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Blue Shield In-Home Healthcare For HMO and PPO Members In Southern California

Visits from a home health care nurse can ease the transition from a hospital discharge and reduce trips to the doctor’s office, urgent care, or the emergency room. Blue Shield of California has contracted with Dispatchhealth to provide in-home visits to address a variety of medical conditions.

Dispatchealth In-Home Healthcare for Blue Shield PPO, HMO

The Dispatchhealth in-home medical care for Blue Shield HMO and PPO members is currently only available in Los Angeles, Orange, Riverside, and San Diego counties in 2023. The types of medical conditions that can be treated include respiratory infections, COPD, catheter problems, cuts and lacerations, diarrhea, edema, influenza symptoms, fever, urinary problems, shingles, minor sprains, strains, bruises, and many more conditions. There are also a several conditions that Dispatchhealth will not treat because they require immediate emergency care such as chest pain, loss of consciousness, shortness of breath, severe abdominal pain, and stroke symptoms.

Schedule In-Home Medical Services

Blue Shield PPO members can schedule a visit by calling the Blue Shield Nurse Hotline or contacting Dispatchealth directly via website or telephone. Blue Shield HMO members must call their Primary Care Physician for a referral for an in-home visit to treat a medical condition. In-home visits are grouped into 5-hour windows corresponding to morning, afternoon or evening. Appointments can be as early as 7 AM or as late as 10 PM, sometimes on the same day as the request. Care is available in English and Spanish.

Cost of In-Home Medical Services

Blue Shield has a separate category for home health care services within their summary of benefits. With a Silver 70 plan the copay for an in-home visit is $45 for a variety of providers including nurse, home health aide, social worker, physical, speech, or occupational therapist. It is unclear what the cost of a Dispatchhealth visit would be if the plan was a Bronze 60 or Bronze HDHP where the plan member must pay the full contracted amount until they have met their medical deductible. Additionally, no cost estimates were provided if the in-home visit required the administration of a drug or the application of bandages, splints, etc.

The addition of easily accessible and reliable in-home health care for minor and routine medical services is increasing with all of the health plans. The goal is to reduce the number of higher cost visits to a doctor’s office, urgent care, or emergency room setting. However, it would be nice if Blue Shield or Dispatchealth could be more specific about the types of health care issues that can be addressed by an in-home visit and the costs to the plan member above the home visit.


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