United States health insurers
How United States insurers may cover stroke rehabilitation, outpatient therapy, home health, equipment, medications, prior authorization, and appeals.
UnitedHealthcare
UnitedHealth Group
UnitedHealthcare offers commercial, Medicare Advantage, and Medicaid plans nationwide. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOUnited StatesViewAnthem Blue Cross Blue Shield
Elevance Health
Anthem Blue Cross Blue Shield, an Elevance Health company, operates Blue-branded plans across 14 states. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOCalifornia, Colorado, Connecticut +11 moreViewAetna
CVS Health
Aetna, part of CVS Health, offers commercial, Medicare Advantage, and Medicaid plans across most of the country. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOUnited StatesViewCigna Healthcare
The Cigna Group
Cigna Healthcare focuses on employer-sponsored commercial plans and Medicare Advantage. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageUnited StatesViewHumana
Humana Inc.
Humana is primarily a Medicare Advantage insurer, with Medicaid managed-care plans in select states. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicare AdvantageMedicaid MCOUnited StatesViewCentene Corporation
Centene Corporation
Centene is a large government-sponsored insurer operating Medicaid, Medicare, and Marketplace (Ambetter) plans through state subsidiaries. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicaid MCOMedicare AdvantageCommercialUnited StatesViewKaiser Permanente
Kaiser Foundation Health Plan
Kaiser Permanente is an integrated HMO that delivers and insures care through its own facilities in select regions. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOCalifornia, Colorado, Georgia +6 moreViewMolina Healthcare
Molina Healthcare, Inc.
Molina Healthcare focuses on Medicaid managed care, Medicare, and Marketplace plans in roughly 20 states. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicaid MCOMedicare AdvantageCommercialUnited StatesViewAmbetter Health
Centene Corporation
Ambetter Health, a Centene brand, offers ACA Marketplace (individual) plans. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialUnited StatesViewAmeriHealth
AmeriHealth Caritas / Independence Health Group
AmeriHealth offers commercial plans in New Jersey and Delaware, while AmeriHealth Caritas operates Medicaid managed care in multiple states. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCONew Jersey, Delaware, PennsylvaniaViewBlue Cross Blue Shield of Michigan
BCBSM, Inc.
Blue Cross Blue Shield of Michigan is the state's largest insurer, offering commercial and Medicare Advantage plans. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMichiganViewCareFirst BlueCross BlueShield
CareFirst, Inc.
CareFirst BlueCross BlueShield serves Maryland, Washington D.C., and Northern Virginia. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMaryland, Washington, D.C., VirginiaViewDevoted Health
Devoted Health, Inc.
Devoted Health is a Medicare Advantage insurer serving seniors in a growing number of states. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicare AdvantageUnited StatesViewEmblemHealth
EmblemHealth, Inc.
EmblemHealth is one of New York's largest nonprofit insurers, serving commercial, Medicare, and Medicaid members. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCONew YorkViewFlorida Blue
GuideWell
Florida Blue is the Blue Cross Blue Shield licensee for Florida. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageFloridaViewHealth Net
Centene Corporation
Health Net, a Centene company, serves California across commercial, Medicare, and Medi-Cal (Medicaid) lines. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOCaliforniaViewHighmark Blue Cross Blue Shield
Highmark Health
Highmark Blue Cross Blue Shield operates in Pennsylvania, West Virginia, Delaware, and parts of New York. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantagePennsylvania, West Virginia, Delaware +1 moreViewHorizon Blue Cross Blue Shield of New Jersey
Horizon Healthcare Services
Horizon Blue Cross Blue Shield of New Jersey is the state's largest health insurer. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCONew JerseyViewIndependence Blue Cross
Independence Health Group
Independence Blue Cross serves the Philadelphia and southeastern Pennsylvania region. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOPennsylvaniaViewL.A. Care Health Plan
Local Initiative Health Authority for Los Angeles County
L.A. Care Health Plan is the nation's largest publicly operated health plan, serving Los Angeles County Medi-Cal members. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicaid MCOCommercialCaliforniaViewMetroPlusHealth
NYC Health + Hospitals
MetroPlusHealth, affiliated with NYC Health + Hospitals, serves New York City Medicaid, Medicare, and Marketplace members. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicaid MCOMedicare AdvantageCommercialNew YorkViewOscar Health
Oscar Health, Inc.
Oscar Health is a technology-focused insurer offering ACA Marketplace and small-group plans. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialUnited StatesViewPremera Blue Cross
Premera
Premera Blue Cross serves Washington and Alaska. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageWashington, AlaskaViewPriority Health
Corewell Health
Priority Health, part of Corewell Health, is a major Michigan insurer across commercial, Medicare, and Medicaid lines. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOMichiganViewRegence BlueShield
Cambia Health Solutions
Regence operates Blue-branded plans across Oregon, Washington, Idaho, and Utah. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageOregon, Washington, Idaho +1 moreViewTufts Health Plan
Point32Health
Tufts Health Plan, now part of Point32Health, serves New England across commercial, Medicare, and Medicaid lines. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOMassachusetts, New Hampshire, Maine +2 moreViewUPMC Health Plan
UPMC
UPMC Health Plan is an integrated, provider-owned insurer based in western Pennsylvania. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
CommercialMedicare AdvantageMedicaid MCOPennsylvaniaViewWellCare
Centene Corporation
WellCare, a Centene brand, offers Medicare Advantage and Medicaid managed-care plans. Coverage for inpatient rehab, outpatient therapy, home health, DME, and medications varies by plan, state, network, and medical-necessity documentation. Prior authorization is commonly required for higher-cost post-acute services such as inpatient rehab, SNF, certain DME, and extended therapy.
Medicare AdvantageMedicaid MCOUnited StatesView
Disclaimer
This resource is for general education only and is not legal, medical, or insurance advice. Coverage varies by plan, employer group, state, network, medical necessity criteria, and current policy documents. Always verify benefits directly with the insurer and request the applicable plan documents.