PSHB FEP Blue Focus
2026 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services
Page 72
Section 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services
Page 72
Benefit Description
Hospice Care (cont.)
Continuous Home Hospice Care
Services provided in the home to members enrolled in home hospice during a period of crisis, such as frequent medication adjustments to control symptoms or to manage a significant change in the member’s condition, requiring a minimum of 8 hours of care during each 24-hour period by a registered nurse (R.N.) or licensed practical nurse (L.P.N.).
You Pay
Preferred facilities: Nothing (no deductible)
Non-preferred facilities (Member/Non-member): You pay all charges
Hospice Care (cont.)
Continuous Home Hospice Care
Services provided in the home to members enrolled in home hospice during a period of crisis, such as frequent medication adjustments to control symptoms or to manage a significant change in the member’s condition, requiring a minimum of 8 hours of care during each 24-hour period by a registered nurse (R.N.) or licensed practical nurse (L.P.N.).
You Pay
Preferred facilities: Nothing (no deductible)
Non-preferred facilities (Member/Non-member): You pay all charges
Benefit Description
Inpatient Hospice Care*
Benefits are available for inpatient hospice care when provided by a facility that is licensed as an inpatient hospice facility and when:
Note: Benefits are provided for up to 30 consecutive days in a facility licensed as an inpatient hospice facility.
*Precertification is required
You Pay
Preferred facilities: 30% of the Plan allowance (deductible applies)
Non-preferred facilities (Member/Non-member): You pay all charges
Inpatient Hospice Care*
Benefits are available for inpatient hospice care when provided by a facility that is licensed as an inpatient hospice facility and when:
- Inpatient services are necessary to control pain and/or manage the member’s symptoms;
- Death is imminent; or
- Inpatient services are necessary to provide an interval of relief (respite) to the caregiver
Note: Benefits are provided for up to 30 consecutive days in a facility licensed as an inpatient hospice facility.
*Precertification is required
You Pay
Preferred facilities: 30% of the Plan allowance (deductible applies)
Non-preferred facilities (Member/Non-member): You pay all charges
Benefit Description
Not covered:
You Pay
All charges
Not covered:
- Advanced care planning, except when provided as part of a covered hospice care treatment plan as previously noted
- Homemaker services
You Pay
All charges