Does Anthem Blue Cross Blue Shield Cover Home Health Care?
- Anthem Blue Cross Blue Shield Medicare Advantage plans cover home health care services such as intermittent skilled nursing care, and some plans may also cover things like caregiver support, home-delivered meals or bathroom grab bar installation for qualified plan members.
Home health care benefits can be an important part of an older adult’s health insurance coverage. Many seniors wish to age in place at home for as long as possible, but some may lack the independence to do so unassisted.
Anthem Blue Cross Blue Shield Medicare Advantage plans (part of the Anthem family of brands and the Blue Cross and Blue Shield group of affiliate companies) provide all of the same home health care benefits that are found in Original Medicare (Medicare Part A and Part B). This means plan members who have been deemed homebound and need part-time or “intermittent” skilled nursing care can qualify for Medicare-covered home health care with a plan from BCBS.
Some Anthem BCBS Medicare plans may also cover additional home health care services such as non-emergency medical transportation, home meal delivery, home health aides and caregiver support, though these benefits may be limited to qualified members of certain types of plans that may not be available in all locations.
All Medicare Advantage (Medicare Part C) plans – including Anthem Blue Cross Blue Shield Medicare plans – are required to cover at least the same benefits covered by Original Medicare. Medicare Advantage plans can also offer other benefits not covered by Original Medicare, such as dental, hearing, vision and prescription drugs.
What Is Medicare Skilled Nursing Care?
According to the Centers for Medicare & Medicaid Services (CMS), skilled nursing care is care given by a nurse or other trained health care provider who can administer IVs and other injections, change out wound dressings, manage medication doses and more.
Medicare defines "part-time or intermittent" care as skilled nursing care or home health aide care for up to 8 hours each day, up to a weekly limit of 28 hours. You could potentially qualify for more frequent care if your doctor documents that it's medically necessary.
When skilled nursing care is needed, the benefits also extend to personal care, or “custodial” care. This includes assistance with activities of daily living like bathing, dressing, toileting, eating, mobility and more. Medicare doesn't cover custodial care when that's the only type of care you need.
Other home health care services covered by Medicare (and thus by Blue Cross Blue Shield Medicare Advantage plans) include physical, occupational and speech therapy, along with social services like counseling.
What Coverage Does Blue Cross Blue Shield Offer In-Home?
There are many additional home health care insurance services that can be beneficial to individuals who are homebound or have difficulty leaving the home. Some of these home health care benefits may be covered by certain types of Medicare Advantage plans from Blue Cross Blue Shield, such as Special Needs Plans (SNPs).
Some of these benefits can include coverage for things like:
- Family caregiver or friend acting as a caregiver
- Home health care or caretaker services
- Home delivered meals and assistance with meal preparation
- In-home hospice care and respite care
- Home modifications such as wheelchair ramps and grab bars
- Durable medical equipment (DME) like walkers or wheelchairs
- Non-emergency medical transportation to doctor’s offices and pharmacies
- Telehealth and 24/7 nurse hotlines
- Health and fitness programs that offer opportunities to participate from home
- Home delivery of prescription drugs and over-the-counter health products
It's important to remember that plans with these benefits may not be available where you live or may be limited to members who qualify due to having certain chronic health conditions or being dual eligible for Medicare and Medicaid.
Does Blue Cross Blue Shield Pay for Family Caregivers?
Yes, some Blue Cross Blue Shield Medicare Advantage plans may provide additional coverage and/or support for at home care and family caregivers.
How Can I Enroll in a BCBS Medicare Plan With Home Health Care Benefits?
Once a year during the Annual Enrollment Period (AEP, also called the fall Medicare open enrollment period), you can make changes to your Medicare coverage. If you anticipate a need for home health care services in the upcoming year, it may be wise to review the home health care coverage of your current plan and compare it to the benefits of other plans available in your area.
Some beneficiaries may be able to change their Medicare coverage during a Special Enrollment Period if they experience certain qualifying life events.
Most Medicare beneficiaries have their choice of more than one Medicare Advantage plan where they live, and the coverage offered can differ in each plan.
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