Member benefits changed with the expiration of the COVID-19 public health emergency (PHE) on May 11, 2023. Here’s what you need to know about COVID-19 and your benefits.
I’m concerned about going into a doctor’s office. Can I have an appointment on the phone or video chat instead?
Yes, if your provider offers this service. We’ll cover telehealth visits with providers in our networks who offer this service until further notice. This includes visits with your primary care provider, specialists, behavioral health providers and ABA providers, and physical, speech and occupational therapists. This visit will cost you the same as a face-to-face visit with your provider, so any copay or cost-share you would normally have will still apply.
How do I find a doctor who does telehealth?We recommend calling your regular provider to see if they offer this service. Many are offering telehealth to help keep their patients at home as much as possible.
Will my plan cover the COVID-19 test?Yes. We’ll cover and waive member costs for any US FDA-approved tests, as well as those currently pending FDA approval, if your doctor recommends it. We’re also waiving member copays and deductibles for the visit to your provider, urgent care center or emergency room related to a COVID-19 test.
New: I’ve tested positive for COVID-19. How long do I need to isolate?As of February 2024, the CDC has updated its COVID-19 isolation guidelines to align with recommendations for flu and other respiratory illnesses. If you test positive for COVID-19, you should isolate and/or stay home while experiencing symptoms and return to work or school once you’re feeling better and have been without a fever for at least 24 hours without the use of a fever-reducing medication. Even after returning to work or school, the CDC still recommends exercising caution for at least five days, which includes:
Visit the CDC’s Respiratory Virus Guidance for more information.
Will my plan cover a COVID-19 test that gets sent to a lab for results?Yes. Your plan covers COVID-19 tests your in-network provider sends to a lab for testing.
Will my plan cover COVID-19 antibody tests?Yes. Your plan covers COVID-19 antibody tests your in-network provider orders. This applies to in-person and telehealth appointments.
Will my plan cover COVID-19 at-home tests that diagnose a current infection?We’ll cover FDA-approved or emergency-authorized at-home tests that diagnose a current infection if authorized by a network provider.
New: I heard you’ll reimburse me for OTC at-home COVID tests. How does that work?Through new federal government rules, we’ll reimburse you for up to eight rapid over-the-counter at-home COVID-19 tests per month that you pay for out of pocket. These tests must be for personal use, and they can’t be used for any return-to-work testing or work-related testing required by your employer. The eight-test limit is per person on your plan. A package of two tests counts as two toward the limit of eight, and taxes and shipping costs are ineligible for reimbursement.
Any test you take at home that must be sent to a lab for results isn’t currently eligible for reimbursement. However, this type of test when ordered by a provider is covered under your BlueCross medical benefits.
Here’s a list of FDA-approved, -authorized or -cleared tests eligible for reimbursement if purchased on or after Jan. 15, 2022.
Please follow these steps for your reimbursement.
Each item above must be the original. Reimbursement requests without all items or with copies or photos of the items won’t be accepted.
Reimbursement for eligible tests will continue throughout the COVID-19 public health emergency.
New: Can I use my FSA/HRA/HSA to buy OTC COVID-19 tests that I’m submitting for reimbursement?If you’re submitting your over-the-counter COVID-19 tests for reimbursement, you can’t use your HSA to pay for them up front or submit a reimbursement request to your FSA or HRA.
Will my plan cover other tests, like flu or strep, that my doctor does before a COVID-19 test?Yes. We’ll cover testing for flu and strep under your usual benefit and cost share. Many providers are performing these tests prior to COVID-19 testing.
Will my health plan cover a COVID-19 vaccine?Yes. Your plan covers vaccines approved by the US FDA to prevent COVID-19 when you get them from an in-network provider.
Will my health plan cover treatment of COVID-19?Yes. If you’re diagnosed with COVID-19, we’ll cover any relevant treatment your in-network provider recommends. In a true emergency, please go to the nearest emergency room.
Will I have to get a preauthorization for testing or treatment of COVID-19?COVID-19 tests don’t require prior authorization, but some treatments and hospital stays do. If you’re seeing an in-network provider, they usually ask for prior authorization on your behalf. But if you get care from an out-of-network provider, please contact us to see if prior authorization will be required, or to let us help you find care from an in-network provider.
Will my plan reimburse me for COVID-19 return-to-work or -school testing?No. We understand that, as businesses reopen and adapt their health and safety practices, many require routine COVID-19 testing as part of their return-to-work or -school safety procedures. Employment-based COVID testing is not part of our health plan benefits, similar to pre-employment and periodic drug testing, and coverage for it isn’t included under the CARES Act. We’ll continue to cover the full cost of COVID-19 testing that’s recommended by your provider based on your symptoms, risk or exposure.
Will my health plan cover medical supplies such as masks, gloves and disinfectant? No. We don’t cover these supplies under your health plan.Updated: Will you allow for early refills so I don’t have to make multiple trips to the pharmacy and risk exposure?
Throughout much of the pandemic, we’ve allowed early refills on many prescriptions. On Sept. 1, 2021, we reverted to our standard refill timeline if your pharmacy benefits are covered through BlueCross. However, you can get 90-day fills for many medications to treat chronic conditions. Your plan may also have mail-order benefits if you don’t want to go out to a pharmacy to get your medications.