Does my plan cover COVID-19 screening and testing?
Yes. During the public health emergency, Blue Shield of California (Blue Shield) and Blue Shield of California Promise Health Plan (Blue Shield Promise) will waive out-of-pocket costs for copays, coinsurance, and deductibles for:
- COVID-19 screenings or evaluations done:
- Virtually using telehealth, including Teladoc
- 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
There are no prior approvals needed for COVID-19 screenings, evaluations, or testing.
What if I need treatment for COVID-19?
There are no prior approvals needed for COVID-19 treatment. Blue Shield and Blue Shield Promise will waive copays, coinsurance, and deductibles for COVID-19 treatments received between March 1 – December 31, 2020. This applies to the following plan types:
- Medicare Advantage plans
- Medicare Supplement plans
If you have a Cal-MediConnect plan, visit our MediCal and Cal-MediConnect COVID-19 resources.
To find out which plan you have, call the customer service number on your member ID card.
If I paid out of pocket for COVID-19 treatment that took place between March 1 and December 31, what do I need to do?
First, call Member Services at the number on your member ID card to see if your provider sent the claim directly to Blue Shield. If the claim has not been submitted by the provider directly, Member Services will help you submit a claim along with an itemized statement for processing a reimbursement.
What virtual care options does my plan cover?
If you have a fever, cough, feel short of breath, or are experiencing other symptoms, we suggest using a virtual care option such as Teladoc ® or the Nurse Advice Line before seeking in-person care. You can also check to see if your primary care physician is offering telehealth services. 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.
Talk to board-certified doctors 24/7 by phone or video.
(800) 835-2362 [TTY: 711]
Varies by plan, see details below.*
NurseHelp 24/7 or
Nurse Advice Line
Get health advice 24/7 from a registered nurse over the phone.
Teladoc access and out of pocket costs vary by plan.*
For these plans, members have $0 copays for all visits always*:
- Blue Shield Medicare Advantage HMO and PPO plans
- Blue Shield Promise Medicare Advantage
- Medicare Supplement Plan G Extra
- Cal MediConnect
These plans were granted temporary access to Teladoc through December 31 with $0 copays through temporary access period:
- All other Medicare Supplement plans (not plan G Extra)
Blue Shield Medicare Advantage PPO plans also include Heal, which provides on-demand house calls in select zip codes. During the coronavirus (COVID-19) pandemic, all initial Heal appointments will be via phone or video. If your issues remain unresolved and you are not symptomatic or exposed to COVID-19 and are seeking care in a Heal covered zip code, your Heal doctor will schedule a house call.
Heal will tell you about any costs associated with your visit upfront, so there are no surprises. At this time, Heal is not available to Blue Shield Medicare Advantage HMO plans, Medicare Supplement plans, and all Blue Shield Promise plans (Medicare, Medi-Cal, and Cal MediConnect).
* Please refer to your Member Handbook/Evidence of Coverage or plan documents for information regarding access to these programs and standard out-of-pocket costs. You can also call Member Services at the number on your ID card or log in to your online account to see what benefits your plan covers.
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 network and non-network providers will be covered for all plans.
Outside of an emergency situation, you should seek care from network providers to save money and make sure you don’t have to pay more out-of-pocket.
If you have a plan with non-network covered benefits, Blue Shield and Blue Shield Promise will cover both network and non-network copays, coinsurance, and deductibles for COVID-19 covered benefits during this time. Medicare Supplement Plan members may see any provider accepting Medicare.
What if I need to refill my prescriptions?
If you are worried you might run out of prescribed medications, Blue Shield and Blue Shield Promise allows early refills on your prescriptions as long as there are refills available with your prescription. This is for all members with pharmacy benefits through Blue Shield and Blue Shield Promise. If you have specific questions about the medicine you take, call the Member Services number on your member ID card.
To meet your needs and promote social distancing, many retail pharmacies are waiving fees for home delivery of prescriptions. Visit your pharmacy’s website or call your local pharmacy for more information. Also, if available, utilize the drive-thru window when picking up your prescriptions.
You can also fill a prescription for a 90-day supply of maintenance medications at retail pharmacies in addition to our mail service pharmacy.
How can I continue seeing my mental health care provider?
If you are currently seeing a mental health care provider, you can continue seeing that provider virtually, such as over the phone or by video. Your standard coverage and out-of-pocket costs apply.
Questions about medical or prescription coverage?
Call the number on your member ID card.