Frequently Asked Questions About Vital Savings on Long Term Care Services


Click here for answers to general questions about the Vital Savings by Aetna program.

What kind of long term care facilities and services are best for my medical needs?
The term “long term care services” actually includes many types of providers and facilities. These could include a skilled nursing facility, assisted living facility or home health care. The first step in choosing a provider is to determine exactly the type of services needed and what providers are available to best meet these needs. A discussion among patient, physician and family members will help you make this determination.

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What provider screening should I do before considering a long term care facility?
If you’ve decided that a nursing home is best able to deliver the services needed, you and your family members should consider the following to narrow your choices:
  • Location
  • Reputation
  • Services Provided
  • Cost
This initial information can be obtained through phone interviews with providers, physicians, friends and community agencies.

Once you’ve identified several potential providers, you should contact the Administrator or Admissions Director to obtain additional information. Some questions you will want to ask include:
  • What services and levels of care are available at this facility?
  • How many beds? Are they accepting new patients? Is there a waiting list and if so what is the usual waiting time?
  • What are the monthly room charges? What are the charges for any additional services? Is there a down payment or deposit required? If so, how much?

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What should I look for when visiting a long term care facility?
After deciding on several possible providers, you should visit those you are considering. Call the providers and schedule an appointment. Let them know that you will want to tour the facility and talk with staff and other patients if possible. You will need to allow at least one hour, and possibly several hours, for this visit.

You should consider the following during your visit:

  • Physical Layout. Are buildings and ground well maintained and free of obvious safety hazards? Are there outside areas for wheelchairs, walking, and activities? Are the rooms clean and neat? Are residents’ personal belongings in evidence? Is there sufficient light? Is the temperature comfortable? Is there adequate bathroom privacy?

  • Staff. What are the number and qualifications of staff members? How many RNs, LPNs, Nursing Assistants, Physical and Occupational Therapists, Dieticians, etc.? How does the staff interact with patients? What is the turnover rate of staff? Is a physician on call 24 hours? How are emergencies handled?

  • Food. If possible, schedule your visit during a mealtime. Does the food look and smell appealing? Do the portions appear to be adequate? Are considerations made for special dietary requirements? Is food served at the proper temperature? Are eating and food preparation areas clean? Is staff available to assist patients with eating, if needed?

  • Atmosphere. What is your overall impression of the facility? Does it appear to be a friendly and caring environment? Are patients well groomed and dressed appropriately? What activities are patients engaged in? Do they appear content? Speak with staff and patients during your visit.

  • Other. Review a sample care plan. Ask to see a copy of their latest state inspection report. Talk with others in your community who have used the facility. Talk with family members of other patients who may be visiting during your visit.

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After choosing a long term care facility, what other considerations need to be made?
After making your final choice, you will still need to perform several important duties:
  • Discuss your plans and choice with the patient and other family members.
  • Continue to be involved in the care process for the patient.
  • Understand all aspects of your arrangement with the nursing home. Ask questions.
  • Visit often and encourage others to do so as well.

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What should I consider when selecting a home health care provider?
There are a number of factors to consider related to service and staff availability, staff qualifications and agency certifications/accreditations. The following questions should help you select an agency that’s appropriate for you:

Which services does your agency offer and what is the cost per visit/hour?
  • Nursing
  • Homemaker and personal care
  • Physical therapy
    • Speech therapy
    • Social work
    • Dietitian services
    • Dental care
    • Medical supplies and equipment
    • Other services
  • What days and hours are services available?
  • Are services available on holidays?
  • What kind of training do your homemaker home health aides receive?
  • Who supervises the home health aides and how often are supervision visits made to the home?
  • How many RNs and LPNs does your agency have?
  • How often are physician consultations made regarding the patient?
  • Is your agency certified for reimbursement in Medicare/Medicaid?
  • Is the agency licensed?
  • Is the agency accredited by one of the accrediting bodies, such as the Community Health Accreditation Program and Joint Commission of Accreditation of Healthcare Organizations?

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What information should I relay to a home care provider?
To begin with, it’s important for the home health agency to know about the person they will be serving. This will enable them to develop a plan of care that meets the individual's needs and provide accurate cost estimates. The following information will be useful to have when first contacting or meeting with any home health agency:
  • Name and age of prospective client
  • Physician (s) name and phone number
  • Current and past health diagnosis
  • Medications and ability to self medicate
  • Special dietary needs
  • Mobility and range of motion
  • Need for assistance with the following:
    • Bathing
    • Walking
    • Dressing
    • Feeding
    • Toileting
  • Need for assistance with:
    • Light housekeeping
    • Laundry
    • Meal preparation
    • Dishes
    • Transportation
    • Shopping
  • Insurance information, including:
    • Medicare
    • Long term care insurance coverage
    • Other health insurance

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Vital Savings by Aetna® is not available in Vermont or Montana.

Vital Savings on Pharmacy is not available in Tennessee.

The Vital Savings by Aetna® program (the "Program") is not insurance. The Program provides Members with access to discounted fees pursuant to schedules negotiated by Aetna Life Insurance Company for the Vital Savings by Aetna® discount program. The Program does not make payments directly to the providers participating in the Program. Each Member is obligated to pay for all services or products but will receive a discount from the providers who have contracted with the Discount Medical Plan Organization to participate in the Program. Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, 1-877-698-4825, is the Discount Medical Plan Organization.