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New FEP SNF/sub-acute benefit effective January 1, 2018

December 20, 2017

Effective January 1, 2018, Federal Employee Program (FEP) members with Standard Option will have coverage based on medical necessity for skilled nursing facility (SNF)/sub-acute care for a maximum of 30 days per benefit period. In addition to meeting medical necessity criteria, the following requirements will apply:

  • The transferring facility must submit a detailed description of the FEP member?s clinical status and proposed treatment plan for review by Independence of the proposed admission.
  • The transferring facility must have the FEP member sign the Consent for Case Management form and fax it to the Independence Case Management department at 215-761-0249 prior to the facility making the request.
  • The FEP member or his or her authorized representative must speak with an Independence Case Manager while at the facility. At the time of outreach, the Case Manager will explain the benefit and its requirements and enroll the member into Case Management to facilitate the transition.

Note: FEP members with Basic Option do not have a SNF/sub-acute benefit; however, Independence can facilitate their transition to a lower level of care. Please call Customer Service at 1-800-ASK-BLUE for more information.

If you have any questions, please contact Sharon Evans at 215-241-2877 or Tracey Carter at 215-241-9739.


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