Aetna Better Health of Virginia provides Medicaid and related healthcare services to residents across the state.
As part of the CVS Health family, it delivers comprehensive coverage for families, seniors, and people with disabilities.
This article explores its services, benefits, recent developments, and what members need to know.
What Is Aetna Better Health of Virginia?
Aetna Better Health of Virginia is a managed care organization (MCO) that administers Medicaid plans. It serves thousands of Virginians, offering access to doctors, hospitals, and wellness programs. The plan focuses on community-based care, helping members stay healthy close to home.
Since 1986, Aetna Better Health of Virginia has been a key player in the state’s Medicaid program. It is accredited by the National Committee for Quality Assurance (NCQA) since 2015, with a Long-Term Services and Supports (LTSS) distinction. This accreditation reflects its commitment to quality care.
Key Services and Benefits
Aetna Better Health of Virginia offers a range of services tailored to meet diverse healthcare needs. These include medical, dental, vision, and behavioral health care. Here are some core benefits:
- Primary Care: Access to primary care providers (PCPs) for routine checkups and preventive care.
- Prescription Coverage: Coverage for medications, with tools to manage prescriptions online.
- Specialty Care: Referrals to specialists for conditions like diabetes or heart disease.
- Wellness Programs: Resources for mental health, pregnancy care, and chronic disease management.
Members can also access transportation to medical appointments and over-the-counter allowances through CVS Health. These benefits aim to make healthcare affordable and convenient.
How It Works in Virginia’s Medicaid System
Virginia’s Medicaid program, known as Cardinal Care, includes managed care plans like Aetna Better Health of Virginia. As of July 1, 2025, the state contracts with five MCOs, including Aetna, to deliver healthcare services. Members are assigned to an MCO but can switch plans during open enrollment.
Aetna Better Health of Virginia partners with local providers to create a robust network. This ensures members can access care without traveling far. The program also supports the Family Access to Medical Insurance Security (FAMIS) for children under 19.
Recent Developments in 2025
Aetna Better Health of Virginia has seen several updates in 2025 that impact its members and providers. These changes reflect efforts to improve services and adapt to new regulations.
Mobile App Enhancements
The Aetna Better Health app, available on iOS and Android, allows members to manage their healthcare on the go. Members can find providers, view claims, request ID cards, and change their PCP. However, some users report issues like app crashes or difficulty finding providers, which Aetna is addressing.
Recent updates aim to improve user experience, but feedback suggests the app still needs work. For example, members have noted challenges with CAPTCHA verification and limited interactivity, like scheduling rides to appointments.
Self-Directed Care Options
In January 2025, Aetna Better Health of Virginia expanded its self-directed care program through a partnership with PPL First. This program helps members with disabilities or aging-related needs hire and manage their own care workers. Members can use the MyAccount tool to monitor budgets and approve timesheets.
A new rule effective September 1, 2024, limits personal care attendants to 16 hours per day to ensure safety. If more hours are needed, members can hire additional attendants, enhancing flexibility.
Provider Network Support
Aetna Better Health of Virginia is strengthening its provider network with resources like training and competitive compensation. Providers can access a secure portal to submit claims, request prior authorizations, and find manuals. The organization also invites providers to join its Provider Advisory Committee to give feedback.
However, some providers have faced challenges, such as being dropped from networks due to administrative issues. Aetna works with the Department of Medical Assistance Services (DMAS) and Gainwell to resolve these quickly.
Challenges Facing Aetna Better Health of Virginia
While Aetna Better Health of Virginia offers robust services, it faces challenges that could affect members. These include regulatory pressures, member dissatisfaction, and operational hurdles.
Regulatory and Legal Issues
In May 2025, Aetna, along with Humana and Elevance Health, faced a U.S. Department of Justice lawsuit. The lawsuit alleges illegal kickbacks to brokers and discriminatory practices against disabled seniors in Medicare Advantage plans. Although this primarily affects Medicare, it could impact Aetna’s reputation in Virginia’s Medicaid market.
Such legal challenges may lead to stricter oversight, potentially affecting how Aetna Better Health of Virginia operates. Members may worry about trust and reliability as a result.
Member Experience with Technology
The Aetna Better Health app has received mixed reviews. Some members find it useful for viewing benefits and claims, but others report frequent crashes and limited functionality. For example, a 2024 Google Play review noted the app often requires reinstallation to work properly.
Aetna’s customer service team is responsive, encouraging members to contact them for support. However, ongoing issues with the app could frustrate users and push them to consider other MCOs.
Provider Network Disruptions
Some healthcare systems, like UW Medicine in Seattle, dropped Aetna’s Medicare Advantage plans in 2025, though this doesn’t directly affect Virginia’s Medicaid program. However, similar network disruptions could occur in Virginia if providers face payment or administrative issues. Aetna is working to maintain strong provider relationships to prevent this.
Comparing Aetna Better Health of Virginia with Other MCOs
To understand how Aetna Better Health of Virginia stacks up, here’s a table comparing it with other Virginia Medicaid MCOs as of July 1, 2025:
| MCO | Key Features | Unique Offering | NCQA Rating (2022) |
|---|---|---|---|
| Aetna Better Health | Comprehensive medical, dental, vision care | Self-directed care via PPL First | 3 out of 5 |
| Anthem HealthKeepers Plus | Wide provider network, wellness programs | Focus on maternal health programs | Not specified |
| Humana Healthy Horizons | Chronic disease management, telehealth | Partnerships with community organizations | Not specified |
| Sentara Community Plan | Behavioral health, long-term care | Integrated care for dual-eligible members | Not specified |
| UnitedHealthCare | Preventive care, mobile app tools | Nationwide provider network | Not specified |
This table shows Aetna’s strengths in self-directed care and comprehensive coverage, though its NCQA rating suggests room for improvement compared to competitors.
How Members Can Make the Most of Their Plan
Aetna Better Health of Virginia offers tools and resources to help members maximize their benefits. Here are a few tips:
- Use the Member Portal: Log in to manage benefits, view claims, and update contact information.
- Explore Wellness Resources: Take advantage of mental health support, pregnancy care tips, and chronic disease management programs.
- Contact Member Services: Call 1-855-463-0933 (TTY: 711) for help with app issues or provider searches.
- Join Open Enrollment: Review other MCOs during Virginia’s open enrollment (October 15–December 7) to ensure the best fit.
The Future of Aetna Better Health of Virginia
Aetna Better Health of Virginia is adapting to a changing healthcare landscape. Its focus on technology, like the mobile app and provider portal, aims to improve access and efficiency. Partnerships with CVS Health and PPL First enhance its community-based approach.
However, challenges like legal issues and app functionality need attention. By addressing these, Aetna can strengthen its position in Virginia’s Medicaid market and better serve its members.
Summary
Aetna Better Health of Virginia plays a vital role in the state’s Medicaid program, offering comprehensive healthcare to diverse populations.
Its services include medical, dental, vision, and wellness programs, with tools like a mobile app and self-directed care options.
Recent developments, such as app updates and provider support, show its commitment to improvement. However, legal challenges, app issues, and potential network disruptions pose risks. Members can maximize their benefits by using online tools and staying informed about plan changes.
FAQ
What services does Aetna Better Health of Virginia offer?
Aetna Better Health of Virginia provides medical, dental, vision, and behavioral health care. It also offers prescription coverage, transportation to appointments, and wellness programs. Members can access these through a network of local providers.
How can I manage my Aetna Better Health plan?
Use the Aetna Better Health app or member portal to view claims, change providers, or request ID cards. You can also call Member Services at 1-855-463-0933 for support. The portal is secure and easy to use.
What is the self-directed care program?
The self-directed care program lets members hire and manage their own care workers. Through PPL First, members can monitor budgets and approve timesheets. A 16-hour daily limit for attendants ensures safety.
Are there issues with the Aetna Better Health app?
Some users report crashes and limited functionality, like difficulty finding providers. Aetna is working to improve the app based on feedback. Contact Member Services for help with app issues.