If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. |X9GZaX~ Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov. Coverage varies by plan type. See the FAQ below for details.) s&jPDed Tests that can be purchased at a retail location or online but are then sent to a lab for processing are not covered unless accompanied by a doctor's order (except for individuals covered by plans based in the District of Columbia). Member Reimbursement: If members purchased an OTC COVID-19 test on or after January 15, 2022, they can submit for a reimbursement of up to $12 per test. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. The number one priority for Blue Cross Blue Shield (BCBS) companiesespecially as the nation faces this unprecedented health crisisis getting their members across the country the care they need. // ]]>, // /ProcSet[/PDF]>>>>stream For example, one box containing two tests counts as two tests. For more information about Pharmacy Prior Approval and the required forms visit the Prior Approval page. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { PO Box 272540 To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. The Contraceptive Exception Form allows members to apply for coverage, or formulary tier, exception for a contraceptive drug/product. This coverage began on January 15, 2022. When filing claims online, you must use a separate claim form for each receipt and for each member. Member Discounts Take advantage of member-only discounts on health-related products and services. All information below is required. Mail-in claim forms allow you to submit a claim for multiple members with one form. Reimbursement requests take up to 4-6 weeks to process, Questions? The New to Market FDA-Approved Medication Review Exception Process allows a member to apply for coverage of an excluded drug at a tier 3 cost share if the member has met the requirements outlined. Call the number located on the back your member ID Card. Purchase up to 8 tests per family member in a 30-day period. To print and mail your claim, download theclaim form (PDF). If the pharmacy continues to direct you to pay at the regular store checkout, please consider paying for the test kit and submitting for reimbursement or trying to use a different pharmacy. b&HXR 2023 Blue Cross Blue Shield Association. This list is subject to change as additional home test kits become available. Members should complete the OptumRx Over-the-Counter Test Reimbursement Form and include their receipts. Use this form to select an individual or entity to act on your behalf during the disputed claims process. To submit a claim online, log in to, or register forMy Account, click My Documents, then Forms and select Over-the-Counter COVID-19 Test Online Claim to get started. If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. For J.D. (To submit a single form for multiple members and/or receipts, use a mail-in form instead. This is especially important before gathering with unvaccinated children, older individuals, those who are immunocompromised, or individuals at risk of severe disease. The following claims process pertains to CareFirst commercial members* only. COVID-19 Coverage for Members Your health is always our priority. All of the content provided on this website or on the linked websites is for informational purposes only and is not intended to serve as medical, legal or tax advice. With each claim form, you should include the same receipt. Reimbursement requests take up to 4-6 weeks to process Questions? Important Please provide what is on your member card, failure to provide at least one of these fields can lead to failure in claim approval. It should not be considered current, complete or exhaustive, nor should you rely on such information to recommend any tests, products, procedures, opinions, or a course of treatment for you or any other individual. Check out the changes and updates to our plan in 2023. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream You can buy the tests for $0 at a participating pharmacy (at the pharmacy counter) when using your BCBSRI member ID card. Here are helpful Service Benefit Plan brochures, claim forms, reference guides and videos. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. Submit a claim only when you are billed for services from a provider that does not directly submit a claim to the local Blue Cross Blue Shield plan. If you have a BCBSRI Medicare Advantage plan that includes a quarterly OTC allowance ($25-$275, depending on your plan), you can also use it to buy COVID-19 home test kits. Wu3B= e&gZ-h'BR$djC?Wn>2esFdUb'$K6Q Please note that this does not apply to members with BCBSRI Medicare Advantage or Plan 65 coverage. You will be reimbursed $12 per test. We use cookies on this website to give you the best experience and measure website usage. You dont need to sign in to search for a pharmacy. To enroll, reenroll, or to elect not to enroll in the FEHB Program, or to change, cancel or suspend your FEHB enrollment please complete and file this form. The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on your current health, your vaccination status, and your history of infection. The Blue Cross Blue Shield Association warns the plan doesn't address the limited supply of home test kits. For members of all BCBSRI plans except Medicare Pumj(jlG_E>;j+/ Your member ID card is your key to using your medical plan benefits. Medicare member reimbursement amount per test may vary by Medicare plan. If you have a large employer, please call member services at the . Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. As of Jan. 15, 2022, people with private health insurance can get reimbursed by their insurer for the cost of up to eight at-home COVID tests per month. You can get these tests for $0 at pharmacies and healthcare providers that are participating with the federal government for this specific program. For members of BCBSRI Medicare Advantage and Plan 65, For members of all other BCBSRI health plans. this.check=function(){var a=this.get(f);if(a)a=a.split(":");else if(100!=e)"v"==h&&(e=Math.random()>=e/100?0:100),a=[h,e,0],this.set(f,a.join(":"));else return!0;var c=a[1];if(100==c)return!0;switch(a[0]){case "v":return!1;case "r":return c=a[2]%Math.floor(100/c),a[2]++,this.set(f,a.join(":")),!c}return!0}; Please note that this network may be different than your plans standard pharmacy network. As part of our mission to improve and protect the healthcare system, particularly under the threat of the Coronavirus/COVID-19, the Blue Cross Blue Shield Association is focused on protecting members from fraudsters who seek to take advantage of the fear and confusion many feel surrounding the coronavirus/COVID-19 during these uncertain times. The claim entered day 179 of the 180-day timeline on Feb. 29, 2020. Also, note that all American households can order free COVID-19 tests from the federal government. Use our. You can find a list of community-based testing sites here. hbbd```b``)n`"EV`U`*8*I2&?tq&e@$E&">I0DjE0!c`) $L*H-`l)`l3Oz's&30t%S! [& *If your pharmacy coverage is not through BCBSRI, your employer may have chosen to offer the home test kit benefit through your pharmacy coverage instead of your BCBSRI health plan.
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