Huntington Ingalls Newport News Anthem Key ... - Benefits Connect

What is covered - 19
• assistive technology services and devices.
Early intervention services for the population certified by the Department are those services listed
above which are determined to be medically necessary by the Department and designed to help an
individual attain or retain the capability to function age-appropriately within his environment. This
shall include services which enhance functional ability without effecting a cure. Benefits for services
listed shall not be limited by the exclusion of services that are not medically necessary.
Emergency room care
Your health plan covers emergency room visits, services, and supplies. If you are admitted to the
hospital from the emergency room, the hospital stays must be reviewed by Anthem within 48 hours of
admission. The emergency room doctor, a relative, or a friend can call Anthem for Hospital Admission
Review (see page 11) in an emergency.
Home care services
Your health plan covers treatment provided in your home on a part-time or intermittent basis. This
coverage allows for an alternative to repeated hospitalizations that will provide the quality and
appropriate level of care to treat your condition. To ensure benefits, your doctor must provide a
description of the treatment you will receive at home. Your coverage includes the following home
health services:
• visits by a licensed health care professional, including a nurse, therapist, or home health aide; and
• physical, speech, and occupational therapy (services provided as part of home health are not subject
to dollar-limits).
These services are only covered when your condition confines you to your home at all times except for
brief absences.
Home private duty nurse’s services
Your health plan covers the cost of medically skilled services of a currently licensed Registered Nurse
(RN) or Licensed Practical Nurse (LPN) in your home when the nurse is not a relative or member of
your family. Your doctor must certify to us that private duty nursing services are medically necessary
for your condition, and not merely custodial in nature.
Hospice care services
Hospice care will be covered, for covered persons diagnosed with a terminal illness with a life
expectancy of six months or less. Covered services include the following:
• skilled nursing care, including IV therapy services;
• drugs and other outpatient prescription medications for palliative care and pain management;