That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Forms for members enrolled in individual, family and employer plans with Florida Blue. Select the list of exceptions for your plan. To access your member services, please visit your BCBS company. For more information, view our privacy policy. ro?gu?"t6Vr K?K@n}r`TyEycB". OTC COVID test kit claim. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. You can submit a claim for reimbursement electronically by logging in to myBCBSRI.com. For members of all BCBSRI plans except Medicare |X9GZaX~ Test kit cost $ endstream endobj 470 0 obj <>/Subtype/Form/Type/XObject>>stream This coverage cant be used for workplace screening or travel. As of January 15, 2022, your health plan administrator may have started covering at-home COVID-19 tests. For help with these documents, please call 1-800-975-6314. . The Blue Cross Blue Shield Association warns the plan doesn't address the limited supply of home test kits. Highest Member Satisfaction Two Years in a Row! Taxes and shipping costs are eligible for reimbursement, but total reimbursement may not exceed $12 per test. Attach an original itemized bill from your provider (required information & example on the back) . The tests listed below are available for $0 at the pharmacy counter. All Rights Reserved. 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . Click on Request at-home tests, and enter your ZIP code for details on the closest store and product availability. You do not need health insurance to receive your free tests. 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 the list. The process for getting COVID-19 home test kits for $0 at CVS is different than other participating pharmacies. Blue Cross Blue Shield sent a statement saying: We received updated guidance from the federal government regarding at-home COVID-19 testing coverage late Monday afternoon. People ages 12 years and older who are moderately or severely immunocompromised. For members of BCBSRI Medicare Advantage and Plan 65, For members of all other BCBSRI health plans. You can also log in to the SydneySM Health mobile app, go to Claims, and choose Submit a Claim. However, even if a pharmacy is not participating in our network, you may be able to buy the test for $0. 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. NDC or UPC number Date purchased / / Quantity of tests. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. Group Hospitalization and Medical Services, Inc., and First Care, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. Pregnant members can use this form to request a blood pressure monitor at no cost. A recent announcement from the federal government intends to increase access to COVID-19 testing. From January 15, 2022 until the end of the Coronavirus Public Health Emergency, each individual on your plan can get up to eight over-the-counter tests each month. Also, note that all American households can order free COVID-19 tests from the federal government. // ]]>, // /ProcSet[/PDF]>>>>stream You can submit any number of receipts on a single claim form. 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=/; "}; For all formulary tier exceptions you will need to complete and file a request form. Effective, Jan. 15, 2022, Blue Cross and Blue Shield of Oklahoma (BCBSOK) will cover the cost of FDA-authorized, over-the-counter (OTC) COVID-19 tests through BCBSOK/Prime Therapeutics pharmacy benefits. That form will be replaced on Jan. 23 once the insurer develops a . Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" endstream endobj 469 0 obj <>/Subtype/Form/Type/XObject>>stream cRequired for employment purposes. This form is for members of non-Medicare plans. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. The policy only covers over-the-counter Covid-19 tests authorized and approved by the U.S. Food and Drug Administration (FDA). You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Member Discounts Take advantage of member-only discounts on health-related products and services. If you have an Anthem Medicaid or Medicare plan, you will need to visit your member website for information on how your health plan covers COVID-19 testing. 3. Who can order a test? To print and mail your claim, download theclaim form (PDF). endstream endobj 467 0 obj <>/ProcSet[/PDF]>>>>stream Will Blue Cross cover COVID-19 testing for non-medically necessary purposes (e.g., return- . W006259 COVID-19 Testing Member Reimbursement Form - Non-Medicare Advantage Please use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. At-home testing options and costs Member Forms. COVID-19 home test kit claim itemized pharmacy receipts to the back of this form. With each claim form, you should include the same receipt. [CDATA[ s&jPDed 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. Even if you dont have symptoms and have not been exposed to someone with COVID-19, using a home test kit before gathering indoors with others can give you information about the risk of spreading the virus that causes COVID-19. To access your member services, please visit your BCBS company. // ]]>, // >>/EncryptMetadata false/Filter/Standard/Length 128/O(a;uY[7y\\ Y)/P -1036/R 4/StmF/StdCF/StrF/StdCF/U(6Tn= )/V 4>> endobj 456 0 obj <>>> endobj 457 0 obj <> endobj 458 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/Properties<>/XObject<>>>/Rotate 0/StructParents 10/Tabs/W/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 459 0 obj <>/ProcSet[/PDF]>>>>stream There are 0 fields that need to be corrected. Use the claims form for OTC at-home tests with a healthcare provider order. If a test is sold in a package of two, that is considered two tests, and youll be reimbursed $24. Visit the CDC website for the most up-to-date testing guidance. The CDC states that home test kits may be used in the following situations: On the CDC website, you can find additional information, including how to use home tests and what to do if your test is negative or positive. For more information, view our privacy policy. endstream endobj startxref Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. We provide information as it becomes available here and on our News and Updates page. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. We use cookies on this website to give you the best experience and measure website usage. Use this form to select an individual or entity to act on your behalf during the disputed claims process. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. The claim entered day 179 of the 180-day timeline on Feb. 29, 2020. Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. When filing claims online, you must use a separate claim form for each receipt and for each member. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Mail claim form and all attachments to BCBSMA, P . 3. At-home diagnostic tests can be purchased over the counter, online, at a local pharmacy, or from a big-box store. We are committed to making sure members get the care they need when they need it. You can buy the tests for $0 at a participating pharmacy (at the pharmacy counter) when using your BCBSRI member ID card. endstream endobj 464 0 obj <>/ProcSet[/PDF]>>>>stream Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. A diagnostic test is used to determine if a person has COVID-19. We recommend you use your $0 coverage through your Medicare Part B benefit first and then use your OTC benefit if needed. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { if (evt.target.id=== 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } Please note that this does not apply to members with BCBSRI Medicare Advantage or Plan 65 coverage. Costco, Wal-Mart, Amazon), please attach itemized register receipts to the back of this form. Blue Cross and Blue Shield of Oklahoma At-Home Testing Guidance for Members. This coverage began on January 15, 2022. Once completed you can sign your fillable form or send for signing. Tests detect COVID, but vaccination remains the best way to protect yourself from severe illness. Blue Cross recommends that members contact and work closely with their health care . Through May 31, all BCBS companies including the BCBS Federal Employee Program (FEP)are: Waiving cost-sharing for COVID-19 testing and treatment. In this case, you should fill out three claim forms one for each member. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. See the list of participating pharmacies and healthcare providers. The following claims process pertains to CareFirst commercial members* only. No, the home tests provided by the government do not count toward your $0 coverage. However, you must include all required information requested in the form. If you use a provider outside of the network, you will need to complete and file a claim form for reimbursement. Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. *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. The Contraceptive Exception Form allows members to apply for coverage, or formulary tier, exception for a contraceptive drug/product. The vaccines are free, safe and effective and widely available for anyone age 5 and up. Your Blue Cross and Blue Shield of Texas (BCBSTX) health plan gives you access to the care you need during the COVID-19 pandemic. O=>WNW% If you buy the tests online or at a retail store (including the regular store checkout at a pharmacy rather than the pharmacy counter), youll need to submit a form, along with your receipt, and will be reimbursed up to $12 per individual test. COVID-19 | Blue Cross and Blue Shield of Illinois. 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. As of April 4, 2022, members with BCBSRI Medicare Advantage and Plan 65 coverage can now receive COVID-19 home test kits at no cost under their Part B benefit. UnitedHealthcare COVID At-Home Test Reimbursement Form. Medicare Advantage members: Use the claims form for OTC at-home tests with a healthcare provider order. This policy will remain in effect for the duration of the Federal Public Health Emergency. Members should complete the OptumRx Over-the-Counter Test Reimbursement Form and include their receipts. Waiving all prior authorization requirements for COVID-19 testing and related covered services. 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. Check out the changes and updates to our plan in 2023. 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.

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