| HMO | Cardiac Rehabilitation |
| Aetna US Healthcare | Covers: Cardiac rehabilitation as part of an inpatient hospital stay. |
| Blue Cross Blue Shield | Covered. |
| CIGNA / Healthsource | Covered.
Cost Sharing: Copayment applies. |
| Doctors Health Plan | Covers: Cardiac rehabilitative programs up to 90 consecutive days per occurrence per contract year; optical therapy for conditions expected to show significant improvement, as determined by Doctors Health Plan.
Limits: Limited to 20 visits per illness per injury per contract year. Requires precertification or prior authorization from Doctors and must be provided by participating provider or facility unless there is no participating provider available. |
| Generations | Covers. |
| Optimum Choice | Covered. |
| PARTNERS | Covered with prior approval by plan.
Cost Sharing: Copayment applies for certain services. |
| Coventry/Principal Health Care of the Carolinas | Covers: Cardiac rehabilitation therapy.
Limits: Therapy is limited to conditions that are expected to show significant improvement in 60 days. Benefits for therapy and/or treatment will be discontinued if it is determined within the first two weeks that the member’s condition will not significantly improve. |
| Qual Choice | Covered.
Cost Sharing: Copayments may apply. |
| The Wellness Plan of North Carolina, Inc. | Covered when medically necessary and referred by a participating physician with prior approval. |
| United HealthCare | Covers: Short-term cardiac rehabilitation services provided in a participating hospital or approved health care facility, under the direction of a participating provider.
Note: Limited to $500 maximum benefit. Prior approval required. |
| WellPath | Covers: Cardiac rehabilitation if WellPath determines the condition is expected to significantly improve within 60 days. Also covers short-term inpatient therapy if the member is already receiving inpatient care and services can only be provided on an inpatient basis.
Limits: Must be provided by a participating provider with prior approval from WellPath. Limited to maximum treatment period of 60 consecutive days per illness or injury. If services for the same condition are received on both an inpatient and outpatient basis, total coverage for both is limited to a maximum treatment period of 60 consecutive days. Cost Sharing: Copayment applies. |