Effective January 1, 2015: Additional services will be covered; call 1-888-849-3681 after January 1, 2015, to ask if a particular service is covered.

The plans cover medically necessary services provided and billed by a licensed home health agency for medical treatment of a covered illness or injury. These services must be part of a treatment plan written by your provider (such as a physician or advanced registered nurse practitioner [ARNP]). The provider must certify that you are homebound and would require hospital or skilled nursing facility care if you did not receive home health care. The following services are covered:

  • Visits for part-time or occasional skilled nursing care and for physical, occupational, and speech therapy.
  • Related services such as occasional care (less frequently than daily visits, and under two hours per visit) from home health aides and clinical social services, provided in conjunction with the skilled services of a registered nurse (RN), licensed practical nurse (LPN), or physical, occupational, or speech therapist.
  • Disposable medical supplies as well as prescription drugs provided by the home health agency.
  • Home infusion therapy.
For services that may be covered under another benefit, such as nutritional counseling or follow-up care for bariatric surgery, see the preceding links for coverage rules and limitations. These limitations apply even if the services are provided in the home or by a home health provider.