Coronavirus (COVID-19) Updates

Individuals and families

How will the end of the public health emergency affect Covid-19 vaccines?

For most people, the cost of the Covid-19 vaccine and the administration of the vaccine will continue to be covered at 100% in-network even after the end of the public health emergency. This is because the Covid-19 vaccines have been added to the Affordable Care Act’s list of preventive benefits. However, please note, vaccines received from an out-of-network provider will be subject to your out-of-network benefit, which may include out-of-pocket expenses.

If you buy your own health care coverage or get it through your employer and they are subject to the Affordable Care Act’s requirements, then there will be no change to what you pay for the Covid-19 vaccine when the vaccine is administered by an in-network provider.

The only employer plans that don't have to cover the cost are employer plans that are not subject to the Affordable Care Act’s requirements, but they may choose the cover the cost anyway.

The best way to see if the cost of the vaccine is covered for you is to log into your member account at bcbsm.com or check the BCBSM mobile app. You can also call the number on the back of your ID card.

How will the end of the public health emergency affect coverage for Covid-19 testing?

For tests that are given by a health care provider, a testing facility or at a lab, you’ll have to pay your normal copay or deductible amount. This includes any charges you’ll receive if you go to an out-of-network health care provider. However, tests that are not medically necessary, such as those provided for employment, travel, school or sports purposes will not be covered.

After May 11, 2023, over-the-counter tests will not be covered. You can purchase these test kits using your HSA plan (if you have one) or pay for them out of pocket.

What about treatment for Covid-19?

Getting treatment for Covid-19 will be like getting treatment for any other illness once the public health emergency ends. The treatment given by health care providers will be subject to normal copays and deductibles.

Are there any other changes I need to be aware of?

During the Covid-19 public health emergency, Blue Cross and BCN put several policies on hold relating to charges you would receive for going to out of network health care providers and prior authorization requirements. This was a government requirement to make sure that you had access to health care during the pandemic. Normal policies will be back in effect on May 12 - once the public health emergency ends.

Be sure to check and make sure that your health care providers (including laboratories and pharmacies) are in your network or participate with Blue Cross and BCN before receiving services from them. You can find in-network health care providers by using the Find-a-Doctor tool when you log into your member account at bcbsm.com. This will help you manage your out-of-pocket costs and make sure that you aren’t liable for the cost of going to an out of network health care provider.

If you had our pharmacy coverage and you didn't use your Blue Cross member ID card, or if you purchased a fully self-administered FDA authorized test from a non-preferred pharmacy or other retailer, and you purchased the test January 15, 2022 through May 11, 2023, you can be reimbursed up to $12 or the cost of the test, whichever is lower. Please note, tests purchased from third parties, such as from neighbors, friends, or online resale marketplaces, will not be reimbursed. Request reimbursement here.

If you purchased an at-home test between Jan. 15 and Jan. 31, 2022, or purchased an at-home test ordered by a provider and want to be reimbursed, submit a request here.

For more information

To read about the end of the public health emergency, Covid-19 and Blue Cross’ response, see our blog at MiBluesPerspectives.com

For information about various topics relating to Covid-19 – including vaccinations, what to do if you have Covid-19, treatments and more, you can go to the CDC Covid-19 website.

Michigan residents can visit Michigan Department of Health and Human Services.

If you have questions about your benefits, want to see if a health care provider is in your network, check your coverage, see recent claims and more, then log into your member account or download the BCBSM mobile app by texting APP to 222764.

Employers and agents

How will the end of the public health emergency affect Covid-19 vaccines?

For most people, Covid-19 vaccines and the administration of the vaccine will continue to be covered at 100% in-network even after the end of the public health emergency. This is because the Covid-19 vaccines have been added to the Affordable Care Act’s list of preventive benefits.

As a result, employer plans subject to ACA requirements must continue to provide 100% coverage in-network for Covid-19 vaccine administration after the end of the PHE. These plans will also cover the cost of the Covid-19 vaccine product after current government supplies are depleted.

Out-of-network coverage will be subject to group-specific benefits. Once the PHE ends, non-participating providers will be permitted to charge members up to the full cost for vaccines.

Employer plans not subject to ACA requirements will need to make decisions about their own benefits for Covid-19 vaccines.

How will the end of the public health emergency affect coverage for Covid-19 testing?

After the Public Health Emergency ends, in most cases, coverage for testing will be subject to normal copays and deductibles.

For tests that diagnose Covid-19 and are given by a health care provider, a testing facility or a lab, people will need to pay their normal copays and deductibles. This includes any charges if they go to an out-of-network health care provider. This is different because during the public health emergency, these tests were covered at 100% both in and out of network.

As before, Blue Cross will not cover the costs of testing for employment, travel, school or sports purposes.

Members will need to pay for over-the-counter test kits as well if they would like to purchase them (either online or in stores).

What about treatment for Covid-19?

Getting treatment for Covid-19 will be like getting treatment for any other condition once the public health emergency ends. The treatment given by health care providers will be subject to normal copays and deductibles (including plan copays and deductibles if a member has a Medicare Advantage plan).

Are there any other changes I need to be aware of?

During the Covid-19 public health emergency, Blue Cross and BCN put several policies on hold relating to charges people would receive for going to out of network health care providers and prior authorization requirements. This was a government requirement to make sure that people had access to health care during the pandemic. Normal policies will be back in effect on May 12 - once the public health emergency ends.

How to use telehealth services to see patients

Telehealth is an umbrella term that includes telemedicine, telephone and online visits which can be beneficial in reducing the need for in-person medical care.

Read through our medical policy to understand our requirements and general guidelines:: Telehealth Medical Policy (PDF)
These telehealth guides will help you learn which services you can use and when to use them:: Telehealth for Medical Providers (PDF); Telehealth for Behavioral Health Providers (PDF); Guidelines for autism interventions (PDF)
The following codes have no member cost-share during the Covid-19 pandemic:: Telehealth procedure codes for Covid-19 (PDF)
You can download a list of Medicare telehealth services from the Centers for Medicare & Medicaid Services website:: Medicare telehealth services list
Frequently asked questions for providers: Frequently asked questions for providers (PDF)
To determine if your patient has telemedicine (provided by network providers) or Blue Cross Online Visits^SM access (conducted by Amwell), consult the following chart:: Determining members telehealth benefits (PDF)
Step-by-step instructions to find Blue Cross Online Visits^SM access (conducted by Amwell): Finding a member's benefits for Blue Cross Online Visits^SM (PDF)

Medicare

Will the end of the public health emergency affect coverage for the Covid-19 vaccine?

For Medicare Advantage members, the cost of the Covid-19 vaccine and the administration of the vaccine will continue to be covered at 100% in-network even after the end of the public health emergency.

How will the end of the public health emergency affect coverage for Covid-19 testing?

Medicare Advantage members will pay their normal copays and deductibles for Covid-19 tests given by a health care provider. This does not include testing for employment, travel, school or sports purposes. These tests are not covered per Blue Cross policy.

As of May 12, 2023, all Covid-19 tests must be ordered by a qualified health care provider (physician, nurse practitioner or physician's assistant). Also, over-the-counter Covid-19 tests will no longer be a covered benefit. Medicare was covering over the counter Covid-19 tests at no cost to people with Medicare Part B, including those with Medicare Advantage plans. This benefit will stop as of May 12, 2023.

How will the end of the public health emergency affect coverage for Covid-19 treatment?

Getting treatment for Covid-19 will be like getting treatment for any other condition once the public health emergency ends. You may need to pay your plan copays and deductibles for any treatment provided by your doctor.

Are there any other changes I need to be aware of?

During the Covid-19 public health emergency, Blue Cross and BCN put several policies on hold affecting charges for out-of-network health care providers and prior authorization requirements. This was a government requirement to make sure that you had access to health care during the pandemic. Normal policies will be back in effect on May 12 - once the public health emergency ends.

Be sure to check and make sure that your health care providers (including laboratories and pharmacies) are in your network and participate with Blue Cross and BCN before receiving services from them. You can find in-network health care providers by using the Find-a-Doctor tool when you log into your member account.

This will help you manage your out-of-pocket costs and make sure that you aren’t liable for the cost of going to an out of network health care provider.

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