Managing medical conditions

Health problems can become bad if not taken care of.  You may need to go to the hospital or need surgery.  Keeping you healthy is a team effort.  You, your doctor and health plan work together. You and your doctor remain in charge.  We support you by:

  • Giving you helpful information about your disease
  • Helping you to stay on your treatment plan
  • Updating your doctor on your disease between office visits

We help you learn about your disease. You can also view our member newsletters to learn more. We help you make informed health care decisions and stay healthy.

For more information on how to use any of the programs listed below or speak to a care manager call 1-888-348-2922. You may opt in or out of these programs at any time.

Some members have special health care needs and medical conditions. Aetna Better Health Care Management includes nurses who work with many health care practitioners, agencies and organizations to get the services and the care that you need.

Our Care Management Program can help make sure you understand your condition and treatment plan. Our team of registered nurses and social workers receive training in the care management process. We will help you get the best care in the most efficient manner. Call our Member Services Department at 1-888-348-2922 and ask to speak to a care manager.

Asthma affects people in different ways. In some people it’s worse, and they have a lot of trouble breathing. Others don’t have as many problems. If you have asthma, the important thing is to discuss your case with your doctor. We’re here to help.

If you’re low risk, we’ll give you information to help you take care of yourself.

If you’re high risk, a care manager will call you to talk about your care. Here are some things the case manager will talk about with you:

  • Taking care of your asthma at home
  • Why taking your medicine is important
  • What causes asthma attacks
  • Why you need to do what your doctor tells you
  • Ways to change your habits so you feel better

It’s important to learn as much as you can about your asthma.

People with diabetes have too much sugar in their blood. If you have diabetes, we can help you manage it better. Without treatment, you could develop major health problems, like heart disease. Diabetes also can severely affect your eyesight.

Some people have mild diabetes. They take care of it by exercising and eating healthy foods. Other people have diabetes that is more serious. They have to take shots of a hormone called insulin. Insulin helps your body's cells use food the right way. Everyone with diabetes needs care from a doctor.

We have a Chronic Care Management Program for members with diabetes. Tell your doctor and us if you have diabetes. Call us if your doctor tells you that you have diabetes. We’ll work with you to see if you are at low risk or high risk for problems.

If you’re at low risk, we’ll give you information to help you care for yourself. Also, we’ll work with your doctor to get you the right care.

If you’re at high risk, a care manager will call you to see if you need more help. We can teach you about diabetes and help you take care of yourself. You’ll learn:

  • How to take care of your diabetes
  • How to watch your blood sugar
  • Why you need to take your medicine
  • How to take good care of your feet
  • Why you need to do what your doctor tells you
  • How to learn healthy habits so you feel better

It’s important to learn as much as you can about your diabetes.

Chronic obstructive pulmonary disease (COPD) is a lung disease. We can help you get care if you have COPD. Many people live active lives with COPD. We can help you live well too.

COPD happens slowly over time. At first, people may not know there’s a problem. With COPD, people’s lungs don’t work as well as they used to. Some people have worse COPD than others. That’s why everyone’s treatment is different. We’ll work with you and your doctor to find the best treatment for you.

We have a Chronic Care Management Program for our members who have COPD. Tell your doctor and us if you have lung disease. We’ll find out if you are at low risk or high risk for problems with COPD.

If you are at high risk, a care manager (CM) will call you to see if you need more help. The CM will talk to you about your treatment. Some people need oxygen therapy or more medicines. If you are a smoker, the CM will also talk to you about how to stop smoking.

If you are in a crisis situation and think you might hurt yourself or someone else, call 911.

Depression can affect your behavior, emotions, and physical health. Your PCP may be able to help you and prescribe medications. Follow up with your doctor to let him know how you are feeling and if the medication is working for you. Your PCP may also suggest that you see a behavioral health doctor. You do not need a PCP referral for behavioral health services.

If you feel you may be depressed, take these important steps:

  • Don’t wait to get help! The earlier you see a doctor the sooner you will feel better.
  • Talk with your doctor about treatment and medication options.
  • Always report to your doctor problems you have with medications.
  • If you see a behavioral health doctor, let your PCP know of medications or treatments that are prescribed.
  • Join a local support group—listening to how others have coped can help in your recovery.
  • Research shows that daily exercise can help you feel better. Check with your doctor about starting an exercise program.
  • Write down the phone number of the Lifeline Crisis line: 1-800-273- TALK (8255). Counselors are available 24 hours/7 days a week if you are having a mental health crisis.
  • Always go to your nearest emergency department or call 911 if you want to hurt yourself or someone else.
  • Keep up with usual activities such as attending church, being with family and friends, and taking care of responsibilities around the house and work.
  • Recovery from depression can take time—be patient with yourself!

If you are high risk a care manager will call you to see if you need more help. We can teach you about mental illness and help you take care of yourself. The care manager can help you:

  • Understand mental illness
  • Learn about recovery, self-care, and locate services
  • Offer support and encouragement

Hypertension, or sometimes called high blood pressure, is diagnosed when your blood pressure measures high. If your blood pressure continues to be high your doctor will work with you on lowering it.

Some people manage their blood pressure with medication or through diet. Some things you can do to improve your blood pressure are:

  • Choose heart healthy foods
  • Reduce sodium
  • Maintain a healthy weight
  • Stop smoking
  • Limit alcohol
  • Control stress.

We have a Chronic Care Management Program for members with hypertension. Tell your doctor and us if you have hypertension. Call us if your doctor tells you that you have hypertension. We will work with you to see if you are at low risk or high risk for health problems.

If you are low risk we will give you information to help you care for yourself.

If you are high risk a care manager will call you to see if you need more help. We can teach you about hypertension and help you take care of yourself. The care manager can help you:

  • Understand high blood pressure
  • Learn ways to control your blood pressure
  • Learn how to track and measure your blood pressure

Congestive heart failure is diagnosed when your heart is not able to pump as well as it should. It is important to pay close attention to your body and symptoms when you have heart failure. You will need to watch for changes in symptoms such as:

  • Rapid weight gain
  • Shortness of breath
  • Swelling
  • Fatigue

We have a Chronic Care Management Program for members with congestive heart failure. Tell your doctor and us if you have congestive heart failure. Call us if your doctor tells you that you have congestive heart failure. We will work with you to see if you are at low risk or high risk for health problems.

If you are low risk we will give you information to help you care for yourself.

If you are high risk a care manager will call you to see if you need more help. We can teach you about congestive heart failure and help you take care of yourself.
The care manager can help you:

  • Understand Congestive heart failure
  • Learn how to track your symptoms

It is important to understand how your heart works. Coronary artery disease starts when damage to the artery lining leads to the buildup of fat-like substances and cholesterol along the artery wall. Damage to the heart artery wall could be caused by things like high blood pressure or smoking. As the plaque begins to build up the arteries that carry the blood to the heart begin to narrow. The more plaque that continues to build up will affect the artery supplying blood to your heart muscle.

If you are high risk a care manager will call you to see if you need more help. We can teach you about congestive heart failure and ways you can take care of yourself. The care manager can help you:

  • Understand congestive heart failure
  • Learn ways to prevent or manage coronary artery disease
  • Offer support and encouragement