2025 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

 

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:
 
  • 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.

 

Benefit Description

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