A nurse case manager with Blue Cross & Blue Shield of Rhode Island found that listening, without judgment, to one patients concerns made all the difference. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. Overseas members will need to complete and file this claim form for any pharmacy services received. 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. Waiving cost-sharing for COVID-19 testing and treatment. If the test is less than $12, reimbursement will be the cost of the test. (PHE), over-the-counter (OTC) COVID-19 FDA-authorized test kits are covered . You are now leaving the blueshieldca.com website, Do NOT use this page for test reimbursement. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. The vaccines are free, safe and effective and widely available for anyone age 5 and up. Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" The health and well-being of our members is our top priority, and we remain committed to ensuring our members and customers have access to the care and information they need. Using facts from the CDC, we hope to answer your questions and arm you with the knowledge you and your children deserve so you can feel confident in your decision. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Postal Service. Check out the changes and updates to our plan in 2023. To be eligible for reimbursement, you must submit: Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services, must be purchased on or after January 15, 2022, used to identify the potential COVID-19 infection, will be self-administered with results that can be self-read, will not be resold, given or supplied to persons other than family members covered under the same policy, The purchase receipt documenting the date of purchase and price, UPC** cut-out from the over-the-counter COVID-19 test packaging, Signed, completed attestation confirming and acknowledging that the purchased over-the-counter at-home COVID-19 test meets eligibility guidelines. OTC COVID test kit claim. endstream endobj 462 0 obj <>/ProcSet[/PDF]>>>>stream (function(){var g=function(e,h,f,g){ California Physicians' Service DBA Blue Shield of California 1999-2023. We recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed. qGm1UCk3Ht}uh>.ky!R'@ E You do not need health insurance to receive your free tests. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . To access your member services, please visit your BCBS company. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. The aforementioned legal entities (excepting First Care, Inc. of Maryland), CareFirst BlueChoice, Inc., and The Dental Network, Inc., are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream If a test reader is required, reimbursement is limited to $12. This coverage began on January 15, 2022. If you have employer coverage, or an individual or family plan, you can get FDA-authorized, over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSIL/Prime Therapeutics pharmacy benefits. An attending health care provider may order a test. For example, a physician, a nurse practitioner, or a physician assistant. Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. No, I am the authorized representative for a Medicare member. |X9GZaX~ You will be reimbursed via check, mailed to the address we have on file within 30 days of Blue Cross Blue Shield of Arizona (BCBSAZ) receiving your reimbursement information. Use our. He has reported on health . Blue Cross and Blue Shield of Texas (BCBSTX) is closely monitoring activity around the Novel Coronavirus 2019 (COVID-19). The Formulary Exception process allows members to apply for coverage of a non-covered drug if they have tried and failed the covered drug (s). Standard Option Basic Option FEP Blue Focus Tier Exception Member Request Form this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. At a participating pharmacy, go to the pharmacy counter (not the store checkout) and use your red, white, and blue Medicare card. Your member ID card is your key to using your medical plan benefits. Example 3: We are expanding access to vaccines, educating communities, and meeting ongoing healthcare and social needs in communities across the country. This currently does not apply to Medicare Advantage members. a|VOXHXT:B4 OTC tests, also known as self-tests, detect if you are currently infected with COVID-19. [CDATA[ Centers for Disease Control and Prevention (CDC), Coronavirus, World Health Organization (WHO), Coronavirus, Keep Your Children 5 and Older Safe With a COVID-19 Vaccine, How to Manage Back-to-the-Workplace Anxiety, Anthem has a limited number of at-home diagnostic test kits available for certain members to order online. and independent licensees of the Blue Cross and Blue Shield Association. The $0 coverage only applies when received at participating pharmacies or through participating healthcare providers. For more information about Pharmacy Prior Approval and the required forms visit the Prior Approval page. 574 0 obj <>stream All rights reserved. *Thisprocess applies to members with individual, employer-sponsored or student health plan coverage, as well as Federal Employee Program (FEP) and Federal Employee Health Benefits Program (FEHBP) plan members. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . Starting February 1, 2022, Medi-Cal members should obtain OTC at-home tests through pharmacies enrolled as Medi-Cal providers. Looking for COVID-19 coverage and benefit information? Sign in or register at Caremark.com (You must be a CVS Caremark member) Select the list of exceptions for your plan. You will be reimbursed $12 per test. For other FDA-approved home test kits (that are generally not available at pharmacies), you can submit a claim for reimbursement. These may include your doctors office, a pharmacy or health clinic, or an urgent care center. D@3[0V In Virginia, CareFirst BlueCross BlueShield, CareFirst MedPlus, and CareFirst Diversified Benefits are the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). Blue Cross recommends that members contact and work closely with their health care . For more information, view our privacy policy. Coverage varies by plan type. 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. However, you must include all required information requested in the form. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. Costco, Wal-Mart, Amazon), please attach itemized register receipts to the back of this form. How to get free at-home tests: Express Scripts Pharmacy Order up to 8 at-home COVID-19 tests every 30 days from Express Scripts Pharmacy. Increasing access to prescription medications. To access your member services, please visit your BCBS company. The claim entered day 179 of the 180-day timeline on Feb. 29, 2020. O=>WNW% Please note that this does not apply to members with BCBSRI Medicare Advantage or Plan 65 coverage. 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. If you have a large employer, please call member services at the . Mail-in claim forms allow you to submit a claim for multiple members with one form. If youre visiting the governments home test kit site without using the link above, please make sure you are on the correct page by looking for the U.S. flag in the top left corner and text that states An official website of the United States government.. If multiple tests are sold in one package, i.e., if one package includes two tests, it counts as two tests and not one test package toward the quantity limit. 2. c I had COVID-19 symptoms. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. Further questions Additionally, the federal government now requires commercial health plans to cover the cost of over-the-counter COVID-19 tests for members. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Once completed you can sign your fillable form or send for signing. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. You can download the claim form hereor call the number on the back of your member ID card to receive one by mail. You can find detailed instructions on how to file an appeal in the Disputed Claims Processdocument. try{(new g(100,"r","QSI_S_ZN_7NEbFnBCgXhmlPT","https://zn7nebfnbcgxhmlpt-carefirst.siteintercept.qualtrics.com/SIE/?Q_ZID=ZN_7NEbFnBCgXhmlPT")).start()}catch(i){}})(); Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California below is required. Everyone qualifies. 2023 Blue Cross Blue Shield Association. cRequired for employment purposes. Here are four ways you can get tests for you and your family: Visit covidtests.gov to get free tests delivered to your home by the U.S. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. We ask everyone to respect and protect community health as the supply chain and our health and retail partners catch up with demand. Commercial members may receive reimbursement for up to eight over-the-counter COVID-19 at-home tests per covered individual in the household per 30-days without a healthcare provider order or clinical assessment. . If you have questions about reimbursement of at-home tests, contact Express Scripts at 855.612.3128. All Rights Reserved. You can be reimbursed (paid back) for both: Medi-Cal members: Do NOT use this page for test reimbursement. If your employer has asked you to submit receipts to your pharmacy benefit plan, please dont submit them here. If you have any questions about your over-the-counter test, you should call your healthcare provider or check out our FAQs. this.set=function(a,c){var b="",b=new Date;b.setTime(b.getTime()+6048E5);b="; expires="+b.toGMTString();document.cookie=a+"="+c+b+"; path=/; "}; Find answers on our member and employer pages, or contact us. Please note that these home test kits cant be used for workplace screening or travel. f/4kg>/ProcSet[/PDF]>>>>stream endstream endobj 469 0 obj <>/Subtype/Form/Type/XObject>>stream If you purchase a test kit that includes two rapid tests, that will count as two of your eight covered tests. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. This form is for members of non-Medicare plans. Forms for members enrolled in individual, family and employer plans with Florida Blue. hbbd```b``)n`"EV`U`*8*I2&?tq&e@$E&">I0DjE0!c`) $L*H-`l)`l3Oz's&30t%S! [& You can only use your $0 coverage at pharmacies and healthcare providers participating with this specific program. Tests detect COVID, but vaccination remains the best way to protect yourself from severe illness. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Updated April 15, 2022. Effective 1/1/2020, roughly 17,500 over-the-counter (OTC) drugs and medications such as . FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. COVID-19 | Blue Cross and Blue Shield of Texas Standing by You Your health, safety and well-being are our top priorities. 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. Pregnant members can use this form to request a blood pressure monitor at no cost. COVID-19 home test kit claim itemized pharmacy receipts to the back of this form. endstream endobj 463 0 obj <>/ProcSet[/PDF]>>>>stream At this time, about half of the insurers reviewed are implementing their testing coverage policy using only reimbursement. In addition to your BCBSRI benefits, every home in the United States is eligible to orderfree COVID-19 home test kits through the federal government atcovidtests.gov. The policy only covers over-the-counter Covid-19 tests authorized and approved by the U.S. Food and Drug Administration (FDA). A recent announcement from the federal government intends to increase access to COVID-19 testing. This coverage applies to all BCBSRI health plans except Medicare. The following claims process pertains to CareFirst commercial members* only. If you go to another location and pay upfront for a home test kit, you cant submit for reimbursement unless you have a doctors note or prescription. During the federal public health emergency, Blue Shield will continue to waive out-of-pocket costs for copays, coinsurance, and deductibles for: COVID-19 screenings or evaluations done: Virtually using telehealth, In a doctor's office, At an urgent care center, or In a hospital (including emergency room). The Blue Cross Blue Shield Association warns the plan doesn't address the limited supply of home test kits. Receipt and UPC barcode from the kit package are required. Important information about expanded coverage. . Wu3B= e&gZ-h'BR$djC?Wn>2esFdUb'$K6Q It must include the original receipt or a copy of the receipt for purchasing the tests. Everyone qualifies. b&HXR Please note that this network may be different than your plans standard pharmacy network. For more information about coverage of over-the-counter tests, view our frequently asked questions. Buying tests to store them for a potential need isn't good for the community or public health. UnitedHealthcare COVID At-Home Test Reimbursement Form. When filing claims online, you must use a separate claim form for each receipt and for each member. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. "We have tests, treatments, and vaccines that can . After choosing BCBS Rhode Island as your health plan, select the Rhode Island Pharmacy Network (which is a national network) and enter your ZIP code. See below.). Our Commitment to You What's Covered Coverage will vary based on your plan. Overseas members will need to complete and file this claim form for any medical services received. 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. // ]]>, //
blue cross blue shield tn covid test reimbursement form
