Does Aetna Cover Home Health Care?

Visit Aetna-MedicareAdvantage.com

Many home health care services and items can be covered by an Aetna Medicare Advantage plan, allowing 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?

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, Aetna Medicare Advantage plans often go above and beyond to include additional home health care benefits.

In fact, Aetna has partnered with a caregiving agency called CareLinx to provide in-home nurse caregiving services for its members. Aetna members may use their plan benefits for covered caregiver services such as meal preparation, cleaning, transportation and more.

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. 

Telehealth

Aetna Medicare Advantage plans cover virtual doctor visits using a computer, tablet or smartphone conducted right from your own home. 

Home-delivered meals

You may use an Aetna plan to cover the cost of meals delivered to your home following an inpatient hospital stay. 

Fitness

Some Aetna Medicare Advantage plans include memberships to the SilverSneakers fitness program which often include home exercise and nutritional programs. 

Transportation

An Aetna Medicare plan can cover the cost of your transportation to a pharmacy or non-emergency doctor’s appointment using public transportation or a ride-sharing service. 

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.

Companionship

Use your Aetna plan to spend up to 10 hours per month with an adult companion or for help with errands, technology or household needs. 

Healthy foods

Aetna Medicare Advantage plans use a healthy foods card that can be used for the purchase of select nutritional items.

Fall prevention

Aetna plans can include an annual in-home assessment to inspect the home for any potential fall risks or other dangers along with an allowance for select safety items designed to lower the risk of falls in the home. 

Enrolling in an Aetna Medicare Advantage Plan

Not all of the benefits outlined above may be available with all plans in every location. Compare Aetna Medicare Advantage plans online to find out exactly what benefits are available from plans offered where you live, and compare the costs of your different Aetna plan options.

You can also connect with a licensed insurance agent for help exploring Aetna Medicare Advantage plans in your area that may offer similar or additional home health care benefits.