Blue Cross Blue Shield and Senior Care Coverage

Overview of Blue Cross Blue Shield Insurance Plans for Seniors

Blue Cross Blue Shield offers Medicare Advantage (Part C), Medicare Supplement (Medigap), and standalone Medicare Part D plans. Let’s take a closer look at each of these options:

• Medicare Advantage: BCBS Medicare Advantage includes Part A and Part B coverage, along with additional benefits. Many BCBS Part C plans include Part D prescription drug coverage, hearing aid discounts, wellness programs, and vision coverage. While you can expect Parts A and B with all Medicare Advantage plans, the additional benefits vary between plans and carriers.
• Medigap: BCBS Medigap plans pay for many of the standard costs that come with Medicare coverage, including premiums, deductibles, and coinsurance payments. A Medigap plan can be added to Original Medicare as supplemental coverage, but it cannot be used with a Medicare Advantage plan.
• Medicare Part D: BCBS Part D can be acquired as either a stand-alone plan with Original Medicare or a plan bundled with your BCBS Medicare Advantage plan. Either way, BCBS Part D plans help reduce the costs of prescription drugs.

If you want a long-term care insurance (LTCI) policy, you may or may not be able to get one through Blue Cross Blue Shield. BCBS does not offer LTCI in every state, but these plans are available in select locations. You will need to contact BCBS directly to see if there are LTCI policies available in your area.

Does Blue Cross Blue Shield Cover Nursing Homes and Skilled Nursing Care?

Medicare does not typically cover nursing home costs, and BCBS Medicare Advantage and Medigap plans are no exception. If you want nursing home coverage, you will need to see if BCBS has LTCI available in your area or find a similar policy through a different carrier. As for skilled nursing care, Medicare Part A can cover some of the costs for medically necessary care that lasts no more than 100 days. If you need additional care at a skilled nursing facility (SNF), you will also need to seek out a long-term care policy.

Does Blue Cross Blue Shield Cover Home Care?

Medicare Part A covers some at-home care services.2 Those who have a BCBS Medicare Advantage plan may have some coverage for home care. Most BCBS Part C plans cover home health care, such as caregiver support and home-delivered meals.

In-home care covered by BCBS policies may include care from a registered nurse or a licensed practical nurse who has supervision by a registered nurse. It can also be accessible to those who need in-home physical therapy, language and speech therapy, or occupational therapy. Medical supplies provided by a doctor and medical services for emotional or social needs may also be covered, depending on the policy.

Does Blue Cross Blue Shield Cover Hospice Care?

BCBS may provide some coverage to individuals who are entering hospice care. Hospice care provides end-of-life support for those with terminal illnesses, including physical, social, medical, and spiritual care. Some Medigap plans include Part A hospice care coinsurance or copayments, and BCBS Medicare Advantage plans may provide some coverage. LTCI policies also cover hospice care.

You can apply for either a preferred or non-preferred BCBS hospice care benefit, which provides a set of services and supplies to members with a projected life expectancy of six months or less. With the preferred plan, you would pay 30 percent of the plan allowance. Non-preferred members pay the full price of the plan.3

Does Blue Cross Blue Shield Cover Assisted Living?

In most cases, BCBS insurance policies do not cover assisted living or other types of long-term care. In assisted living communities, the goal is to provide the individual with the support they need for ongoing care. This does not often include much medical need, and assisted living communities typically do not have constant medical care available. As a result, most Medicare plans do not cover this type of care.

There may be exceptions if there is medical care involved. Each individual plan will define the amount and level of care provided in these cases. Though it is not common on all forms of insurance available through BCBS, coverage may be available on specialized plans or with LTCI.

How Do I Enroll in a Blue Cross Blue Shield Medicare Plan for Senior Care?

BCBS makes it easy to understand what plans are available to you based on your eligibility and location. You can learn more about available policies on the BCBS website. If you are ready to enroll in a plan, you can use the search tool to see which plans are available in your area (using your ZIP code).

Your ability to enroll online will depend on your location, as BCBS uses different terms and conditions by state. Once you see which plans are available in your area, BCBS will let you know if you can enroll online, or it will provide you with a phone number to enroll by phone with a licensed agent. Since the enrollment process can vary by state, your experience signing up may differ based on your location.

What Other Options Exist to Pay for Senior Care?

Typically, senior care is funded by seniors and their families. In some cases, Medicare and Medicaid can help those who need skilled nursing care, but there are limitations. To pay for senior care, many older adults choose to tap into retirement funds and investments, sign up for LTCI, convert life insurance policies, use a reverse mortgage, or get a home care loan.