Occupational Therapy

Aetna covers short-term occupational therapy to teach or re-learn activities of daily living or to restore physical function after a specific disease or injury, and excludes OT that is non-improving, asymptomatic/without an identifiable clinical condition, ongoing supervised maintenance after maximal benefit, educational training where plan exclusions apply, and driver training. Key requirements: therapy must be prescribed by a physician/licensed practitioner, delivered by a licensed OT (or under their direct supervision), be of sufficient complexity to require a therapist, and there must be objective expectation of significant improvement within about 1 month or a demonstrated need only to establish a safe home maintenance program.

"Home-based OT: in Aetna’s HMO and QPOS plans, such home-based OT accumulates towards the 60-day limit or other applicable rehabilitation benefit limits (check benefit plan descriptions)."