Aetna Better Health and VirtualCare2go Appointments

Check Your Exact Plan and Provider Network

Health-plan names can look similar even when the networks and benefits are different.

Before scheduling a virtual appointment, Aetna Better Health members should identify the complete plan name shown on their current insurance card and confirm that VirtualCare2go® and the scheduled provider participate with that exact network.

Visit the VirtualCare2go Aetna Better Health page for more information.

Does VirtualCare2go Accept Aetna Better Health?

VirtualCare2go lists Aetna Better Health—CHIP among its accepted insurance options.

That listing does not guarantee that every Aetna, Medicaid, CHIP, employer, marketplace, or Medicare plan is covered.

Confirm:

• Your coverage is active

• Your complete plan name

• VirtualCare2go participates with the exact network

• The scheduled provider is in network

• Virtual appointments are covered

• Your plan does not require another platform

• A PCP referral is not required

• Prior authorization is not required

• Your child or dependent meets eligibility requirements

• You understand any possible member responsibility

Why Does the Exact Plan Matter?

Aetna offers different insurance products and networks. Benefits may vary between:

• Aetna Better Health

• CHIP plans

• Medicaid-related plans

• Employer-sponsored plans

• EPO plans

• HMO plans

• PPO plans

• Medicare Advantage plans

• Other Aetna networks

Do not rely only on the Aetna logo. Use the complete plan name, member ID, group information, and member-services number printed on your card.

What Conditions May Be Evaluated Virtually?

VirtualCare2go may evaluate appropriate non-emergency concerns, including:

• Allergies

• Cold symptoms

• Cough or congestion

• Mild fever

• Flu-like symptoms

• Sinus symptoms

• Sore throat

• Pink eye

• Rashes

• Eczema

• Minor skin concerns

• Insect bites

• Constipation

• Mild diarrhea

• Nausea or vomiting

• Headaches without emergency symptoms

• Urinary symptoms

• Other stable concerns

The healthcare professional may determine that an in-person examination or testing is necessary.

How Should You Verify Coverage?

Call the member-services number on your Aetna Better Health card.

Ask:

• Is VirtualCare2go in my network?

• Is the scheduled provider in network?

• Are video urgent-care appointments covered?

• Is a PCP referral required?

• Does my PCP need to submit an authorization?

• Must I use an Aetna-selected telemedicine service?

• Is prior authorization required?

• Is there a copay or other member responsibility?

• Are follow-up appointments covered?

• Are prescriptions covered separately?

• Which laboratories are in network?

• Is testing subject to separate authorization?

• Are there age or geographic restrictions?

Record the representative’s name and reference number.

Is a PCP Referral Required?

Some Medicaid, CHIP, or HMO plans require members to use an assigned primary care provider.

Before the appointment, determine whether:

• A PCP is assigned

• The PCP must provide a referral

• The PCP must submit authorization

• The virtual provider must appear in the plan directory

• Follow-up must be coordinated through the PCP

• A recent PCP change is already effective

A pending PCP change may not provide immediate coverage.

What Should You Prepare?

Have the following ready:

• Current insurance card

• Photo identification

• Parent or guardian information when applicable

• Medication and supplement list

• Allergies

• Preferred pharmacy

• Assigned PCP information

• Referral or authorization documents

• Relevant medical records

• Recent vital-sign readings

• A charged device

• Reliable internet

• A private and well-lit setting

Can a Provider Prescribe Medication?

A provider may prescribe medication when clinically appropriate and legally permitted. A prescription is not guaranteed.

Confirm:

• The pharmacy accepts your plan

• The medication is covered

• Prior authorization is not required

• Step therapy does not apply

• Quantity limits do not apply

• A covered alternative is available

Are Testing and Imaging Included?

Testing and imaging are usually separate services.

Confirm:

• The facility participates with your network

• The requested service is covered

• A referral is required

• Prior authorization is required

• Your deductible or cost-sharing applies

• A separate claim will be submitted

Never assume that coverage for the virtual visit automatically includes every outside service.

Can Children Attend Virtual Appointments?

Eligibility depends on the child’s plan, age, symptoms, provider availability, and clinical needs.

A parent or legal guardian may need to attend, provide consent, present insurance information, report the child’s current weight and temperature, and coordinate follow-up with the assigned PCP.

Children with severe symptoms may require immediate in-person or emergency care.

Where Is VirtualCare2go Available?

VirtualCare2go provides virtual care throughout Texas, including Dallas–Fort Worth, Arlington, Farmers Branch, Brownwood, Houston, Austin, El Paso, San Antonio, and other Texas communities.

When Should You Call 911?

Call 911 for severe chest pain, severe breathing difficulty, stroke symptoms, seizures, loss of consciousness, uncontrolled bleeding, severe allergic-reaction symptoms, major trauma, or another potentially life-threatening condition.

Connect With VirtualCare2go

Aetna Better Health members should confirm their exact plan, network, provider participation, referral rules, authorization requirements, and possible member responsibility before scheduling.

Visit VirtualCare2go or call (817) 508-8169 for assistance.

Medical disclaimer: This article provides general educational information and does not replace professional medical advice, diagnosis, treatment, insurance advice, or emergency evaluation. Benefits and network participation vary.