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) or in a doctor’s office, urgent care center, or 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 Advantage plans
- 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.
Medi-Cal members have no out-of-pocket costs for treatments.
What virtual care options does my plan cover?
If you have a fever, cough, and feel short of breath, 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. Through May 31, Blue Shield is covering your costs for Teladoc visits. 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. 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 for on-demand house calls in select cities. Learn how Heal can help. If Heal is included in your plan, there is no copay for remote screenings. If you don’t have Heal in your plan, you can request a remote call for $19 cash price to screen for COVID-19. If the doctor comes to your home, different costs apply. See if Heal is available for you.
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 out-of-network covered benefits, Blue Shield will cover both network and non-network copays, coinsurance, and deductibles for COVID-19 covered benefits during this time. However, it’s important to note that non-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 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. If you have specific questions about the medicine you take, call the Member Services number on your member ID card.
Blue Shield Commercial members should consider ordering a 90-day supply through our mail service pharmacy, CVS Caremark. 90-day supply prescriptions are available for maintenance medications used to treat chronic conditions for most lines of business. Call your doctor to switch to a 90-day prescription.
Medicare and Cal-MediConnect members can also fill a prescription for a 90-day supply of maintenance medications at retail pharmacies in addition to our mail service pharmacy. Call your local pharmacy to ask about delivery or utilize the drive-thru window when picking up prescriptions, if available.
Medi-Cal members can fill a prescription for up to 100-day supply of medications at retail pharmacies or through our mail service pharmacy. Call your doctor to switch to 100-day prescription and to ask about mail service pharmacy.
Questions about medical or prescription coverage?
Call the number on your member ID card.