Nov 22, 2021
BCBSRI introduces new health plan aimed at bringing value and quality to Rhode Islanders eligible for both Medicare and Medicaid
BlueRI for Duals offers companion services, grocery delivery, dedicated care teams, and more
PROVIDENCE, RI (November 22, 2021) – Blue Cross & Blue Shield of Rhode Island (BCBSRI) is taking important steps to make healthcare more accessible and affordable with a new Dual Eligible Special Needs Plan (D-SNP) designed to support people who need a high-level of support and care. BlueRI for Duals (HMO D-SNP) is now available for Rhode Islanders who qualify for both Medicare and Medicaid. This may be a good option for low income adults who are 65 years or older and younger adults with disabilities.
“Addressing the social factors that disproportionately affect the health and well-being of dual-eligible Rhode Islanders is the backbone of our D-SNP offering,” said Melissa Cummings, BCBSRI executive vice president and chief customer officer. “We’ve created a thoughtful, coordinated program of care management in partnership with our provider network as part of a plan that delivers benefits to help members prioritize their health while saving money, maintaining independence and staying connected.”
Nearly 37,000 Rhode Islanders are dual-eligible. Data shows that many who are dual-eligible face significant challenges to their health and well-being. Nationally, more than 50 percent of dual-eligible individuals live below the federal poverty level, 42 percent of them are disabled, and 23 percent of dual-eligible individuals over 65 years of age have Alzheimer’s Disease.
BlueRI for Duals coordinates care and benefits between Medicare - a federal program - and Medicaid - a state program - to provide high-quality, affordable coverage to those who need it most. BCBSRI Medicaid specialists help members understand what resources they’re eligible for, and also help members fill out applications for additional benefits.
In addition to a wide network of providers, Rhode Islanders who enroll in BlueRI for Duals get access to a health navigator who works in tandem with their care team and chosen primary care provider (PCP) to ensure the member receives the best care. Health navigators help members reach their health goals and assist with things like setting up appointments with healthcare providers, scheduling transportation, connecting with community resources for food or housing support, and more.
BlueRI for Duals offers a robust portfolio of benefits for a $0 monthly premium, including:
Benefits that support wellness goals and save money
- Wellness reimbursement — $200 to use toward healthy activities, including exercise classes, weight-loss programs and sports lessons.
- Over-the-counter (OTC) benefit — $275/quarter to buy a wide range of health-related items online or at some stores like Walmart, Dollar General, Family Dollar, Rite Aid, Walgreens and CVS Pharmacy.
- Dental coverage — $3,000 benefit including services for crowns and onlays, denture repairs and more.
- $0 mail-order drugs — Members get a 90-day supply of prescriptions at no cost when filled through mail order.
- Hearing — No-cost routine office visits and up to two hearing aids for $0 copay, plus a three-year supply of batteries and a hearing aid fitting and evaluation.
- Allowance for glasses and vision hardware — No-cost routine office visits and a $300 allowance for glasses or vision hardware.
- Acupuncture — $0 copays for up to 12 visits per year.
Benefits offering convenience and flexibility
- Monthly grocery delivery for members who qualify — Monthly delivery of seasonal fruit and vegetables, eggs, prepared foods, bread, cheese and more.
- Private ride service — Up to 50 one-way rides to or from PCP or specialist visits, as well as community locations that support health and well-being, like senior centers and libraries.
- $0 national gym benefit and home fitness kits — Access to more than 16,500 fitness centers across the country, as well as a selection of home fitness kits through Silver&Fit®.
- Meal deliveries — One week of home-delivered healthy meals after discharge from a hospital stay.
- Doctors Online — Access to top-rated, board-certified doctors or therapists from the comfort of home at no cost.
Benefits that keep members connected
- Daily living assistance — Members get hands-on help seven days/week. Papa Pals pairs older adults with in-home “Pals” to foster companionship and offer assistance with everyday tasks like household chores, technology, food shopping and transportation.
- Caregiver reimbursement — Members get $100 per year to reimburse caregivers who provide basic household and transportation assistance.
- Dementia Care Coordination Program — Members and caregivers can receive support and resources tailored for dementia or other dementia-related diagnoses.
- Peer Recovery Program — Members can get support, education and resources to facilitate recovery from substance use disorders.
- Social interaction opportunities — BCBSRI’s partner Amava offers in-person and virtual volunteer opportunities with leading local and national organizations, as well as online social “circles.”
Rhode Islanders can learn more about BCBSRI’s BlueRI for Duals plan by:
- Calling the BlueRI for Duals Support team at 1-401-459-5477 (TTY: 711) to discuss a plan or request a home visit.
- Attending a virtual or in-person informational meeting: Visit bcbsri.com/duals to schedule an appointment or register for a meeting to learn more.
- Visting Your Blue Store℠:
- Cowesett Corners, 300 Quaker Lane, Warwick
- Highland Commons, 71 Highland Avenue, East Providence
- Lincoln Mall Shopping Center, 622 George Washington Highway, Lincoln
- Marshalls Plaza, 1400 Oaklawn Avenue, Cranston
During the Medicare annual election period (AEP), between October 15 and December 7, 2021, eligible adults can enroll or make changes to their Medicare plan, which goes into effect on January 1, 2022. If adults have Medicaid, they become eligible for special election periods (SEPs) when they can join, switch or drop plans. After Jan 1, 2022 dual-eligible adults with both Medicare and Medicaid can also join a new plan or switch plans once per quarter January-March, April-June, and July- September.
- Those considering a new Blue Cross plan may call BCBSRI’s BlueRI for Duals Sales Support team at 1-401-459-5477 (TTY: 711) from 8 a.m. to 8 p.m., seven days a week (Oct. 1-March 31).
- Existing members may call BCBSRI’s BlueRI for Duals Member Support team at
(401) 277-2958 or 1-800-267-0439 (TTY: 711) from 8 a.m. to 8 p.m., seven days a week (Oct. 1-March 31).
To learn more about dual-eligibility and BlueRI for Duals, listen to this recent episode of BCBSRI’s The Rhode to Health Podcast: https://soundcloud.com/therhodetohealth/the-duals-difference-s4-ep16.