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State of Illinois
Aetna health benefit plans

Welcome to your new Aetna health benefits plan. We know that change isn't always easy, but here at Aetna, we are committed to providing you with the best possible customer experience. We value you and are looking forward to helping you improve your health and well-being, one healthy day at a time.

Aetna will be administering the following health plan options for the State of Illinois:

  • Aetna HMO (Formerly Coventry HMO)
  • Aetna OAP (Formerly Coventry OAP)
  • QCHP (Formerly administered by Cigna)

For more information about theses health plan options, please scroll down or you may click the menu button in the upper right corner. Then select the Description of Coverage button, and then select your Group for specific information about these plans.

As one of America's leading health care companies, Aetna offers you a strong national network of over 664,000 primary care doctors and specialists and more than 5,660 hospitals.

You’ll be joining over 23 million Aetna medical plan members throughout the nation who are already taking advantage of our great health programs and services.*

Overview

With the Aetna health benefits plans offered by the State of Illinois, you get access to tools, tips, programs and services. You'll get benefits, such as:

Large national network of doctors and hospitals

In-network lab benefits

Worldwide emergency care coverage

Access to online and mobile tools

*Based on current membership data as of June 30, 2016.

Here are some of the programs available to you:


Discounts on health and fitness products like yoga equipment, over-the-counter vitamins and homeopathic remedies.

Flexible membership options at over 10,000 gyms through the Aetna Fitness program and GlobalFit® network.

Tools and resources

When you're an Aetna member, you’ll also get access to online tools and member services to make it easy for you to get answers to your health care questions. Log in or register with Aetna Navigator® —your secure member website, to gain access to these great features:

Find a doctor

Personal health record

Disease management

Check claim status

Talk with a registered nurse 24/7

Find and print ID cards and forms


Descriptions of coverage

Use the chart below to find your plan. Click on the Aetna plan name to learn more.


Questions and answers

To see if your doctor is in our network, click a plan link below.

For step-by-step instructions, click on a plan below.

You can print your ID card from Aetna Navigator®.

  • Log in or register with Aetna Navigator® —your secure member website
  • Look under “Request & Changes”
  • Select “ID card”
  • Print your ID card

You can also display a digital copy of your Aetna ID card through the Aetna Mobile app.

Find what you need — wherever, whenever — with Aetna Mobile app. To download your free Aetna Mobile app, visit www.aetna.com/mobile.

  • Go to Aetna Navigator® —your secure member website and log in or register
    The claims tab shows a quick view of the most recent claims on file. Each claim line includes the date of service, patient and provider name.
  • Click on the “details” link to access the Claim Details screen
    View more information about the selected claim. There is also a link to search for other claims on file.

CVS/caremark administers the pharmacy benefits for the Aetna HMO, OAP and QCHP Plans. For more information on the CVS/caremark pharmacy benefits, visit www.caremark.com or call 1-877-232-8128.

Urgent care centers are a great option for when you need prompt medical treatment for non‑emergency care.*

Urgent care centers can treat common problems like sprains, animal bites, ear and throat pain and more. They offer convenient hours, including extended evening, weekend and holiday hours. You just walk right in — no appointments needed.

To find an urgent care center near you, log in to Aetna Navigator® — your secure member website. If you have questions before you go, call our Informed Health® Line to talk with a registered nurse 24/7 by calling 1-800-556-1555.

*It isn't always easy figuring out what's a non-emergency versus an emergency. So if you have any doubt, play it safe and head to your local ER or call 911.

State of Illinois


Local Government Health Plan


Teachers Retirement Insurance Program


College Insurance Program


PRIOR AUTHORIZATION LIST 2017


Questions? Let’s talk.

Call Aetna Member Services
1-855-339-9731,
Monday – Friday, 7 a.m. to 5 p.m. CT

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Limitations and Exclusions apply.

Health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York and/or Aetna Life Insurance Company (Aetna). Each insurer has sole financial responsibility for its own products. This material is for information only.

Health benefits and insurance plans contain exclusions and limitations. Not all health services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Aetna may receive a percentage of the fee you pay to the discount vendor. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com.


©2017 Aetna Inc.

90.00.906.1-IL (3/17)

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