Aetna Better Health® of Louisiana

Positive change Spring 2018

Applied behavior analysisBehavior analysis is based on a scientific study of how people learn. By doing research, techniques have been developed that increase useful behavior (including communication) and reduce harmful behavior. Applied behavior analysis (ABA) therapy uses these techniques. ABA is helpful in treating autism spectrum  disorders.

Who is eligible? •Be from birth through 20 years of age. • Exhibit the presence of excesses and/or deficits of behaviors that significantly interfere with home or community activities (examples include, but are not limited to, aggression, self-injury, elopement, etc.). • Be medically stable and do not require 24-hour medical/nursing monitoring or procedures provided

in a hospital or intermediate care facility for persons with intellectual disabilities (ICF/ID). • Be diagnosed by a qualified health care professional with a condition for which ABA-based therapy services are recognized as therapeutically appropriate, including autism spectrum disorder. •Have a comprehensive diagnostic evaluation by a qualified health care professional; and have a prescription for ABA-based

therapy services ordered by a qualified health care professional.

These services will be available effective Feb. 1, 2018. All medically necessary services must be prescribed by a physician, and prior authorization is required. The provider of services will submit requests for prior authorization.

If you have any questions, please contact Aetna Better Health of Louisiana 24 hours a day, 7 days a week, at 1-855-242-0802, TTY 711.

Aetna Better Health® of Louisiana 2400 Veterans Memorial Blvd., Suite 200 Kenner, LA 70062

Standard U.S.Postage

PAID Walla Walla, WAPermit No. 44

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

If you don’t have transportation, we will cover transportation to services covered by Aetna Better Health of Louisiana. We will also cover transportation to Medicaid-covered services such as dental care.

We use LogistiCare for your transportation needs. You can get a ride to your provider visit and to the pharmacy, if you go to the pharmacy immediately following the appointment.

To schedule a ride, call LogistiCare at 1-877-917-4150, TTY 1-866-288-3133. There is no limit on the number of trips provided. You can call Monday through Friday, 8 a.m. to 5 p.m.

If you have an urgent need or need help with

a ride that you already scheduled, you can call LogistiCare’s “Where’s my ride” toll-free number, 24 hours a day, 7 days a week, 365 days a year, at 1-877-917-4151.

Transportation appointments must be scheduled three (3) business days in advance. You may make your reservation up to thirty (30) days in advance. LogistiCare will assist with ongoing transportation needs for services, such as dialysis or other reoccurring treatments.

When making your reservations, keep in mind that you should not arrive more than one hour before your scheduled  appointment.

Please have these details ready when you call LogistiCare: •Name of the provider • Provider’s address • Provider’s telephone number • Time of appointment • Type of transportation needed (e.g., regular car, wheelchair-accessible van)

Getting a second

opinion. When a PCP or a specialist says you need surgery or other treatment, you have the right to check with another provider. This is called a second opinion. A second opinion is available at no charge to you. Your PCP can recommend a provider, or you can call Member  Services.

Getting specialist care Sometimes you may need care from a specialist.

Specialists are providers who treat special types of conditions. For example, a cardiologist treats heart conditions. A pulmonologist treats lung conditions, like asthma. A psychiatrist or licensed mental health professional treats mental

health and substance use conditions. Your PCP can recommend a specialist to you. You can look in the online provider directory at aetnabetterhealth.com/ louisiana, or call Member Services at 1-855-242-0802, TTY 711. We will help you find a specialist near you.

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Pharmacy services If you need medicine, your provider should choose one from our list of preferred drugs. When you get a prescription, make sure that the drug is on our list. We’ve posted thelist of medicines we cover online at aetnabetterhealth.com/ louisiana. It also tells you when a drug can or cannot be prescribed. You can call us with any questions at 1-855-271-6603, TTY 711.

Sometimes your provider will want to give you a drug that is not on our list. If the provider feels that only the drug he wants to prescribe will work for you, he or she can request approval from us. The provider knows how to do this.

Remember to take your prescriptions to one of the pharmacies listed in our provider directory.

Prescription refills The label on your medicine bottle tells you how many refills your doctor has ordered. You may only get one refill at a time. If the doctor hasn’t ordered refills, you must call him or her at least five (5) days before your medicine runs out. The doctor may want to see you before giving you a refill.

Healthy habits: 5 ways to pass them on to your child The sooner kids start good habits, the more likely those habits are to stick for life. And those habits start with you.

Here are five ways you can help your child eat well and move more from an early age.

1. Be a good role model. Your child watches what you do. So ifyou want your child to exerciseand eat wisely, it’s importantthat you do the same. Take awalk after dinner, rather thanturning on the TV. Snack on acrisp apple—not chips or cookies.

2. Reshape plates. Make half ofthe food you put on your family’splates fruits and veggies.

3.Make family time exercisetime. Hike with your child in anearby park. Bike or shoot somehoops together. Have everyonehelp wash the car.

4. Think about drinks.Encourage your child to drinkplenty of water instead ofsugary sodas or fruit drinks.

5. Serve healthy snacks. Smartchoices include sliced apples,celery sticks and low-fat yogurttopped with fruit.

Sources: American Academy of Family Physicians; National Institutes of Health

Contact us Aetna Better Health of Louisiana 2400 Veterans Memorial Blvd., Suite 200, Kenner, LA 70062

24 hours a day, 7 days a week 1-855-242-0802 TTY: 711 aetnabetterhealth.com/louisiana

This newsletter is published as a community service for the friends and members of Aetna Better Health of Louisiana, 2400 Veterans Memorial Blvd., Suite 200, Kenner, LA 70062. This is general health information

and should not replace the advice or care you get from your provider. Always ask your provider about your own health care needs. Models may be used in photos and illustrations. 2018 © Coffey Communications, Inc. All rights reserved.

LA-18-03-01 Date of issue: 03/16/2018

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AETNA BETTER HEALTH® OF LOUISIANA

Nondiscrimination Notice

Aetna complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Aetna does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

Aetna: • Provides free aids and services to people with disabilities to communicate effectively with us, such as:o Qualified sign language interpreters o Written information in other formats (large print, audio, accessible electronic formats,

other formats) • Provides free language services to people whose primary language is not English, such as:

o Qualified interpreters o Information written in other languages

If you need a qualified interpreter, written information in other formats, translation or other services, call the number on your ID card or 1-800-385-4104.

If you believe that Aetna has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with our Civil Rights Coordinator at:

Address: Attn: Civil Rights Coordinator 4500 East Cotton Center BoulevardPhoenix, AZ 85040

Telephone: 1-888-234-7358 (TTY 711) Email: MedicaidCRCoordinator@aetna.comHours of operation: 8:00 a.m. – 5:00 p.m.

You can file a grievance in person or by mail or email. If you need help filing a grievance, our Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal. hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building, Washington, D.C. 20201, 1-800-368-1019, 1-800-537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, and its affiliates.

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Multi-language Interpreter Services

ENGLISH: ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call the number on the back of your ID card or 1-800-385-4104 (TTY: 711).

SPANISH: ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al número que aparece en el reverso de su tarjeta de identificación o al 1-800-385-4104 (TTY: 711).

FRENCH: ATTENTION: si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le numéro indiqué au verso de votre carte d’identité ou le 1-800-385-4104 (ATS: 711).

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TAGALOG: PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tumawag sa numero na nasa likod ng iyong ID card o sa 1-800-385-4104 (TTY: 711).

KOREAN: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 귀하의 ID 카드 뒷면에 있는 번호로나 1-800-385-4104 (TTY: 711) 번으로 연락해 주십시오.

PORTUGUESE: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linquísticos, grátis. Ligue para o número que se encontra na parte de trás do seu cartão de identificação ou 1-800-385-4104 (TTY: 711).

JAPANESE:注意事項:日本語をお話になる方は、無料で言語サポートのサービスをご利用いただけます。 IDカード裏面の電話番号、または 1-800-385-4104 (TTY: 711)までご連絡ください。

GERMAN: ACHTUNG: Wenn Sie deutschen sprechen, können Sie unseren kostenlosen Sprachservice nutzen. Rufen Sie die Nummer auf der Rückseite Ihrer ID-Karte oder 1-800-385-4104 (TTY: 711) an.

RUSSIAN: ВНИМАНИЕ: если вы говорите на русском языке, вам могут предоставить бесплатные услуги перевода. Позвоните по номеру, указанному на обратной стороне вашей идентификационной карточки, или по номеру 1-800-385-4104 (TTY: 711).

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