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Flex 2002 News:
Home Health Care Benefits Broadened
Home health care is designed to allow hospitalized patients
to go home faster and still have access to necessary medical care. As a
general rule, expenses for home health care services and supplies—such as
nursing care, physical therapy, medical supplies and drugs, access to medical
equipment and machines, etc.—are covered as if they were provided in a hospital.
Currently, under the
90/10, 80/20, POS and PPO options, home health care benefits are available
after a hospital stay of at least three days. To ensure that all patients
have access to this type of care, beginning in 2002, under all non-HMO medical
options, home health care benefits will be available as medically necessary—and
will no longer be subject to any minimal hospital stay. However, current
coverage exclusions for custodial care and maintenance therapy will continue
to apply.
What This Change Means To You
If you are covered or are electing coverage under the 90/10, 80/20, POS
or PPO options, and you are anticipating a hospital stay, keep in mind:
- Effective January
1, 2002, home health care benefits will be available if medically necessary—and
will no longer be subject to any minimal hospital stay. Also, coverage
for up to 120 days (per calendar year) of care delivered in a skilled
nursing facility will be available.
- As a general rule,
services and supplies provided at home or in skilled nursing facilities—such
as nursing care, physical therapy, medical supplies and drugs, access
to medical equipment and machines, etc.—are covered as if they were
provided in a hospital.
- For more information
about benefits associated with home health care and skilled nursing
facilities—as well as the administrative certification and referral
requirements associated with these types of care—contact Aetna U.S.
Healthcare 800-541-6711.
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2009 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, N.J., U.S.A.
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Home health care is designed to allow hospitalized patients
to go home faster and still have access to necessary medical care. As a
general rule, expenses for home health care services and supplies—such as
nursing care, physical therapy, medical supplies and drugs, access to medical
equipment and machines, etc.—are covered as if they were provided in a hospital.
Currently, under the
90/10, 80/20, POS and PPO options, home health care benefits are available
after a hospital stay of at least three days. To ensure that all patients
have access to this type of care, beginning in 2002, under all non-HMO medical
options, home health care benefits will be available as medically necessary—and
will no longer be subject to any minimal hospital stay. However, current
coverage exclusions for custodial care and maintenance therapy will continue
to apply.
