Does my plan cover COVID-19 testing?
Yes, Blue Shield will waive out-of-pocket costs for copays, coinsurance, and deductibles for:
- COVID-19 screenings performed:
- 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 recommended by a doctor
There are no prior approvals needed for COVID-19 screening or testing.
What if I need treatment for COVID-19?
There are no prior approvals needed for COVID-19 treatment. Blue Shield will waive copays, coinsurance, and deductibles for COVID-19 treatments received between March 1 – May 31, 2020. This applies to the following plan types:
- Plans purchased through Blue Shield of California directly
- Plans purchased through Covered California
- Medicare Supplement plans
- Fully-insured employer-sponsored plans
- Self-insured and flex-funded employer-sponsored plans where the plan sponsor has elected to pay for copays, coinsurance, and deductibles for COVID-19 treatment (These plans are not required to cover these costs)
To find out which plan you have, call the customer service number on your 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, we suggest using a virtual care option such as Teladoc or NurseHelp 24/7SM before seeking in-person care. This will help reduce the risk of spreading the virus. For members who usually have Teladoc copays or coinsurance, we are waiving these costs for all Teladoc virtual care visits through June 30, including visits that aren’t related to COVID-19. NurseHelp 24/7SM is always available at no additional cost.
- With Teladoc, you can talk to a doctor 24/7 by phone or video to screen for the virus. Learn how Teladoc can help.
- You can also talk to a registered nurse anytime with NurseHelp 24/7SM.
Not all plans have access to these services. Log in to your online account to see what benefits your plan covers.
You can also call your primary care physician (PCP) for advice, and they may be able to see you virtually. If your doctor or nurse recommends testing for COVID-19, they can tell you where to go to get tested.
Some plans also include Heal, which provides on-demand house calls in select cities. Heal is conducting virtual screenings during this crisis. They will tell you about any costs associated with your visit upfront, so there are no surprises. If you don’t have Heal in your plan, you can still access their services, but will have to pay all costs out-of-pocket. See if Heal is available for you.
What if I seek care from an out-of-network provider for COVID-19? Will it be covered?
In the case of a medical emergency, care provided by network and out-of-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 out-of-network covered benefits, Blue Shield will cover both network and out-of-network copays, coinsurance, and deductibles for COVID-19 covered treatment benefits during this time. However, it’s important to note that out-of-network providers may charge more than the covered benefit amount. In this case, you may be responsible for paying the difference.
What if I need to refill my prescriptions?
If you are worried you might run out of prescribed medications, Blue Shield of California allows early refills on your prescriptions as long as there are refills available. This applies to all members with pharmacy benefits through Blue Shield. 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.
Most members can order a 90-day supply of maintenance medications through our mail service pharmacy, CVS Caremark®, with no delivery fee. To review your pharmacy benefits, log in to your online account and call your doctor to switch to a 90-day prescription.
What if I continue seeing my mental health care provider?
If you are currently seeing a mental health care provider, you can continue to see that provider virtually, such as over the phone or by video. Your standard coverage and out-of-pocket costs apply.
Do you have any resources to help me manage stress and my health while at home?
Sanvello, a mental and wellness health app in our Wellvolution® program network that helps members manage stress, anxiety, and depression, is providing expanded access and premium programming for members through 7/31/2020. All content – 45 different mindfulness and meditation sessions, coping tools, guided journeys, and community boards – is available at no additional cost during the COVID-19 public health emergency. Most Blue Shield members can use their account login information to access Sanvello at Wellvolution.com. In addition to Sanvello’s mental health resources, our virtual Wellvolution programs also provide nutrition and fitness support to help you eat better, move more, and even treat chronic conditions like diabetes.
Please note: Some ASO and Medi-Cal plans do not have access to Wellvolution. Please check your evidence of coverage (EOC)/member handbook for more eligibility information.
Questions about medical or prescription coverage?
Call the number on your member ID card.