Skilled Home Health Care Nursing Services

Aetna covers skilled home health nursing (excluding custodial care and home infusion) only when services require licensed nursing skill, are intermittent/hourly (visits up to 4 hours; home health nursing = a consecutive 4‑hour period), and are not primarily for ADL/comfort assistance. Coverage requires the member be homebound, services be ordered by a physician/PA/NP as part of an active treatment plan provided in lieu of hospitalization/SNF to prevent serious complications, and compliance with applicable plan terms and limits (private‑duty nursing may cover additional needs on some plans).

"Skilled nursing care consists of those services that must be performed by a registered nurse or licensed practical (vocational) nurse, and meet all of the following criteria for skilled nursing ser..."

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