2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Home Health Services
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Home Health Services
Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.
Benefit Description
Home Health Services
Home nursing care (skilled) for two hours per day limited to 10 visits when:
You Pay
Preferred: $25 copayment per visit (no deductible)
Non-preferred (Participating/Non-participating): You pay all charges
Note: You pay 30% of the Plan allowance (deductible applies) for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 128 for more information about “agents.”)
Benefit Description
Home Health Services
Home nursing care (skilled) for two hours per day limited to 10 visits when:
- A registered nurse (R.N.) or licensed practical nurse (L.P.N.) provides the services; and
- A physician orders the care.
You Pay
Preferred: $25 copayment per visit (no deductible)
Non-preferred (Participating/Non-participating): You pay all charges
Note: You pay 30% of the Plan allowance (deductible applies) for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 128 for more information about “agents.”)
Benefit Description
Not covered:
You Pay
All charges
Not covered:
- Nursing care requested by, or for the convenience of, the patient or the patient’s family
- Services primarily for bathing, feeding, exercising, moving the patient, homemaking, giving medication, or acting as a companion or sitter
- Services provided by a nurse, nursing assistant, health aide, or other similarly licensed or unlicensed person that are billed by a skilled nursing facility, extended care facility, or nursing home
- Private duty nursing
You Pay
All charges