Does my plan cover COVID-19 screening and testing?

Yes, Blue Shield of California Promise Health plan Medi-Cal and Cal MediConnect covers COVID-19 screening and testing at no cost. This includes:

  • COVID-19 screenings or evaluations done:
    • Virtually using telehealth
    • In a doctor’s office
    • At an urgent care center
    • In a hospital (including emergency room [ER])
  • COVID-19 testing that’s ordered by a healthcare provider who is licensed to order these tests 

You do not need prior approval to get COVID-19 screenings, evaluations, or testing.

View testing coverage

 

What if I need treatment for COVID-19?

You do not need prior approval to get COVID-19 medical treatment. Blue Shield Promise Medi-Cal and Cal MediConnect members have no out-of-pocket costs for medical treatments. 

There are no copays, coinsurance, or deductibles for COVID-19 medical treatments. This applies to the following plans:

  • Blue Shield Promise Medi-Cal 
  • Blue Shield Promise Cal MediConnect Plan (Medicare-Medicaid Plan)

To find out which plan you have, call the Customer Care number on your Blue Shield Promise member ID card. 

 

What virtual care options does my plan cover?

If you have a fever, cough, feel short of breath, or are experiencing other symptoms, check to see if your primary care physician is offering telehealth services. You can also try a virtual care option such as Teladoc® or the Nurse Advice Line before trying in-person care. This will help reduce the risk of spreading the virus. If your doctor recommends testing for COVID-19, they can tell you where to go to get tested.

VIRTUAL CARE
Description
Out-of-Pocket Cost

Primary Doctor
Doctors within your plan’s network may have virtual visits available.
$0

Teladoc®
Talk to board-certified doctors 24/7 by phone or video. 
Call (800) 835-2362 [TTY: 711].
 
$0

Nurse Advice Line
Get health advice 24/7 from a registered nurse over the phone. Call (800) 609-4166 [TTY: 711].
$0

Teladoc visits and the Nurse Advice Line are always available at no cost. The doctors and nurses speak English and Spanish. We also use interpreters for all other languages, at no cost to you.

Log in to get care

 

What if I seek care from a non-network provider for COVID-19? Will it be covered?

In the case of a medical emergency, care provided by in-network and out-of-network providers will be covered for all plans. 

Blue Shield Promise Medi-Cal 

Out-of-network providers are those that do not have an agreement to work with Blue Shield Promise Health Plan. Except for emergency care, you may have to pay for care from providers who are outside of our network. If you need care that is medically necessary and not available in our network, you may be able to get it outside of the network at no cost to you as long you get prior approval. If you need help with out-of-network services, please call the number for your region:

  • Los Angeles County members: (800) 605-2556 [TTY: 711] 8 a.m. to 6 p.m., Monday – Friday.
  • San Diego County members: (855) 699-5557 [TTY: 711] 8 a.m. to 6 p.m., Monday – Friday.

Blue Shield Promise Cal Medi Connect Plan

If you need medical care that Medicare and/or Medi-Cal requires our plan to cover, but the providers in our network cannot provide it, you may be able to go to an out-of-network provider. But your Primary Care Physician (PCP) must submit a request for approval for you to use out-of-network services. You must get this approval from the plan or your PCP’s affiliated medical group before going to an out-of-network provider. In this case, you will pay the same amount you would pay if you went to a network provider.

 

What if I need to refill my prescriptions?

If you are worried you might run out of prescribed medications, Blue Shield Promise Health Plan allows early refills on your prescriptions as long as there are refills available with your prescription. If you have specific questions about the medicine you take, call the  Customer Care number on your member ID card.

Many retail pharmacies are waiving fees for home delivery of prescriptions to meet your needs and promote social distancing. Call your pharmacy or visit their website for more information. If it is offered, you can also use the drive-thru window when picking up your prescriptions.

Medi-Cal members can also fill a prescription for up to a 100-day supply of medications at retail pharmacies or through our mail service pharmacy. Call your doctor to switch to a 100-day prescription and to ask about our mail service pharmacy. 

CalMediConnect members can also fill a prescription for a 90-day supply of maintenance medications at retail pharmacies or through our mail service pharmacy. Call your doctor to switch to a 90-day prescription and to ask about our mail service pharmacy. Learn more about Cal-MediConnect pharmacy benefits.

 

Can I continue seeing my mental health care provider?

If you are seeing a mental health care provider right now, you can continue to see that provider virtually, such as over the phone or by video. If you don’t currently have a mental health provider, learn how to find one

 

Contact Blue Shield Promise Medi-Cal

If you have any questions about your benefits or the cost for care you got from your doctor or hospital, please contact us. If you receive a bill for a service, please contact us.

Los Angeles County

 Phone:(800) 605-2556 [TTY: 711], 8 a.m. - 6 p.m., Monday – Friday.

 Fax: (323) 889-6236

Email us

  Blue Shield of California Promise Health Plan
Member Services
601 Potrero Grande Dr.
Monterey Park, CA 91755

 

San Diego County

 Phone:(855) 699-5557 [TTY: 711], 8 a.m. - 6 p.m., Monday – Friday.

 Fax: (619) 528-4820

Email us

  Blue Shield of California Promise Health Plan
Member Services
601 Potrero Grande Dr.
Monterey Park, CA 91755

 

Contact Blue Shield Promise Cal MediConnect Plan

If you have any questions about your benefits, the cost for care you received from your doctor or hospital; or if you receive a bill for a service, please contact Blue Shield of California Promise Cal MediConnect Plan Customer Care.

Phone:(855) 905-3825 [TTY: 711], 8 a.m. - 8 p.m., seven days a week.

Fax: (323) 889-5416

Email us

  Blue Shield of California Promise Health Plan
Customer Care
601 Potrero Grande Dr.
Monterey Park, CA 91755