COVID-19 Coverage - Updated March 31, 2023

COVID-19 Vaccines - Regardless of your plan, COVID-19 vaccinations rendered by in-network providers will continue to be covered 100%. Vaccines provided by out-of-network providers will no longer be covered unless the plan has an exception to cover out-of-network preventive benefits. Normal cost sharing will apply – this means you may be responsible for copays, coinsurance, and deductibles associated with your visit.

COVID-19 Screening and Testing - In-office COVID-19 tests administered by a provider will now be covered under your plan’s minor diagnostic test benefit and COVID-19 provider screenings will be covered according to the place of service benefit (e.g., office visits, urgent care, etc.). Normal cost sharing will apply – this means you may be responsible for copays, coinsurance, and deductibles associated with your visit.

If you have questions about these coverage changes, please call Member Services at 800-538-5038. FEHB members, please call 844-345-FEHB.

We’ve complied with the federal government’s extension of timely filing deadlines for claims and appeals, COBRA, and Special Enrollment periods for those enrolled on an employer-sponsored plan*. These changes apply from March 1, 2020 and end 60 days after the May 11th expected end of the National Emergency (July 10, 2023), or one year from the date first eligible for relief, whichever is earlier. The following periods and dates have a suspension period:

• The date you can file a claim
• The date you can file an appeal of adverse benefit determination
• The date you can file a request for external review after receiving an adverse benefit determination
• The date you can elect COBRA coverage and the date you can make your first COBRA premium payment
• The date you can elect or change coverage if you qualify for a Special Enrollment Period

*This only applies to members of all fully insured and self-funded groups that are regulated by the Employee Retirement Income Security Act. 

For Select Health Medicare members, prior to September 1, 2021, cost sharing (copays and coinsurance) for in-network treatment of COVID-19 is covered 100%. Effective September 1, 2021, regular cost sharing applies. Other plan benefits related to COVID-19 treatment are covered according to the Centers for Medicaid and Medicare guidelines under a public health emergency. Screening and testing for COVID-19 are covered in- and out-of-network for a $0 copay.

For Medicaid members (those on a Select Health Community Care plan), COVID-19 screening, testing, vaccination, and treatment are covered as an emergency service and can be received through in-network and out-of-network providers.

If your child is covered by a CHIP plan, screening, testing, vaccination, and treatment for COVID-19 are covered as an emergency service and can be received from in- and out-of-network providers.