Benefits FAQS

Below are the answers to commonly asked questions.  If your question and answer is not included below, call Member Services Department at 1-888-348-2922 TTY: 711 between 8:30 a.m. and 5 p.m. for help.

Call Member Services at 1-888-348-2922 TTY: 711 between 8:30 a.m. and 5 p.m

As a member of Aetna Better Health of West Virginia, you have the right to file a complaint at any time. You can file a complaint if you are unhappy with something about Aetna Better Health of West Virginia or one of our practitioners or providers. You can also file a complaint if you disagree with our decision about your appeal. To file a verbal complaint call us at 1-8883482922. You can also file a written complaint, or allow someone like your PCP to do so on your behalf. If you choose to write to us, you will need to include your address.

To file a written complaint, please mail a letter to:

Aetna Better Health of West Virginia
Attn: Member Complaints
500 Virginia Street East, Suite 400
Charleston, WV 25301

As a member of Aetna Better Health of West Virginia, you have the right to appeal a decision, including non-coverage decisions. You can file an appeal if you do not agree with our decision about your service authorization or prior authorization request. Our decision to reduce, suspend, or stop services will be sent to you in a Notice of Action letter. You will have 60 calendar days from the date of the Notice of Action to file an appeal with Aetna Better Health of West Virginia. If you would like your benefits to continue while the appeal is pending, you or your provider must file a request within 10 calendar days of date on the Notice of Action letter. You can file an appeal by calling Member Services at 1-8883482922 or you can do so in writing. All verbal appeals must be followed up in writing. With written consent, you can also have someone else, like your PCP, a family member, friend or attorney, file an appeal on your behalf.

To file an appeal you will need to send us a letter that has:

  • Your name.
  • Your practitioner's name.
  • The date of service.
  • Your mailing address.
  • The reason why we should change our decision.
  • A copy of any information that you think supports your appeal. This could include additional documents, records or information related to your appeal.

Please mail the letter to:

Aetna Better Health of West Virginia
Attn: Appeals Department
500 Virginia Street, East
Suite 400
Charleston, WV 25301

Babies born to mothers enrolled in the Aetna Better Health Medicaid program will be enrolled automatically in the Aetna Better Health Medicaid program for up to 3 months. The 3 months start with the month of the birth. Please call the Change Center at 1-877-716-1212 to report the birth of your baby. This is important to make sure your baby does not have a problem receiving care.

Call your DHRR caseworker and let them know your new address. Members can also call Member Services to report an address change at 1-888-348-2922; TTY 711.

If a card is lost or stolen, please call Member Services right away at 1-888-348-2922; TTY 711.

You should not get a bill for covered services or treatment from a participating Aetna Better Health provider. If you get a bill from your doctor or hospital, please call Member Services at 1-888-348-2922; TTY 711 with the billing information, and we will help you.

If you have medical transportation needs or questions (not relating to an emergency) please call MTM at 1-844-549-8353 or visit their website.

If you have questions regarding dental benefits or services please call Scion Dental at 1-888-983-4693 or visit their website.