AZ Blue Best Life Plus (HMO): Skilled Nursing Facility (SNF) Care
SNF is post-acute care, typically following a hospitalization, provided most often in a facility, that involves licensed nursing care and oversight.
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How To Receive
Details on how to apply
A provider will determine if admission to an SNF is needed.
The provider will write a corresponding order for admission and include in the order the services to be received while at the SNF.
Contact the AZ Blue Best Life Plus Team at 1-800-446-8331 (TTY 711) for prior authorization.
The ordering provider or the selected SNF will help with prior authorization.
The SNF will reach out to schedule an intake/admission time.
The SNF may also help with prior authorization.
Attend the intake/admission appointment and follow guidance from the SNF care team.
Be prepared for your loved one to remain at the SNF following the intake/admission.
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Skilled Nursing Facility (SNF) care and rehabilitation services are provided on a continuous daily basis in a skilled nursing facility. Examples of care include physical therapy, medications that can only be given by a registered nurse, or complex wound care that cannot be performed in the home. Typically, but not always, admission to an SNF follows a hospitalization and is utilized as post-acute care before returning home.
Covered services include but are not limited to:
Semiprivate room (or a private room if medically necessary)
Meals, including special diets
Skilled nursing services
Physical therapy, occupational therapy, and speech therapy
Drugs administered to you as part of your plan of care (this includes substances that are naturally present in the body, such as blood clotting factors)
Blood - including storage and administration*
Medical and surgical supplies ordinarily provided by SNFs
Laboratory tests ordinarily provided by SNFs
X-rays and other radiology services ordinarily provided by SNFs
Use of appliances such as wheelchairs ordinarily provided by SNFs
Physician/Practitioner services
Generally, you will get your SNF care from network facilities. However, under certain conditions listed below, you may be able to pay in-network cost-sharing for a facility that isn’t a network provider, if the facility accepts our plan’s amounts for payment.
A nursing home or continuing care retirement community where you were living right before you went to the hospital (as long as it provides skilled nursing facility care)
A SNF where your spouse is living at the time you leave the hospital
*Coverage of whole blood and packed red cells begins only with the fourth pint of blood needed—costs for the first 3 pints of blood in a calendar year must be paid out-of-pocket or the blood must be donated from self or by someone else. All other components of blood are covered beginning with the first pint.
BENEFIT PERIOD: There is no limit to the number of benefit periods. A "benefit period" starts on the day of admission to a hospital or skilled nursing facility. It ends after 60 days in a row without hospital or skilled nursing care. Upon hospital admission, after one benefit period has ended, a new benefit period begins.
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