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 is eliminating the non-skilled benefit for all Medicare Advantage plans except BlueRI for Duals (D-SNP), making these services non-covered. This means claims for non-skilled services will be denied for most Medicare Advantage members.
Action Required
By January 1, 2025: Billing team must update system to flag BCBSRI Medicare Advantage plans (except D-SNP) as non-covered for non-skilled services. Verify patient coverage before providing non-skilled care and inform patients of potential out-of-pocket costs. Update encounter forms to remind providers that non-skilled services are not covered. Claims for non-skilled services will be denied.