COVID-19 resources & information

Up-to-date information and resources for our members can be found at:

• North Carolina Department of Health and Human Services (NCDHHS)
• COVID-19 Testing and Treatment
• COVID-19 Vaccines

Testing

• Find a COVID-19 Test in North Carolina
• Centers for Disease Control (CDC) Testing for COVID-19
• At-Home Testing Information (Spanish)

Vaccines

• Find a COVID-19 Vaccine in North Carolina
• COVID-19 Vaccines Beyond North Carolina
• Centers for Disease Control (CDC) Vaccine Guidance

Treatment

• Find COVID-19 Treatment in North Carolina
• COVID-19 Treatment Beyond North Carolina
• Centers for Disease Control (CDC) Treatment Guidance

If members receive COVID-19-related services, including testing, treatment or the vaccine, at an out-of-network provider, they may be responsible for the cost of the treatment, test, vaccine and/or administration based on their individual benefits.  

When the federal vaccine supply runs out, vaccine providers may begin billing patients for any amount not covered by their health plan.

If members have specific questions about coverage, we encourage them to contact Customer Service through Blue Connect℠ or by using the number on the back of their insurance card.

Effective May 12, 2023, Blue Cross NC and ASO groups will cover both the cost of the vaccine and vaccine administration at 100% when members receive the COVID-19 vaccine at an in-network provider as part of our preventive care services.

If members receive the COVID-19 vaccine at an out-of-network provider, they may be responsible for the cost of the vaccine and/or vaccine administration based on their individual preventative care benefits.

The federal government has invested in a large supply of COVID-19 vaccines and will continue to cover the cost of the COVID-19 vaccine until that supply is exhausted.

COVID-19 vaccines given at pharmacies are covered for Blue Cross NC members, as part of our preventive care services, and reimbursement will be determined based on whether the provider is in-network or out-of-network. 

Effective May 12, 2023, COVID-19 tests administered by a provider that are consistent with CDC guidance and has been cleared, approved or given emergency use authorization (EUA) by the FDA are covered based on each individual’s insurance plan, and members may be responsible for a portion of their costs to include copayments, coinsurance and deductible amounts.

For more information on testing and how to find a COVID-19 test, visit NC Department of Health and Human Services.

Effective May 12, 2023, members will be responsible for the cost of over the counter (OTC) COVID-19 tests and can pay or be reimbursed under health flexible spending arrangements (health FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs), or Archer medical savings accounts (Archer MSAs) because the cost to diagnose COVID-19 is an eligible medical expense for tax purposes.

Eligible Medicare Advantage members may use an OTC card to purchase OTC COVID-19 tests.

North Carolina Medicaid coverage for FDA-approved OTC COVID-19 home tests ended on September 30, 2024. However, Healthy Blue® Medicaid members may receive free COVID-19 at-home tests at Community Access Points.

The North Carolina Department of Health and Human Services (NCDHHS) partnered with more than 270 local organizations statewide, called Community Access Points, to distribute free COVID-19 at-home tests in their communities. You can find your nearest Community Access Point on the NCDHHS website. You should call a Community Access Point before going to pick up a test to make sure tests are available. Locations may choose to limit the number of tests available per person, per day. Individuals must be 14 years or older to pick up free at-home tests. An ID is not required.

Commercial members can purchase over-the-counter (OTC) tests with their health flexible spending arrangements (health FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs), or Archer medical savings accounts (Archer MSAs).

COVID-19 tests do not need prior approval. That means your doctor doesn’t need to ask us for approval before you’re tested for COVID-19. 

COVID-19 treatments are covered based on each individual’s insurance plan, and members may be responsible for a portion of their treatment costs to include copayments, coinsurance and deductible amounts.

Blue Cross NC Medicare Advantage members will continue to be covered under the Part B preventive vaccine benefit when receiving monoclonal antibodies until the end of the calendar year that the EUA declaration ends.  Blue Cross NC Medicare Advantage members will be responsible for cost sharing when receiving treatment at an out-of-network facility, as specified under the plan benefit, beginning on June 10, 2023. 

Blue Cross NC is currently covering telehealth services for behavioral health, primary care and outpatient visits, which accounted for more than 97% of telehealth claims received during the last two years.

The policy applies to all Blue Cross NC fully insured and administrative services only (ASO) plans, including the State Health Plan. It does not apply to Blue Cross NC members receiving care from out-of-state providers. Members who do not have a commercial plan can find more information about their telehealth coverage below.

• Medicare Advantage members should review their evidence of coverage. 
• Healthy Blue members have certain telehealth visits covered at parity under Medicaid benefits determined by the state.
• Federal Employee Program members can find details in their Service Benefit Plan Brochure.