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If a test reader is required, reimbursement is limited to $12. Check out the changes and updates to our plan in 2023. Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. 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.. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Reimbursement requests take up to 4-6 weeks to process Questions? The following resources provide you with the information needed to administer Blue Cross and Blue Shield of Texas (BCBSTX) plans for your patients. All information . See the list. 510 0 obj <>/Encrypt 455 0 R/Filter/FlateDecode/ID[]/Index[454 121]/Info 453 0 R/Length 185/Prev 186847/Root 456 0 R/Size 575/Type/XRef/W[1 3 1]>>stream The $0 coverage only applies when you receive your home test kits at participating locations. You must submit a separate claim form for each covered family member. Today, the Blue Cross Blue Shield Association (BCBSA) announced that independent and locally-operated BCBS companies across the country and the BCBS Federal Employee Program (FEP . Ted S. Warren/AP. Use the doctors, labs and facilities in your BCBSTX health plan's provider network for: Tests to diagnose COVID-19 The New to Market FDA-Approved Medication Review Exception Process allows a member to apply for coverage of an excluded drug at a tier 3 cost share if the member has met the requirements outlined. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Use this order form for specialty medications. Serving residents and businesses in the 28 eastern and southeastern counties of New York State. Then, complete and submit the online form. This list is subject to change as additional home test kits become available. See our FAQfor detailed instructions. The aforementioned legal entities (excepting First Care, Inc. of Maryland), CareFirst BlueChoice, Inc., and The Dental Network, Inc., are independent licensees of the Blue Cross and Blue Shield Association. 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. Many Blue Cross Blue Shield of Rhode Island plans include $0 coverage for COVID-19 test kits without a prescription. Pregnant members can use this form to request a blood pressure monitor at no cost. All rights reserved. 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. Here's how to get reimbursed: Submit a claim form Sources: Find answers on our member and employer pages, or contact us. Reimbursement is not available through medical benefits with BlueCross BlueShield or Cigna. You do not need health insurance to receive your free tests. All information below is required. Your member ID card is your key to using your medical plan benefits. Everyone qualifies. Also, note that all American households can order free COVID-19 tests from the federal government. You do not need health insurance to receive your free tests. 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()};}; For J.D. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . However, you must include all required information requested in the form. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. See below.). The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Health Insurance Providers Help Vaccinate More Than 2 Million Seniors Against COVID-19 in Underserved Communities, Blue Cross and Blue Shield Federal Employee Program (FEP) Joins White House Effort to Achieve National Vaccination Goal, Blue Cross Blue Shield Association Partners with Feeding America and its Network of 200 Food Banks to Drive Education of COVID-19 Vaccination, Blue Cross and Blue Shield Companies Join National Commitment to Protect Employees and Communities from COVID-19, Health Insurance Providers Commit to Help Millions of Seniors in Underserved Communities Receive COVID Vaccines, HPV vaccination rates low despite risks of related cancers, Infographic: COVID-19 patients with high-risk conditions 3x more likely to need the ICU, Why flu shots are so important during COVID-19 pandemic, Blue Cross Blue Shield Companies Invest in COVID-19 Relief, Frequently Asked Questions about COVID-19 Vaccination, Guidance for Communities, Workplaces and Schools. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Outcome - The time to file this claim is suspended starting on March 1, 2020, until 60 days after the National Emergency is declared over. Fill Online, Printable, Fillable, Blank COVID-19 Testing Member Reimbursement Form Non-Medicare Advantage (Blue Cross Blue Shield of Michigan) Form Use Fill to complete blank online BLUE CROSS BLUE SHIELD OF MICHIGAN pdf forms for free. this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; Please note that you cant submit for reimbursement for a home test kit unless you have a doctors note or prescription. Coverage varies by plan type. (function(){var g=function(e,h,f,g){ Tests that can be purchased at a retail location or online but are then sent to a lab for processing are not covered unless accompanied by a doctor's order (except for individuals covered by plans based in the District of Columbia). Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services, must be purchased on or after January 15, 2022, used to identify the potential COVID-19 infection, will be self-administered with results that can be self-read, will not be resold, given or supplied to persons other than family members covered under the same policy, The purchase receipt documenting the date of purchase and price, UPC** cut-out from the over-the-counter COVID-19 test packaging, Signed, completed attestation confirming and acknowledging that the purchased over-the-counter at-home COVID-19 test meets eligibility guidelines. A diagnostic test is used to determine if a person has COVID-19. You'll be reimbursed by check within 60 calendar days. If you need more space to include additional members, receipts, or healthcare providers, you may use a separate sheet of paper. Mail-in claim forms allow you to submit a claim for multiple members with one form. 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. You can only use your $0 coverage at pharmacies and healthcare providers participating with this specific program. try{(new g(100,"r","QSI_S_ZN_eQKLROMaB9E1yfz","https://zneqklromab9e1yfz-carefirst.siteintercept.qualtrics.com/SIE/?Q_ZID=ZN_eQKLROMaB9E1yfz&utm_source=Qualtrics")).start()}catch(i){}})(); 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. Pickup cannot happen via drive-thru and tests will not be shipped. During the federal public health emergency, Blue Shield will continue to waive out-of-pocket costs for copays, coinsurance, and deductibles for: COVID-19 screenings or evaluations done: Virtually using telehealth, In a doctor's office, At an urgent care center, or In a hospital (including emergency room). Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . Leading the way in health insurance since 1929. 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. Some people may be eligible for a second booster, including: Adults ages 50 years and older. 1095-B Tax Form Message. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. Medicare Advantage members: Use the claims form for OTC at-home tests with a healthcare provider order. If you buy the tests online or at a retail store (including the regular store checkout at a pharmacy rather than the pharmacy counter), youll need to submit a form, along with your receipt, and will be reimbursed up to $12 per individual test. Blue Cross Blue Shield of Massachusetts is starting with a reimbursement system, with a submission form available on its website. Blue Shield of California has neither reviewed nor endorsed this information. 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}; 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. NDC or UPC number Date purchased / / Quantity of tests. 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}; (CVS, a participating pharmacy, has a different process for getting your home test kits for $0. Only visit the ER or call 911 if youre experiencing life-threatening symptoms. Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California If your employer has asked you to submit receipts to your pharmacy benefit plan, please dont submit them here. 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. Here is the process: If you prefer to have your home test kits shipped to your house, you can pay out-of-pocket and submit for reimbursement using this form. You can find a list of community-based testing sites here. Receipt and UPC barcode from the kit package are required. endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream 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. Should you wish to request to recruit a facility or physician into the GMMI network, please complete this nomination form. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream PO Box 272540 Telehealth. There are 0 fields that need to be corrected. It must include the original receipt or a copy of the receipt for purchasing the tests. ro?gu?"t6Vr K?K@n}r`TyEycB". For more information, view our privacy policy. Once you reach the limit of eight tests per member per calendar month, we will not reimburse claims for additional tests. Your signature is also required in the COVID-19 home test kit claim section. Please note: Your receipt must be dated January 15, 2022 or later to be eligible for reimbursement. Then, complete and submit the online form. Our Commitment to You What's Covered Coverage will vary based on your plan. Visit the, Reimbursement is limited to OTC COVID-19 at-home tests. Blue Shield and Blue Shield Promise cover these types of tests: 1Tests ordered by a healthcare provider means that a licensed and authorized healthcare provider has requested that you obtain a test for COVID-19. OTC COVID test kit claim. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. or retailer (e.g. | 8cqy .-mg7b Y0118_22_062A_C 02082022 For help with these documents, please call 1-800-975-6314. . 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. OTC tests are covered with no out-of-pocket costs when purchased at the pharmacy counter for members with . The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. CHICAGO - Blue Cross and Blue Shield (BCBS) companies are working closely with state and local governments, as well as partners within the health care system, to address local needs from the COVID-19 outbreak. Commercial Health Plans, Northeast Region. Instead of showing your BCBSRI member ID card at the pharmacy counter, you provide that information online and then pick up the home test kits at a CVS Pharmacy location. The claim entered day 179 of the 180-day timeline on Feb. 29, 2020. Please note that taxes and other fees are not covered. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. They are typically easy to use and produce rapid results. Member Discounts Take advantage of member-only discounts on health-related products and services. To access your member services, please visit your BCBS company. Reimbursement is limited to $12 per test, which may include tax and shipping/delivery charges (to a maximum of $12). If you have a large employer, please call member services at the . Please note that taxes and other fees are not eligible for reimbursement. // , // /ProcSet[/PDF]>>>>stream No, I am the authorized representative for a Medicare member. F2g5 :s+Jc c I had COVID-19 symptoms. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { Please note that these home test kits cant be used for workplace screening or travel. You can view a complete list ofparticipating pharmacies in Rhode Islandor search thenational directoryfor participating pharmacies. endstream endobj 468 0 obj <>/ProcSet[/PDF]>>>>stream 2. endstream endobj 465 0 obj <>/ProcSet[/PDF]>>>>stream You can submit any number of receipts on a single claim form. endstream endobj 469 0 obj <>/Subtype/Form/Type/XObject>>stream You can get up to 8 individual tests per calendar month from participating pharmacies and healthcare providers during the COVID-19 public health emergency. Example 3: These enhancements include covering services not previously covered and waiving fully insured member costs for select services related to COVID-19. To access your member services, please visit your BCBS company. Health plans are offered by Blue Shield of California. reimbursement through FSA, HRA, or HSA accounts? Prime has an established electronic connection with most pharmacies, even those not in their network, and the claim should process successfully. Sign in or register at Caremark.com (You must be a CVS Caremark member) Effective, Jan. 15, 2022, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will cover the cost of FDA-authorized, over-the-counter (OTC) COVID-19 tests through BCBSOK/Prime Therapeutics pharmacy benefits. In response to the COVID-19 pandemic, Blue Cross is expanding reimbursement for all services delivered through telehealth that meet the coverage criteria in the policy. If you have employer coverage, or an individual or family plan, you can get FDA-authorized, over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. All Rights Reserved. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. follow the latest CDC guidance for isolation. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. This is especially important before gathering with unvaccinated children, older individuals, those who are immunocompromised, or individuals at risk of severe disease. Testing and Treatment Coverage 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. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. We ask everyone to respect and protect community health as the supply chain and our health and retail partners catch up with demand. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. For more information, view our privacy policy. Overseas members will need to complete and file this claim form for any pharmacy services received. Important Please provide what is on your member card, failure to provide at least one of these fields can lead to failure in claim approval. When filing claims online, you must use a separate claim form for each receipt and for each member. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. An FDA-approved home test kit would be eligible for reimbursement if you had an order or prescription from a healthcare provider and if the test was medically necessary to diagnose COVID-19.