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Helping caregivers provide
Get the tools you need to give loved ones the care they deserve.
Take better care of your loved ones and yourself, with support and resources from the Blue Shield Balance (HMO)1 Plan.
Is your loved one enrolled in Medicare? Learn about the different options available to them.
Find the comprehensive plan information you need to assist your loved one with benefits and coverage.
Blue Shield offers a variety of benefits and services to help make managing prescriptions easier.
Blue Shield Balance (HMO) members can receive a $25 allowance each month to purchase specific healthy grocery items.2
Blue Shield Balance (HMO) offers a $45 allowance each month to cover OTC health and wellness products.
Get the confidence you need to care for those you love with resources specially designed to assist you on your caregiver journey.
As a caregiver to your loved one, you will need to complete one or all of documents listed below to act as his or her representative to receive information about their health or make decisions on their behalf.
A detailed document that gives permission to use protected health information for purposes other than treatment, payment, or health care operations.
English (PDF, 141 KB)
Español (PDF, 200 KB)
An AOR form allows you to appoint a relative, friend, advocate, attorney, or your physician to act as your representative to make any requests, to present or elicit evidence, to obtain appeals information, and to receive any notice in connection with the member’s appeal.
English (PDF, 117 KB)
Español (PDF, 94 KB)
An Advance Directive is a form that allows an individual to appoint a person or persons to make health care decisions for them, if they lose the capacity to make those decisions for themselves.
English (PDF, 753 KB)
Español (PDF, XX, KB)
A POLST or Physician Orders for Life-Sustaining Treatment form is used with advance directives to serve as a continuity of care assurance. You can download the forms below or visit capolst.org for more information.
As a caregiver to your loved one, you will need to complete one or all of the documents listed below to act as his or her representative to receive information about their health or make decisions on their behalf.
A detailed document that gives permission to use protected health information for purposes other than treatment, payment, or health care operations.
English (PDF, 141 KB)
Español (PDF, 200 KB)
An AOR form allows you to appoint a relative, friend, advocate, attorney, or your physician to act as your representative to make any requests, to present or elicit evidence, to obtain appeals information, and to receive any notice in connection with the member’s appeal.
English (PDF, 42 KB)
Español (PDF, 40 KB)
An Advance Directive is a form that allows an individual to appoint a person or persons to make health care decisions for them if they lose the capacity to make those decisions for themselves.
English (PDF, 753 KB)
A POLST or Physician Orders for Life-Sustaining Treatment form is used with advance directives to serve as a continuity of care assurance. You can download the forms below or visit capolst.org for more information.
