| HMO | Other Therapy Services |
| Aetna US Healthcare | Cognitive Therapy. Covers treatment for a 60 day period per incident of illness or injury beginning with the first day of treatment for non-chronic conditions, acute illnesses, and injuries. This must be part of a treatment plan coordinated with the HMO upon referral by PCP and upon approval by HMO.
Cost Sharing: Copayment applies |
| Blue Cross Blue Shield | Covers: Medically necessary services that are not specifically excluded. |
| CIGNA / Healthsource | Excludes: Pain therapy, family therapy, sex therapy, or recreation therapy unless covered on a mental health rider. |
| Doctors Health Plan | Excludes: Pain management therapy (except as medically necessary). |
| Generations | Excludes: Sex therapy and recreational therapy. |
| Optimum Choice | Excluded. |
| PARTNERS | Covers: Sclerotherapy if used in conjunction with a related surgical procedure, or when medically necessary for the treatment of esophageal varices.
Excludes: Sclerotherapy for the treatment of varicose veins (unless part of a medically necessary surgical procedure.) |
| Coventry/Principal Health Care of the Carolinas | Covers: Pain management therapy with prior approval. |
| QualChoice | Excludes: The injection of sclerosing solutions for the treatment for varicose veins. |
| The Wellness Plan of North Carolina, Inc. | Covers: Covers physical medicine
Limits: Limited to 20 sessions in any 12 month period. Excludes: Recreational, educational, music, and sleep therapy. |
| United HealthCare | Covered only when medically necessary. |
| WellPath | Covers: Pain management therapy if WellPath determines the condition is expected to improve significantly 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. |