Does Aetna Cover Home Health Care?
- Some Aetna Medicare Advantage plans may help cover home health care such as physical therapy, skilled nursing care, home meal delivery or non-emergency transportation, but these benefits may be limited to qualified beneficiaries who have certain health conditions. Learn about other Aetna Medicare plan benefits and find out how you can compare plans online.
Some home health care services and items can be covered by an Aetna Medicare Advantage plan, helping plan members to continue living safely and comfortably in their own home or in a nursing home or assisted living facility.
What Insurance Covers In-Home Care?
Original Medicare and some private insurance will cover in home care for elderly people and other beneficiaries who meet certain qualifications.
Through Aetna Medicare Advantage plans, you may be eligible for home health care insurance services like in-home care for the elderly or in-home nurse care.
What Aetna Home Health Care Services are Covered?
Medicare Advantage plans (also called Medicare Part C) are required by law to include all benefits that are found in Original Medicare (Medicare Part A and Part B), which means any Medicare Advantage plan offered by Aetna will come with at least the following home health care coverage:
- Intermittent skilled in-home nurse care
Skilled nursing care involves services that a nurse would deliver, like caring for wounds and administering injections. Medicare defines “intermittent” as no more than 8 hours per day or 7 days per week over a period of 21 days or less. There are some exceptions in special circumstances. You can review more detailed information online about Aetna skilled nursing care and insurance coverage. - Personal care
Personal care is “non-skilled” care, or assistance with things like mobility, dressing, bathing, eating and toileting. Personal care is only covered by Original Medicare when skilled nursing care is also needed. Some Aetna Medicare plans may cover more personal care services than Original Medicare covers. - Physical therapy
Physical therapy aims to improve or maintain strength, mobility and range of motion following an injury, illness or surgery. Original Medicare can cover physical therapy, occupational therapy and speech therapy in your home if certain conditions are met, such as your doctor deciding that the treatment is medically necessary. - Occupational therapy
Occupational therapy is designed to help someone perform activities of daily living like bathing and dressing. - Speech therapy
Speech therapy focuses on speech language skills and can also include swallowing and various cognitive skills. - Social services
Covered social services can include counseling and other mental health and social support resources to address social or emotional conflicts interfering with one’s treatment or recovery. - Durable medical equipment (DME)
Durable medical equipment includes mobility assistance items like walkers and crutches along with various medical equipment and supplies used primarily in the home.
For certain home health care services, Medicare requires a beneficiary to be certified as home-bound by a doctor and under the coordinated care of a doctor or home health services team. While Aetna Medicare Advantage plans will provide coverage for each of the home health care services listed above, a Medicare Advantage plan can have differing eligibility rules and other conditions.
Do Aetna Medicare Plans Pay for Other Caregiving Services?
Yes. While Medicare Advantage plans are required to meet the above coverage of home health care, some Aetna Medicare Advantage plans may include additional home health care benefits.
Covered caregiving services may also be provided by a friend or family member, and Aetna offers a caregiving resource guide to help new caregivers find their way.
Below are some of the home health care services and other benefits that may be utilized within the home that you might find covered in an Aetna Medicare Advantage plan.
Please note that some of these benefits may be limited to members of Dual-Eligible Special Needs Plans (D-SNPs) or plan members who have certain chronic illnesses or conditions.
Telehealth
Aetna Medicare Advantage plans cover qualified virtual doctor visits using a computer, tablet or smartphone conducted right from your own home.
Home-delivered meals
Some Aetna Medicare Advantage plans may help cover the cost of meals delivered to your home following a qualifying inpatient hospital stay.
Fitness
Some Aetna Medicare Advantage plans include memberships to the SilverSneakers fitness program which can include home exercise and nutritional programs.
Home delivery of over-the-counter health products
Pain relievers, cold remedies, vitamins and other over-the-counter health items can be purchased from a participating pharmacy or from the Aetna product catalog and delivered right to your door.
24-hour nurse hotline
With an Aetna Medicare Advantage plan, you can consult a nurse at any time of day or week through a telephone hotline.
Personal emergency response system
Aetna Medicare Advantage plans can help cover a LifeStation personal emergency response system that can call for help with just the push of a button.
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