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Medical Supplies Medical supplies such as oxygen, crutches, splints, casts, trusses and braces, syringes and needles, catheters, and colostomy bags and supplies are covered, based on medical necessity.

Mental Health Services All in-patient hospital admissions for mental health services must be certified as medically necessary by Intracorp.

The following is a list of covered services, provided the treatment is determined medically necessary:

  • Inpatient stabilization services for up to 30 days per calendar year (hospitalization after stabilization is achieved is not covered)

  • Mental health day treatment or partial hospitalization programs for up to 60 days per calendar year

  • Outpatient treatment up to 52 visits per calendar year

Mental health services must be provided by an appropriately licensed psychiatrist, psychologist, clinical social worker, or professional counselor in order to be eligible for coverage.

Mental health services provided in a residential facility are not covered.

Nursing Services - Private Duty and Home Health Nursing services of a practicing Registered Nurse (RN) or Licensed Practical Nurse (LPN) are covered when those services meet the following criteria:

  • Are ordered and supervised by a physician,

  • Require the technical skills of an RN or LPN,

  • Are certified by Intracorp to be provided in the home instead of the hospital, and

  • Are certified by Intracorp as medically necessary prior to initiation.

Benefits for private duty and home health nursing services are limited to $10,000 per calendar year.

No nursing benefits will be provided for: Services of a nurse who ordinarily lives in the patient’s home or is a member of the patient’s family Services of an aide, orderly, companion, or sitter Nursing services provided in a nursing facility or a personal care facility


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