Nutritional Support

Aetna covers enteral (tube) or parenteral (IV) nutritional support—including standard semi‑synthetic intact‑protein enteral formulas—when a member has permanent non‑function of the structures that permit food to reach the small bowel or has small‑bowel disease that impairs digestion/absorption, and excludes oral nutrition and regular grocery products (e.g., thickeners, baby food, gluten‑free products, protein powders) as well as nutrition solely for anorexia/nausea or end‑stage disease when the GI tract functions. Key requirements: the feeding must be necessary to provide sufficient nutrients to maintain weight and strength commensurate with the member’s health (partial impairments may qualify), coverage depends on the member’s benefit plan (check plan), and state law may mandate oral coverage in some jurisdictions.

"For home enteral or parenteral nutrition: care plan that includes justification for home therapy, duration, monitoring plan, and documentation of prior inpatient management and stabilization."