Skilled Nursing Facility
The Plan covers confinement in a skilled nursing facility for noncustodial care. For each benefit period, the Plan will pay up to 80 percent of the member copayment established by Medicare from the 21st through the 100th day of a confinement which is also covered by Medicare.
A "benefit period" means a period beginning with a member's admission to a hospital or skilled nursing facility and ending after he or she has not been confined in a hospital or skilled nursing facility for 60 consecutive days. The term does not include any period of time or hospital confinement prior to the month in which the member becomes covered by the Plan.
You must receive preauthorization from Anthem Blue Cross prior to receiving any skilled nursing facility benefit. Anthem Blue Cross's toll-free telephone number for preauthorization is 800-274-7767.