Aetna Healthy Home Visit

[ps2975]

For those of you enrolled in an Aetna Medicare plan, have you had an Aetna Healthy Home Visit? I have had a barrage of emails and snail mail from Aetna urging me to have such a visit, and now they’re offering a gift card if I do so. I had spoken to Aetna quite a while back regarding these visits and asked them if the results could be used to raise my premiums. Rather than getting a “yes” or “no” response, I was told “probably not.”  That was all I needed to hear. I’ll pass.  Anyone else have history regarding this subject?

[8strts]

Well, I have United Healthcare and I always do a physical because sometimes they find things you don’t think about and they check your feet impulses,which was a surprise for me. This is to see if blood is flowing through your veins ( like for diabetes) with no problems.

Now, this time I received a text message to get a wellness exam, which covers a whole lot more than the physical but they are giving a $50 gift card this year, which is like What? I was so surprised, so I might do it, who doesn’t need money?

Last year, I had an argument with the person doing it, her idea and my idea was totally different, especially on how to take care of myself. So, hopefully I won’t get the same person and get my gift card and take my granddaughter out.

[GailL1]

@8strts 

What you describe is NOT what the OP is talking about.  Everybody should get a once over by their PCP every one or two years, sometimes more often.

What the OP is talking about is calls from their MA plan insurer to set up[ a time when they can come to where they live and evaluate them.  This evaluation is different than an annual check by ones doctor.

The (MA) insurance company send out a clinician and they will probably take vitals, but also look around the home for safety issues.  Depending on the DX from the doc, they may look in the refrig to see what one may be eating.  They will talk about medications, make sure the beneficiary is taking them correctly and they have some way of taking them in a timely fashion.

Call this a much more in-depth exam where other environmental and social things are measured.  Yes, they may look for other indicators of a completely different Dx so that you can be up coded and then they get paid more for you by Medicare.

Personally, I feel that if this is needed, and it would be in a lot of cases, that the clinician should be under the control of the PCP and not the MA insurer.  

[GailL1]

You don’t have to do it, in fact, it might be better that you don’t - it is important to see your doc for an annual wellness check, med review and anything you might want to talk to him about.

Some MA companies use this method to upcode you - they get paid more from Medicare if you have complex Dx and more than one.

STAT News - 01/20/2023  UPCODING BY MA plans Must be Reined In

This has been around since at least 2014 - now, there could be some advantages also but probably for those who already have multi-Dx.  They could also live alone -

What these visits should be used for is to get to know the beneficiary more - where & how they may live for safety concerns.  They take your vitals and see how you perform alone caring for yourself.  OR they could ask questions about your socialization - who may come and go -  What’s your transport issues?  Can you prepare your meds according to directions ?  What about meals and meal prep?  You know stuff like that -  which some people do need.

Do MA plans do something about some of these issues?  Yes they can - some of them have added benefits to help some low income beneficiaries to get access to needed care in the home and it helps their bottom line by keeping people safely at home.

If you or anybody reading this decides to do one off these in-home evaluations - get a copy of the final report for your medical records.

My suggestion to CMS on this assessment tool is to have it ordered by your PCP and for that doc to also get a copy of the report.

If there are concerns noted in the report - perhaps the MA insurer should also give a synopsis of what could be done to remedy it - again copying the doc, beneficiary.

[cat0w]

I don't have Aetna, but I do go in at least once each year for my free Medicare checkup. I went for this year's checkup on Feb. 6. I was asked the Medicare questions. Examples are, do I feel safe in my home, do I have smoke alarms, and do they work, do I have grab bars in my bathrooms etc.