Medicare AdvantageCoverageHigh impact
Removal of non-skilled benefit for Medicare Advantage Plans
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Effective January 1, 2025, BCBSRI will eliminate the non-skilled benefit for all Medicare Advantage plans except BlueRI for Duals (D-SNP). Services previously covered under this benefit will now be considered non-covered and claims will be denied.
Action Required
Before January 1, 2025: Billing team must identify all services currently billed under non-skilled benefits for BCBSRI Medicare Advantage patients and stop submitting claims for these services. Update billing system to flag BCBSRI MA plans (except D-SNP) as non-covered for non-skilled services. Notify providers to inform patients these services will no longer be covered and patients will be responsible for full payment.