Medical Management Programs

Keeping our members healthy is very important. We offer several programs and processes for our members that are designed to help us evaluate the medical care our members need.

Our Care Management Program will help you understand and control complex health conditions. Care managers can be nurses or social workers. They work with adults and children. Care managers can help you:

  • Learn about your health care
  • Work with your primary care provider (PCP) when medical questions come up
  • Plan your care with a medical team (your PCP, family or specialists)
  • Schedule rides to appointments
  • Get special equipment and home health services if you need them

Children who have special medical, behavioral or educational requirements can get the help they need through the care management program.  If you or your child have special health care needs, call Member Services at:

  • 1-800-248-7767 (Bexar) 
  • 1-800-306-8612 (Tarrant)
  • 1-800-735-2989 (for members that are hard of hearing)

If you have a chronic health condition, our Disease Management programs can help you stay healthy.  These programs are for adults suffering from asthma, diabetes, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD) & depression.

Disease Management nurses will work with you and your doctor to help you learn about your condition and how to better care for yourself.  

To learn more about our disease management programs, call Member Services at 1-800-248-7767 (Bexar), 1-800-306-8612 (Tarrant) or 1-800-735-2989 (for members that are hard of hearing).

Service Management is a special service performed by a care manager to help you and your child make a plan to manage your child’s health and behavioral health care needs. When your AAPCA child enrolls with Aetna Better Health of Texas, they may be assigned to a care manager. If your child does not have a care manager, you can ask for one. The care manager’s job is to help you with all of your health care needs.

A care manager will:

  • Help you identify your child’s health care needs and services
  • Use a “screening survey” to help decide if your child need more help right away
  • Talk with any case managers, providers, pharmacists or other persons that you say are important for your child’s care needs
  • Help you get the services your child needs
  • Work with you and your child to write a service plan with actions and goals
  • Stay in contact with you to check up on your child’s health and keep track of your child’s service plan

If your child have special health care needs, call Member Services at:

  • 1-800-248-7767 (Bexar) 
  • 1-800-306-8612 (Tarrant)
  • 1-800-735-2989 (for members that are hard of hearing)