May 2022

Here are details on COVID-19 Test to Treat program coverage

The federal government’s new Test to Treat program provides a one-stop location for an individual to get a COVID-19 test and, if the test is positive and he or she is eligible for treatment with an oral antiviral drug such as Paxlovid™ or Molnupiravir, the prescription can be written by a health care provider and then filled, all in the same visit.

Test to Treat locations can include:

Federally qualified health centers
Long-term care facilities
Pharmacies with an on-site health clinic

Here’s what you need to know about Blue Cross Blue Shield of Michigan and Blue Care Network coverage for Test to Treat providers:

There’s no member cost share associated with covered COVID-19 testing. COVID-19 testing for employment, school or public health surveillance isn’t covered. However, the assessment for a possible oral antiviral drug is eligible for member cost share for treatment.
The federal government is supplying the antiviral drugs at no cost to providers. Don’t bill for the cost of drugs supplied by the government.
Health care providers should bill for the test administration and treatment assessment using the member’s medical benefit.
Pharmacies can bill for dispensing the drug using the member’s pharmacy benefit.

Here are resources for learning more:

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