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.