If you have health coverage through a large employer, we recommend you contact your Benefits or HR Administrator to determine if your over-the-counter COVID-19 testing claim should be submitted to CareFirst as a medical claim or to your employers Pharmacy Benefit Manager as a pharmacy claim. IMPORTANT CORONAVIRUS/COVID-19 ANTI-FRAUD MESSAGE TO CONSUMERS. Blue Shield of California has neither reviewed nor endorsed this information. Medicare Advantage members: Use the claims form for OTC at-home tests with a healthcare provider order. The policy only covers over-the-counter Covid-19 tests authorized and approved by the U.S. Food and Drug Administration (FDA). You can view a complete list ofparticipating pharmacies in Rhode Islandor search thenational directoryfor participating pharmacies. 0 As of January 15, 2022, you can get reimbursed by your health plan for the costs of over-the-counter diagnostic COVID-19 tests until the end of the Coronavirus Public Health Emergency. Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed. Once you reach the limit of eight tests per member per calendar month, we will not reimburse claims for additional tests. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . endstream endobj 469 0 obj <>/Subtype/Form/Type/XObject>>stream You can buy the tests for $0 at a participating pharmacy (at the pharmacy counter) when using your BCBSRI member ID card. To access your member services, please visit your BCBS company. Testing and Treatment Coverage It must include the original receipt or a copy of the receipt for purchasing the tests. Purchase FDA-authorized OTC tests at a retail location and then submit a Health Benefits Claim Form, providing an itemized receipt that clearly shows that your purchase was for a COVID-19 OTC test to your local BCBS Plan. Each person on your plan is covered for up to 8 individual home test kits every 30 days. Beginning January 15, 2022, and for the duration of the Federal Public Health Emergency, over-the-counter tests used for diagnostic purposes that are purchased online or at a store or pharmacy will also be covered. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Complete the Member Request Form for ACA HIV Prevention Coverage. All information . The government is committed to ensuring access to OTC tests. O=>WNW% If you use a pharmacy in Prime's network, you should not have to submit a separate claim when you buy the tests at the pharmacy counter. After completing the form, be sure to sign the COVID-19 home test kit claim section and attach your home test kit receipt. See our FAQfor detailed instructions. These may include your doctors office, a pharmacy or health clinic, or an urgent care center. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { if (evt.target.id=== 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } m]6Us4xgTI0a+yhO,FR~E=KT#NbgA={jAul,WldU/ FDA-approved tests are covered for $0 when received at a pharmacy or healthcare provider participating with the federal government. [CDATA[ This coverage began on January 15, 2022. 2. All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nations recovery. 3. Who can order a test? Once completed you can sign your fillable form or send for signing. A nurse case manager with Blue Cross & Blue Shield of Rhode Island found that listening, without judgment, to one patients concerns made all the difference. If youre visiting the governments home test kit site without using the link above, please make sure you are on the correct page by looking for the U.S. flag in the top left corner and text that states An official website of the United States government.. Use this order form for specialty medications. The CDC states that home test kits may be used in the following situations: On the CDC website, you can find additional information, including how to use home tests and what to do if your test is negative or positive. If any information is missing from the invoice, contact the provider. The Contraceptive Exception Form allows members to apply for coverage, or formulary tier, exception for a contraceptive drug/product. All of the content provided on this website or on the linked websites is for informational purposes only and is not intended to serve as medical, legal or tax advice. Read our Nondiscrimination and Language Assistance notice. Using facts from the CDC, we hope to answer your questions and arm you with the knowledge you and your children deserve so you can feel confident in your decision. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Looking for COVID-19 coverage and benefit information? "The surges are worrisome, but we are better off today than when the COVID-19 pandemic started," Yeats said. For members of all other BCBSRI heath plans Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers. If you bought or ordered an at-home COVID-19 test on or after January 15, 2022, you may be able to get reimbursed for the cost. Since Medicare members and members of non-Medicare plans have different coverage, be sure to look at the information below that applies to you. For members of all BCBSRI plans except Medicare Important information about expanded coverage. Our Commitment to You What's Covered Coverage will vary based on your plan. // ]]>, // /ProcSet[/PDF]>>>>stream If a test reader is required, reimbursement is limited to $12. If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. COVID-19 TESTING AND REIMBURSEMENT. We are committed to making sure members get the care they need when they need it. Overseas members should use the Overseas Medical Claim Form. Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California With each claim form, you should include the same receipt. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. reimbursement through FSA, HRA, or HSA accounts? Please note that taxes and other fees are not covered. F2g5 :s+Jc After choosing BCBS Rhode Island as your health plan, select the Rhode Island Pharmacy Network (which is a national network) and enter your ZIP code. You can find provider manuals, reimbursement documents and procedures. Contact your local health department to learn about free COVID-19 testing locations or pickup sites. For example, a physician, a nurse practitioner, or a physician assistant. Forms for members enrolled in individual, family and employer plans with Florida Blue. Find and download forms often used by our members. 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As of January 15, 2022, your health plan administrator may have started covering at-home COVID-19 tests. News Release For Release December 8, 2021 Contact: Sara Teachout (802) 371-3254 teachouts@bcbsvt.com Blue Cross Blue Shield of Vermont to Cover Certain Take Home Antigen Tests Berlin, Vermont . 2023 copyright Anthem Insurance Companies, Inc. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. In addition to your benefits, every home in the United States is eligible to orderfree COVID-19 home test kits through the federal government atcovidtests.gov. Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. In addition to your BCBSRI benefits, every home in the United States is eligible to orderfree COVID-19 home test kits through the federal government atcovidtests.gov. endstream endobj 464 0 obj <>/ProcSet[/PDF]>>>>stream Member Reimbursement: If members purchased an OTC COVID-19 test on or after January 15, 2022, they can submit for a reimbursement of up to $12 per test. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { See the list of participating pharmacies and healthcare providers. Submit a separate form for each patient. Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. [CDATA[ For the Health of America. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. The IRS no longer requires us to automatically mail Form 1095-B to members. Log in to blueshieldca.com (Engagement Point users at, Enter that information as indicated. To be eligible for reimbursement, your test must be . or retailer (e.g. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Prime has an established electronic connection with most pharmacies, even those not in their network, and the claim should process successfully. COVID-19 Coverage Expanded to Include Over-the-Counter Kits for Diagnostic Tests. ro?gu?"t6Vr K?K@n}r`TyEycB". The Dispense as Written exception process allows for coverage of the brand drug without paying the difference in cost between brand and generic. Standard Option Basic Option FEP Blue Focus Tier Exception Member Request Form Starting today, Blue Cross commercial members can walk into any of the 60,000 pharmacies in the national Express Scripts network and buy certain tests at the pharmacy counter for $0: Inteliswab Covid-19 Rapid Test Binaxnow Covid-19 Ag Self Test Quickvue At-Home Covid-19 Test Ellume Covid-19 Home Test endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream qGm1UCk3Ht}uh>.ky!R'@ E All Rights Reserved. For members of BCBSRI Medicare Advantage and Plan 65 Should you wish to request to recruit a facility or physician into the GMMI network, please complete this nomination form.
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