Wellcare CalViva Health Dual Align (HMO D-SNP): Supervised Exercise Therapy (SET)

Supervised exercise therapy (SET) is used to alleviate painful and disruptive symptoms associated with peripheral artery disease.

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Cost
$0 copay per session
Prior Authorization Required
Yes
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain an order from a primary care provider or other specialist for SET.

  2. Locate a SET program.

  3. Schedule an initial evaluation visit with the SET program.

  4. Attend the evaluation visit, where additional sessions will be scheduled.

  5. Attend the ongoing sessions until program completion.

Availability
Up to 36 sessions over 12 weeks; additional 36 weeks as authorized
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Research has shown supervised exercise therapy (SET) to be an effective, minimally invasive method to alleviate the most common peripheral artery disease (PAD) symptom of intermittent claudication (painful to debilitating cramping in the leg induced by exercise and caused by obstruction of the arteries).

SET has been shown to be significantly more effective than unsupervised exercise and could prevent the progression of PAD and lower the risk of cardiovascular events that are prevalent in people with PAD.

SET has also been shown to perform at least as well as more invasive revascularization treatments.

SET is covered for members who have symptomatic peripheral artery disease (PAD). Up to 36 sessions over a 12-week period are covered if the SET program requirements are met.

The SET program must:

SET may be covered beyond 36 sessions over 12 weeks for an additional 36 sessions over an extended period of time if deemed medically necessary by a healthcare provider. 

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