 8 PM, 7 days a week.

As a member, you’ll get coverage for:

• Routine and diagnostic exams

• Hearing aids, fittings and accessories 

Need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week.

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 health care visits and more.   

Info about your care team

Your care team is here to help you get the care and services you need. Your team may include your doctor, care coordinator and other health care providers. It may also include support people you choose, like a family member or caregiver.

Your care coordinator is trained to help you understand and manage your care. When you enroll in our plan, we assign you a care coordinator. They can help you:

• Find community resources

• Arrange care among doctors, hospitals and other providers

• Get support services covered through fee-for-service Medicaid 

• Connect with community programs that may help you

Your care coordinator can also answer questions about your health care needs. They’ll work with you and your providers to help make your care feel more connected.

More about your care team and care coordinator (PDF)

Questions?

Need help or have questions? You can call your care manager directly. Or call us at 1-855-676-5772  (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week. 

Need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week.  

As a member, you can get coverage for:

• Diagnosis and medical or surgical treatment of injuries and diseases of the foot (such as hammer toe or heel spurs) 

• Routine foot care for conditions affecting the legs, such as diabetes

• More (non‑Medicare covered) foot-care services: up to 6 visits every year

Need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week.

We make it easy to get the medicines you need to feel better. There are no copays or deductibles when your medicine is on our drug list or formulary. This is a list of the medicines we cover. 

Don’t see yours on the list? Ask your provider to find a similar medicine. And you can fill your prescription at any pharmacy in our network. To learn more, call us at 1-855-676-5772 (TTY: 711). We’re here 8 AM to 8 PM, 7 days a week. . 

Download the list of medicines we cover:

• 2026 Formulary (English) (PDF)
• 2026 Formulary (Spanish) (PDF)

Need help finding a provider? Call us at 1-855-676-5772 (TTY: 711). We’re here from 8 AM to 8 PM, 7 days a week.