If you purchased an OTC at-home test at the direction of your health care provider, please use this form: If you purchased an OTC at-home test for any other reason, please use this form: Send a copy of all your receipt(s) with the form. f/4kg>/ProcSet[/PDF]>>>>stream Contact your local health department to learn about free COVID-19 testing locations or pickup sites. endstream endobj 464 0 obj <>/ProcSet[/PDF]>>>>stream To be reimbursed for a COVID home test kit purchased at any pharmacy . This coverage cant be used for workplace screening or travel. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Please note that this network may be different than your plans standard pharmacy network. To use your quarterly OTC benefit, you must buy the home test kits in store through the national retailers in your OTC network: Walmart, Dollar General, Family Dollar, Rite Aid, Walgreens, and CVS Pharmacy. For the Health of America. Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers. It should not be considered current, complete or exhaustive, nor should you rely on such information to recommend any tests, products, procedures, opinions, or a course of treatment for you or any other individual. If you have a BCBSRI Medicare Advantage plan that includes a quarterly OTC allowance ($25-$275, depending on your plan), you can also use it to buy COVID-19 home test kits. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. Use the claims form for OTC at-home tests with a healthcare provider order. Also, note that all American households can order free COVID-19 tests from the federal government. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. See the list. The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. Medical, Vision, Dental Claims and Reimbursement Forms Prescription Drug Forms Coverage and Premium Payment Forms Personal Information Forms Medicare Forms HIPAA. You can submit a claim for reimbursement electronically by logging in to myBCBSRI.com. if (evt.target.id === 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } Attach an original itemized bill from your provider (required information & example on the back) . Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. No, the home tests provided by the government do not count toward your $0 coverage. Chico, CA 95927-2540. That form will be replaced on Jan. 23 once the insurer develops a . To be eligible for reimbursement, the purchased over-the-counter at-home COVID-19 tests: Members must complete a claim form to be reimbursed for over-the-counter COVID-19 testing. You do not need health insurance to receive your free tests. Should you wish to request to recruit a facility or physician into the GMMI network, please complete this nomination form. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. below is required. The following resources provide you with the information needed to administer Blue Cross and Blue Shield of Texas (BCBSTX) plans for your patients. Find and download forms often used by our members. If you buy the tests at a participating pharmacyat the pharmacy counteryou will pay $0 when using your BCBSRI member ID card. Health plans are offered by Blue Shield of California. You can get these tests for $0 at pharmacies and healthcare providers that are participating with the federal government for this specific program. Pumj(jlG_E>;j+/ Tests detect COVID, but vaccination remains the best way to protect yourself from severe illness. COVID-19 | Blue Cross and Blue Shield of Illinois. By continuing to use this website, you consent to these cookies. bxx,| Yes, home test kits can be purchased with your quarterly OTC allowance ($25-$275, available with most BCBSRI Medicare Advantage plans). What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. If the pharmacy continues to direct you to pay at the regular store checkout, please consider paying for the test kit and submitting for reimbursement or trying to use a different pharmacy. . Thats a big step toward stopping the spread of the virus. An antibody test determines whether the person has had COVID-19 and therefore may have some level of immunity. c I had COVID-19 symptoms. As part of our mission to improve and protect the healthcare system, particularly under the threat of the Coronavirus/COVID-19, the Blue Cross Blue Shield Association is focused on protecting members from fraudsters who seek to take advantage of the fear and confusion many feel surrounding the coronavirus/COVID-19 during these uncertain times. CareFirst of Maryland, Inc. CareFirst Community Partners, Inc. and The Dental Network, Inc. underwrite products in Maryland only. However, we recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed. Then, complete and submit the online form. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. You can view a complete list ofparticipating pharmacies in Rhode Islandor search thenational directoryfor participating pharmacies. this.start=function(){var t=this;"complete"!==document.readyState?window.addEventListener?window.addEventListener("load",function(){t.go()},!1):window.attachEvent&&window.attachEvent("onload",function(){t.go()}):t.go()};}; endstream endobj 470 0 obj <>/Subtype/Form/Type/XObject>>stream m]6Us4xgTI0a+yhO,FR~E=KT#NbgA={jAul,WldU/ Important information about expanded coverage. Since Medicare members and members of non-Medicare plans have different coverage, be sure to look at the information below that applies to you. The number one priority for Blue Cross Blue Shield (BCBS) companiesespecially as the nation faces this unprecedented health crisisis getting their members across the country the care they need. For help with these documents, please call 1-800-975-6314. . Get started with your reimbursement request. Standard Option Basic Option FEP Blue Focus Tier Exception Member Request Form Many Blue Cross Blue Shield of Rhode Island plans include $0 coverage for COVID-19 test kits without a prescription. Copyright document.write(new Date().getFullYear()) Blue Cross & Blue Shield of Rhode Island. To submit a claim online, log in to, or register forMy Account, click My Documents, then Forms and select Over-the-Counter COVID-19 Test Online Claim to get started. 3. Telehealth. PO Box 272540 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. . See below.). Log in using the Sydney, You can still use in-person diagnostic COVID-19 testing sites. Throughout the pandemic, CareFirst has enhanced our benefits to ensure members can get the care they need. The government is committed to ensuring access to OTC tests. To enroll, reenroll, or to elect not to enroll in the FEHB Program, or to change, cancel or suspend your FEHB enrollment please complete and file this form. qGm1UCk3Ht}uh>.ky!R'@ E We ask everyone to respect and protect community health as the supply chain and our health and retail partners catch up with demand. Please note that these home test kits cant be used for workplace screening or travel. You can be reimbursed (paid back) for both: Medi-Cal members: Do NOT use this page for test reimbursement. You can view a complete list of. The $0 coverage only applies when you receive your home test kits at participating locations. Member Discounts Take advantage of member-only discounts on health-related products and services. this.get=function(a){for(var a=a+"=",c=document.cookie.split(";"),b=0,e=c.length;b2esFdUb'$K6Q Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. COVID-19 home test kit claim itemized pharmacy receipts to the back of this form. Overseas members should use the Overseas Medical Claim Form. We recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed. The protection of your privacy will be governed by the privacy policy of that site. You can find provider manuals, reimbursement documents and procedures. Please review the terms of use and privacy policies of the new site you will be visiting. We use cookies on this website to give you the best experience and measure website usage. Looking for COVID-19 coverage and benefit information? Testing and Treatment Coverage endstream endobj startxref But some are still hesitant to get the shot. Purchase up to 8 tests per family member in a 30-day period. At-home testing options and costs If they have, you are eligible to order 8 tests every 30 days for each person on your plan. Select the list of exceptions for your plan. For more information about coverage of over-the-counter tests, view our frequently asked questions. Only visit the ER or call 911 if youre experiencing life-threatening symptoms. endstream endobj 462 0 obj <>/ProcSet[/PDF]>>>>stream Mail-in claim forms allow you to submit a claim for multiple members with one form. In Virginia, CareFirst BlueCross BlueShield, CareFirst MedPlus, and CareFirst Diversified Benefits are the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). Complete this form for each covered member, You can submit up to 8 tests per covered member per month, Tests must be purchased on or after January 15, 2022. Once we process your claim, the contract holder will receive a reimbursement check by mail. We're here to help you stay informed about COVID-19 and to access the care and coverage you need. If a test reader is required, reimbursement is limited to $12. 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. Reimbursement requests take up to 4-6 weeks to process, Questions? You can submit any number of receipts on a single claim form. Thats why we are committed to ensuring our members who are dealing with a diagnosis of COVID-19 can easily access the care they need.. Sign in or register at Caremark.com (You must be a CVS Caremark member) You will be reimbursed $12 per test. At-home diagnostic tests can be purchased over the counter, online, at a local pharmacy, or from a big-box store. If you go to another location and pay upfront for a home test kit, you cant submit for reimbursement unless you have a doctors note or prescription. Check out the changes and updates to our plan in 2023. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream Blue Cross and Blue Shield companies (BCBS) will also increase access to prescription drugs, enhanced telehealth and other clinical support . and independent licensees of the Blue Cross and Blue Shield Association. All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nations recovery. // ]]>, // /ProcSet[/PDF]>>>>stream Visit the Medi-Cal website for more details. Here's how to get reimbursed: Submit a claim form %PDF-1.7 % Commercial Health Plans, Northeast Region. Medicare member reimbursement amount per test may vary by Medicare plan. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. You can also log in to the SydneySM Health mobile app, go to Claims, and choose Submit a Claim. In this case, you should fill out three claim forms one for each member. (If you dont already have a CVS account, youll need to create one.). The tests listed below are available for $0 at the pharmacy counter. Taxes and shipping costs are eligible for reimbursement, but total reimbursement may not exceed $12 per test. Provide your BCBSRI health plan information and follow the steps to order the tests. 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. endstream endobj 465 0 obj <>/ProcSet[/PDF]>>>>stream this.check=function(){var a=this.get(f);if(a)a=a.split(":");else if(100!=e)"v"==h&&(e=Math.random()>=e/100?0:100),a=[h,e,0],this.set(f,a.join(":"));else return!0;var c=a[1];if(100==c)return!0;switch(a[0]){case "v":return!1;case "r":return c=a[2]%Math.floor(100/c),a[2]++,this.set(f,a.join(":")),!c}return!0}; CHICAGO -- Blue Cross Blue Shield Association (BCBSA) announced today that its network of 36 independent and locally-operated Blue Cross and Blue Shield (BCBS) companies will waive prior authorizations and increase coverage for COVID-19 as described below. SECTION 2 - PATIENT INFORMATION Reason for the test cI was exposed to someone with COVID-19. As of Jan. 15, 2022, people with private health insurance can get reimbursed by their insurer for the cost of up to eight at-home COVID tests per month. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. To find an in-network pharmacy, click here or download the fepblue app. [CDATA[ For all formulary tier exceptions you will need to complete and file a request form. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Test kit cost $ Postal Service. For example, a physician, a nurse practitioner, or a physician assistant. Medicare member reimbursement amount per test may vary by Medicare plan. Dylan Scott covers health care for Vox. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. These tests include: BinaxNow COVID-19 AG Card Quickvue at-home COVID-19 Intelliswab COVID-19 rapid test On/Go COVID rapid test The following claims process pertains to CareFirst commercial members* only. CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. These enhancements include covering services not previously covered and waiving fully insured member costs for select services related to COVID-19. Complete the Member Request Form for ACA HIV Prevention Coverage. 1Orders not picked up within 72 hours (about 3 days) will be cancelled. These may include your doctors office, a pharmacy or health clinic, or an urgent care center. [CDATA[ Please check with your employer if you have questions. Lets say you made a one-time purchase of up to 24 tests for three members. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . Use this order form for specialty medications. You can find detailed instructions on how to file an appeal in the Disputed Claims Processdocument. 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. Effective 1/1/2020, roughly 17,500 over-the-counter (OTC) drugs and medications such as . You can submit up to 8 tests per covered member per month Tests must be FDA-authorized Tests must be purchased on or after January 15, 2022 Your commercial plan will reimburse you up to $12 per test. OTC tests are covered with no out-of-pocket costs when purchased at the pharmacy counter for members with . Submit one form per member. All information below is required. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. People ages 12 years and older who are moderately or severely immunocompromised. Commercial members may receive reimbursement for up to eight over-the-counter COVID-19 at-home tests per covered individual in the household per 30-days without a healthcare provider order or clinical assessment. 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. Find your BCBS company. **The UPC (Universal Product Code) is the barcode and 12-digit-number that typically runs below it. Visitcovidtests.gov, and click the blue "Order Free At-Home Tests" button. You must submit a separate claim form for each covered family member. When filing claims online, you must use a separate claim form for each receipt and for each member. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. |X9GZaX~ The policy only covers over-the-counter Covid-19 tests authorized and approved by the U.S. Food and Drug Administration (FDA).

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