Member materials
- Aetna Better Health of Illinois member handbook — English (PDF)
- Aetna Better Health of Illinois member handbook — Spanish (PDF)
- HBIA HBIS member handbook — English (PDF)
- HBIA HBIS member handbook — Spanish (PDF)
- Aetna Better Health of Illinois Certificate of Coverage — English (PDF)
- Aetna Better Health of Illinois Certificate of Coverage — Spanish (PDF)
- Aetna Better Health of Illinois MLTSS Certificate of Coverage — English (PDF)
- Aetna Better Health of Illinois MLTSS Certificate of Coverage — Spanish (PDF)
- Aetna Better Health of Illinois MLTSS eligibility document — English (PDF)
- Aetna Better Health of Illinois MLTSS eligibility document — Spanish (PDF)
- Member Quick Reference Guide ― English (PDF)
Forms
- Health risk screening form (Adult) — English (PDF)
- Health risk screening form (Adult) — Spanish (PDF)
- Health risk screening form (Child) — English (PDF)
- Health risk screening form (Child) — Spanish (PDF)
- Authorization to disclose protected health information form — English (PDF)
- Authorization to disclose protected health information form — Spanish (PDF)
- Removal of authorization to disclose information form — English (PDF)
- Removal of authorization to disclose information form — Spanish (PDF)
- Authorized representative designation form — English (PDF)
- Authorized representative designation form — Spanish (PDF)
- Medical appeal request form — English (PDF)
- Medical appeal request form — Spanish (PDF)
- Power of attorney for health care — English (PDF)
- Power of attorney for health care — Spanish (PDF)
- Primary care physician (PCP) change request form — English (PDF)
- Primary care physician (PCP) change request form — Spanish (PDF)
- Notification of pregnancy form — English (PDF)
- Notification of pregnancy form — Spanish (PDF)
- Authorization to release psychotherapy notes form — English (PDF)
- Authorization to release psychotherapy notes form — Spanish (PDF)
- Protected Health Information Access Request form — English (PDF)
- Protected Health Information Access Request form — Spanish (PDF)
- Request for an accounting of Disclosures of PHI form — English (PDF)
- Request for an accounting of Disclosures of PHI form — Spanish (PDF)
Outpatient treatment request form — English (PDF)
Additional resources
- Office visit checklist — English (PDF)
- Office visit checklist — Spanish (PDF)
- Childhood wellness visit checklist — English (PDF)
- Childhood wellness visit checklist — Spanish (PDF)
- Child immunization — English (PDF)
- Child immunization — Spanish (PDF)
- You and your PCP - Preventive Care Flyer — English (PDF)
- You and your PCP - Preventive Care Flyer — Spanish (PDF)
- Flu Shot Flyer — English (PDF)
- Flu Shot Flyer — Spanish (PDF)