Does Blue Cross Blue Shield Cover Home Care?

October 16, 2023

Home care is becoming an increasingly important aspect of healthcare—compared to living in a nursing home or assisted living facility, in-home care offers the possibility of a more personalized care experience that fosters a more independent, dignified way of life. Many people particularly seniors, prefer the comfort and familiarity of receiving care in their own homes. However, the cost of home care can be a significant concern for families.

Nova Home Care provides affordable in-home care services for your special needs child, senior family members, or a loved one recovering from injury or illness. We work with Medicaid and healthcare providers to ensure that clients receive the financial support they need to cover the costs of home care, and, when applicable, compensation for family caregivers. One question that often arises is whether health insurance providers like Blue Cross Blue Shield (BCBS) cover home care services. In this article, we will explore the coverage options provided by BCBS for home care.

What Is Blue Cross Blue Shield?

Blue Cross Blue Shield is a network of independent health insurance providers operating in the United States that, taken together, form one of the largest insurance carriers in the entire country. However, each BCBS plan is managed by a separate company, so coverage can vary depending on your specific plan and location.

Who Is Eligible For Blue Cross Blue Shield?

BCBS offers a wide range of health insurance plans, including those for individuals, families, and employers. These plans can differ in terms of cost, coverage, and eligibility criteria, but if you are a BCBS member, then your plan might cover home care.

Does Blue Cross Blue Shield Cover In-Home Care?

Whether or not BCBS covers home care services depends on the type of care needed and the specific plan you have. Generally, BCBS plans may cover certain home care services, but the extent of coverage can vary. In-home care services covered by BCBS are available through Medicare Advantage plans, which bundle the usual Medicare Parts A (Hospital Insurance) and B (Medical Insurance) services with some extras that will depend on your specific plan. One important thing to keep in mind is that BCBS will usually offer home care services under the same criteria as Medicare—this means that the home care covered must be both skilled and intermittent (not round-the-clock, indefinite care).

Home Care Services Covered by Blue Cross Blue Shield 

If you have a Medicare Advantage plan through BCBS, it may cover the following home care services:

Skilled Nursing Care

BCBS often covers skilled nursing care provided by registered nurses or licensed practical nurses in the home. This may include services like wound care, medication management, and monitoring of chronic conditions.

Home Health Aides

Some BCBS plans may cover home health aide services, which can include assistance with activities of daily living (ADLs) such as bathing, dressing, and meal preparation.

Physical Therapy, Occupational Therapy, and Speech Therapy

BCBS may provide coverage for these therapies when they are prescribed by a healthcare provider and administered at home.

Medical Equipment and Supplies

BCBS may cover the cost of durable medical equipment and supplies needed for home care, such as wheelchairs, oxygen equipment, or diabetic supplies.

Hospice Care

BCBS often covers hospice care services for individuals with terminal illnesses, ensuring comfort and support in their own homes.

Home Infusion Therapy

In some cases, BCBS plans may cover home infusion therapy, which involves administering medication through intravenous (IV) or other means at home.

How To Apply For In-Home Care With Blue Cross Blue Shield

It’s important to note that BCBS plans typically require pre-authorization or a referral from a healthcare provider to cover home care services. Additionally, coverage may be subject to certain limitations, such as a maximum number of visits or a specific duration of care.

Check Your Plan’s Coverage

To determine whether your specific BCBS plan covers home care services, you should review your plan documents or contact your BCBS provider directly. It’s crucial to understand the details of your coverage, including any co-pays, deductibles, or out-of-pocket expenses you may be responsible for.

Contact A Home Care Agency

While Blue Cross Blue Shield may offer coverage for certain home care services, the extent of that coverage can vary widely depending on your plan and the services needed. If you or a loved one requires home care and are not sure how to cover the costs, an experienced home care agency can help you navigate the system, contact the relevant institutions, and create a personalized care plan that meets your needs at an affordable or even no personal cost.

Nova Home Care is an established home care agency serving clients in the states of Indiana, Arizona, Connecticut, Minnesota, and Colorado, with services that cover personal care, homemaking, companionship, and transportation. We help families in these states arrange in-home care, paid for by the relevant local and federal institutions, and employ family caregivers where applicable. If you, a friend, or family member is in need of high-quality, reliable in-home care or has any questions about insurance or Medicaid coverage in your area, contact Nova Home Care online and let us help you or your loved one get the care needed to live a satisfying life at home.

You May Be Eligible!