COVID-19 coverage information
In line with California law, COVID-19 vaccines, testing, and treatment will still be covered for most Blue Shield of California members, but coverage and any applicable out-of-pocket costs may vary by plan. Please review the tables below for additional details about COVID-19 coverage. If you have any questions about your insurance type, please call the Customer Service number on your member ID card.
- Medi-Cal plan coverage will remain unchanged.
| INSURANCE TYPE | LAB TESTING1 | AT-HOME TEST KITS | VACCINES | TREATMENT | |
|---|---|---|---|---|---|
| Fully-insured (including group and individual and family plans)3 | In-network | $0 out-of-pocket costs | Up to $12 reimbursement per test for up to eight tests per month4 | $0 out-of-pocket costs | For most treatments, out-of-pocket cost may apply based on plan benefits, but some prescribed treatments (called therapeutics) have $0 out-of pocket cost |
| out-of-network | Out of pocket cost will apply based on your plan benefits5 | Up to $12 reimbursement per test for up to eight test per month4 | Out-of-pocket cost will apply based on your plan benefits5 | Out-of-pocket cost will apply based on your plan benefits5 | |
| INSURANCE TYPE | LAB TESTING1 | AT-HOME TEST KITS | VACCINES | TREATMENT |
|---|---|---|---|---|
| ASO (Administrative Services Only) plans2 | Coverage and out-of-pocket costs apply based on your plan benefits for both in-network and out-of-network providers | Not covered | Covered and $0 cost for in-network providers Out-of-network coverage and out-of-pocket costs based on your plan benefits |
Coverage and out-of-pocket costs apply based on your plan benefits for both in-network and out- of-network providers |
| Medicare Advantage & Medicare Supplement | Out-of-pocket costs apply based on a member’s plan benefits | Not covered | $0 out-of-pocket costs | Out-of-pocket costs will apply for any new treatments received |
1Lab testing refers to COVID-19 diagnostic testing, for example in-office at your doctor or ordered by your care provider. In addition, for fully insured plans lab testing also includes COVID-19 screening testing.
2Review your Blue Shield member ID card for the letters “ASO” (Administrative Services Only) to learn if you are on an ASO plan. Otherwise, call the customer service number on your member ID card. Some ASO plans have customized benefits that may be different from the information presented in this table. Please consult your plan materials or contact customer service for additional information.
3If you receive your health insurance through your employer, association, trust, etc., call the customer service number on your member ID card to see whether you have a fully-insured plan. If you purchased your plan directly from Blue Shield, a broker, or Covered California, you have an individual and family plan.
4Members can get reimbursed up to $12 per test for up to eight over-the-counter (OTC) COVID-19 tests per month for each person covered under your plan, as long as a timely claim for reimbursement is submitted via Blue Shield of California's claim submission process.
5For HMO plans, cost share will continue to be waived for these COVID-19 services.
COVID-19 testing
Find out which COVID-19 tests are available to members and where to get tested.
Medicare coverage for COVID-19
Learn about what coverage and care you can receive through your Blue Shield, Blue Shield Promise Medicare Advantage, or Medicare Supplement benefits.
Medi-Cal coverage for COVID-19
Learn about what coverage and care you can receive through your Medi-Cal benefits.
Last updated: 11/10/2023
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