40 • The physician or Allied Health Professional certifies that:  The Home Health Care is medically necessary; and  In the absence of the Home Health Care, the covered individual would be an inpatient at an Acute Care Hospital; or • A Cigna case manager recommends the Home Health Care services as being the most appropriate treatment in the most effective setting possible for the patient’s medical condition. Home Health Care charges include: • Charges for the services of a home health aide on a part - time or intermittent basis. Services under this benefit are limited to 40 visits in a calendar year. Note: The Plan will not pay for visits that exceed the 40 - visit limit. One home health aide visit is limited to four hours or less. • Charges for nutrition counseling. • Charges for psychiatric treatment by a licensed social worker who is practicing within the scope of the license. • Practitioner charges and medical support charges. Hospice Care Charges for Hospice Care by a Hospice Care Program or othe r qualified Hospice Care provider as listed below are covered medical charges under the terms of the Plan. Charges that are incurred only: (a) during a period (no longer than 6 months) for which the Claims Administrator validates a physician’s certificatio n that the participant is a terminally ill patient, and (b) during the bereavement period, will be covered under the terms of the Plan. Covered Hospice Care charges include the following, if provi ded by a Hospice Care Program: • Confinement of the terminall y ill participant as an inpatient in a Hospice Care facility. • Home Health Care furnished to the terminally ill participant in his or her home. Such Home Health Care may include, as part of Hospice Care:  Services of a home health aide.  Professional services of a Nurse.  Physical therapy or other therapy furnished by an Allied Health Professional.  Charges for nutrition counseling and special meals.  Medical Support Charges. • Charges for medical social services furnished to the terminally ill participant or to t he participant’s family unit. • Charges for bereavement counseling furnished to the terminally ill participant’s family unit during the bereavement period, up to three (3) individual or family sessions for all members of the terminally ill participant’s fami ly unit. • Inpatient Respite Care is limited to eight (8) days per lifetime. For Hospice Care only, the terms of the medical coverage are modified as set forth below to enable Hospice Care charges to meet the definition of covered medical charges: • The excl usion for Custodial Care does not apply.