COVID-19 FAQs

You have questions about COVID-19,
we are here to answer them.

Frequently Asked Questions

General

Where can I get more information on COVID-19 vaccines and boosters?

Will patients be balance billed if they see an out-of-network provider?

Current federal regulations prohibit any provider from balance billing patients for the COVID-19 vaccines or boosters.

Who can members contact if they have questions or concerns about a claim?

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.


COVID-19 Vaccines and Boosters

How much will it cost me to get a vaccine or booster?

We are covering FDA approved vaccines and boosters, including emergency use authorization (EUA), at no cost for all members, both during the public health emergency and after.

The federal government covers, at no member cost-share, the vaccine and booster, and the administration fee in 2022 for traditional Medicare and Medicare Advantage members.

For members on a commercial plan, the federal government covers the vaccine and booster costs during the public health emergency. Blue Cross NC (or the ASO group, for customers on those plans) covers the cost of vaccine administration fees. After the public health emergency, Blue Cross NC and ASO groups are required to cover the cost for the vaccine and booster, and administration costs at 100% for in-network providers.

Are vaccines and boosters covered when given at a retail pharmacy?

Vaccines and boosters given at pharmacies are covered for Blue Cross NC members, with no member cost share.

Will coverage be the same for Blue Cross NC members who receive the vaccine or booster outside North Carolina?

For Blue Cross NC members living or traveling outside North Carolina, the federal government covers the cost of the vaccine and booster, and Blue Cross NC (or the ASO group, for customers on those plans) covers the cost of administration fees during the public health emergency. After the public health emergency, the cost of the vaccine and booster, and administrative fees are covered as preventative services and reimbursement will depend on whether the provider is in network or out-of-network.

Will Administrative Services Only (ASO) groups be required to cover vaccine and booster costs?

The applicable federal regulations state that the health benefit plan or insurer must cover the admin fee at 100%. This is a temporary benefit change that applies to all plans under federal law during the public health emergency, with the federal government paying the cost of the vaccine and booster, and ASO groups to cover administration costs the same for both INN and OON providers during that time. After the public health emergency, ASO groups are required to cover the cost for the vaccine and booster, and administration costs at 100% for in-network providers.

Are the vaccines and boosters effective?

The Centers for Disease Control and Prevention (CDC) shared data showing that vaccines  and boosters continue to be remarkably effective in reducing risk of severe disease, hospitalization and death, even against the Delta variant.

According to the latest data from North Carolina hospitals, 91% of all COVID patients and 96% of all COVID ICU patients were unvaccinated. The bottom line is that vaccines and boosters save lives. More than 11 million doses of the COVID-19 vaccine have been administered in North Carolina.

What should I do after I receive the vaccine or booster?

Everyone should continue to wear a mask indoors and in public places where social distancing is not possible, even if masks are not mandated. Learn more about current CDC mask recommendations and requirements here.

Updated Guidance from North Carolina Department of Health and Human Services (NCDHHS) includes:

Who is eligible to get the vaccine and booster?

Anyone age 5 and older is now eligible for the COVID-19 vaccine. Teens 12 to 17 years old can only receive the Pfizer booster, and parental consent is required.

North Carolinians should visit the NCDHHS COVID-19 Response website for information on vaccines and boosters for children to learn more.

Where can I get the vaccine and booster?

Use the NCDHHS vaccine and booster location tool to find a spot near you.

Members who live outside North Carolina will need to follow their local and state guidelines to determine where they should get the vaccine or booster.

Federal Employee Plan (FEP) members should use the FEP vaccine network to find a participating retail pharmacy.

Looking for a COVID-19 vaccine or booster for someone who is at home because of limited mobility? You can find at-home vaccine providers here.

Do I need a booster or additional dose of the COVID-19 vaccine?

Booster shots are now available for individuals who have been fully vaccinated.

Individuals who received both doses of the Pfizer or Moderna vaccine more than six months ago are eligible for a booster shot if they fall within one of these groups:

  • Age 65 and older
  • Age 18 - 64 and at high risk of severe COVID-19
  • Age 18 - 64 and work in a high-risk setting, for example healthcare workers, teachers, childcare providers or food workers.

Individuals 18 and older who received the Johnson & Johnson vaccine more than two months ago are eligible for a booster shot.

Teens 12 to 17 years old can only receive the Pfizer booster, and parental consent is required.

Visit the CDC website for details on COVID-19 booster shot eligibility and guidance, including mix-and-match options.

The NCDHHS encourages individuals to speak with a doctor, nurse or pharmacist if they have questions about what booster is right for them.

Visit myspot.nc.gov for the most up-to-date info on COVID-19 vaccines. As new guidance is released from the Centers for Disease Control and Prevention (CDC) and other public health authorities, Blue Cross NC will update communications on COVID-19 vaccines and boosters. Get more information on the CDC Vaccines and Booster Shots website. 

Is my child eligible to get the vaccine and booster?

Children ages 5 and up are now eligible to receive the Pfizer vaccine.*

*Teens 12-17 years old can only get the Pfizer booster. Parental Consent is required.

Whether or not you vaccinate your kids is a personal choice. However, getting vaccinated is an important step in stopping the pandemic for both kids and adults. Read, "What to Expect with Your Child's Covid-19 Vaccine" on our blog to learn more.

Children are vulnerable to the COVID-19 virus just like everyone else.  According to NCDHHS, cases of COVID-19 among children in the U.S. rose approximately 240% during the most recent surge, demonstrating a need to protect children from the disease. Visit the NCDHHS Covid Response website to learn more about vaccines for kids.

 

Are COVID-19 vaccines and boosters safe for kids and teens?

Yes. The CDC and the FDA have determined that COVID-19 vaccines are safe and effective for this age group. Scientists are continuing to monitor safety in adolescents.

According to the FDA, the vaccine is safe and effect. Read the FDA October 2021 press release on COVID-19 vaccines. There were no safety concerns or serious side effects noted in the clinical trials and ongoing study. Download the Briefing Document from Pfizer to learn more.

Where can my child get vaccinated and boosters?

The vaccine and boosters are widely available across the state. Children ages 5 to 11 can get them at any location that has the smaller dose of Pfizer available, including at their pediatrician or doctor’s office, hospitals, local pharmacies and grocery stores.

There are hundreds of locations in North Carolina that carry Pfizer for 5 to 11-year-olds, and NCDHHS set up family vaccination and booster sites across the state so that every child has a spot to take their shot.

To find a vaccine or booster for children ages 5-11, visit covid19.ncdhhs.gov/vaccines.

Is there a cost to vaccinate or get a booster for my child?

No, there is no cost to vaccinate your child. COVID-19 vaccines and boosters are provided without any out-of-pocket cost to you, regardless of insurance and immigration status. The only thing required is parental consent.

Will my child experience side effects from the COVID-19 vaccine or booster?

According to NCDHHS, there may be temporary and minimal side effects. Learn about temporary side effects in children – visit the NCDHHS Covid-19 Response website.Children may experience a sore arm and feeling tired or achy for a day or two. NCDHHS further notes the risks of serious side effects from the vaccine are far less than the risk of serious illness from COVID-19.

Get up-to-date information and resources for Blue Cross NC members.

Should I get vaccinated or a booster if I am pregnant, breastfeeding or plan to become pregnant?

Yes. The  that anyone over the age of 12 get the vaccine, including those who are pregnant, plan to become pregnant or breastfeeding. See the CDC recommendations for pregnant people here.

According to the CDC, the vaccine and boosters are safe to receive during your pregnancy. It is one of the best ways to protect yourself and your baby since pregnant women are at an increased risk for severe illness from COVID-19. The CDC further notes that for women who are breastfeeding, the vaccine is safe and can pass along COVID-19 antibodies to your breastfeeding child, providing them with further protection from the virus.

If you have additional questions about protecting your newborn from COVID-19, consult your pediatrician. Guidelines and recommendations are constantly changing, and they can ensure you’re practicing the latest.


Testing

Where can I get a COVID-19 test?

North Carolina residents can find a number of COVID-19 testing options, including more information about OTC COVID-19 testing, at ncdhhs.gov/GetTested.

Testing options include, but are not limited to:

To find a testing location outside of North Carolina, visit https://www.hhs.gov/coronavirus/community-based-testing-sites/index.html.

When should I get tested?

We encourage members to speak to their primary care provider, pharmacist, or refer to this NCDHHS website if they have questions about COVID-19 testing.

How much will it cost me to get a COVID-19 test?

Health plans and issuers are required to cover at no cost-share to members (copayments, deductibles and coinsurance), COVID-19 testing methods performed in labs or at-home when ordered by a provider, are consistent with current CDC guidance and have been cleared, approved or given emergency use authorization (EUA) by the FDA. With new federal requirements put in place to expand access to COVID-19 tests, Blue Cross NC will cover over-the-counter (OTC) tests that have been approved or received emergency use authorization (EUA) by the FDA, beginning on January 15, 2022, and continue through the public health emergency. These OTC tests do not have to be ordered by a doctor and can be self-administered and self-read at home.

Depending on where you purchase your OTC test, you will pay no out-of-pocket costs or pay and be reimbursed.

We encourage members to get their OTC COVID test from an in-network pharmacy and present their insurance card, the same way they purchase their prescriptions. By purchasing from an in-network pharmacy counter, insurance is filed electronically, allowing members to purchase the test with no out-of-pocket costs.

Members can also pay out of pocket and mail an OTC COVID-19 test claim form to our pharmacy benefit manager, Prime, for reimbursement. This applies to members who purchase OTC tests without their Blue Cross NC prescription drug card or at a location other than a pharmacy counter.

Most Blue Cross NC members should not need reimbursement for their OTC COVID-19 tests. If members present their Blue Cross NC member ID card at an in-network pharmacy counter, they will pay no out-of-pocket costs.

Reimbursement for test kits purchased from out-of-network pharmacies and retailers (any location other than a pharmacy counter) is limited to no more than $12 per individual test.

Pursuant to COVID-19-related legislation and regulations, Blue Cross NC will continue waiving member cost-sharing (copays, deductibles and coinsurance) for COVID-19-related provider screening visits and testing until the public health emergency is over.

COVID-19 tests for general workplace health and safety (such as employee “return to work” programs) are not required to be covered.

We encourage members to speak to their primary care provider, pharmacist, or refer to this NCDHHS website if they have questions about COVID-19 testing.

Is prior authorization required for COVID-19 testing?

COVID-19 tests, including over-the-counter (OTC) 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.

How should I purchase an OTC COVID-19 test?

Members have two options for obtaining an OTC COVID-19 test: 

  • Purchase at a local pharmacy counter using a Blue Cross NC prescription benefits card to pay no out-of-pocket costs 
  • Purchase at an out-of-network pharmacy or any location other than a pharmacy counter, pay out-of-pocket for the tests and submit a claim form to be reimbursed up to $12 per test 

Members who plan to get their eligible OTC COVID-19 test from an in-network pharmacy must present their prescription benefits card, the same way they purchase their prescriptions. By purchasing at an in-network pharmacy counter, insurance is filed electronically, allowing members to purchase the test with no out-of-pocket costs. Pharmacy benefits manager Prime’s preferred network for the OTC COVID-19 test kits is not limited to a particular chain and includes, Walmart, Walgreens, Kmart, CVS, EPIC Pharmacies, Various Independent Pharmacies and more.

If a local pharmacy is not able to directly cover the cost of tests, members can pay out of pocket and mail an eligible OTC COVID-19 test claim form to our pharmacy benefit manager, Prime, for reimbursement. This applies to members who purchase OTC tests without their Blue Cross NC prescription drug card at an out-of-network pharmacy or location other than a pharmacy counter. 

Which tests are not covered? 

COVID-19 tests for general workplace health and safety (such as employee “return to work” programs) are not required to be covered.

We encourage members to speak to their primary care provider, pharmacist, or refer to this NCDHHS website if they have questions about COVID-19 testing. 

Will I be reimbursed for my OTC COVID-19 test?

If members present their Blue Cross NC prescription benefits card at an in-network pharmacy counter, they will pay no out-of-pocket costs for their OTC COVID-19 tests and will not need reimbursement.

Any member who purchases OTC tests without their Blue Cross NC prescription drug card or at a location other than a pharmacy counter can pay out of pocket and mail an OTC COVID-19 test claim form to our pharmacy benefit manager, Prime, for reimbursement.

Reimbursement for test kits purchased from out-of-network pharmacies and retailers (any location other than a pharmacy counter) is limited to no more than $12 per individual test. To be reimbursed for an OTC COVID-19 test, the test must be approved or have emergency use authorization (EUA) by the FDA.

Members are eligible to receive up to eight (8) OTC COVID-19 tests per month. Each test is counted separately regardless of how many tests are sold in one package.

When submitting a claim to be reimbursed, members must mail a:

The address to mail the OTC COVID-19 Test paper claim is:

Prime Therapeutics
Mail route: Commercial
PO Box 25136
Lehigh Valley, PA 18002-5136

Upon receipt of the required materials, pharmacy benefits manager Prime will issue a check reimbursing the member. The standard turnaround time for reimbursement is 21 days. Depending on volume, additional time may be needed to process reimbursement requests. Purchasing the tests through your pharmacy will eliminate the need for reimbursement.

COVID-19 tests for general workplace health and safety (such as employee “return to work” programs) are not required to be covered.

*Note: A pharmacist signature and pharmacist NPI number are NOT required on the claim form.  However, the member MUST sign the form attesting that the test kits are not being used for testing required by their employer, return to work, travel, attending recreational events, and will not be resold.

Do I have to purchase an OTC test from a specific retailer to be reimbursed?

No. OTC COVID-19 tests that have been approved or received emergency use authorization (EUA) by the FDA are covered regardless of where you purchase them.

We encourage members to get their OTC COVID test from an in-network pharmacy and present their insurance card, the same way they purchase their prescriptions. By purchasing from an in-network pharmacy counter, insurance is filed electronically, allowing members to purchase the test with no out-of-pocket costs. Members can also purchase OTC tests at a location other than a pharmacy counter. When purchasing an OTC test from an out-of-network pharmacy or retailer, members are required to pay out of pocket and mail an OTC COVID-19 test claim form to our pharmacy benefit manager, Prime, for reimbursement.

If a local pharmacy is not able to directly cover the cost of tests, members can pay out of pocket and mail an eligible OTC COVID-19 test claim form to our pharmacy benefit manager, Prime, for reimbursement.

Prime’s preferred network for the COVID test kits is not limited to a particular chain. OTC COVID tests will be available through pharmacies (in-network or out-of-network) and retailers (any location other than a pharmacy counter).

If I don’t want to pay any up-front out-of-pocket costs for my OTC test, which pharmacies can I use? 

Click here to view the list of in-network pharmacies for Blue Cross NC members to purchase an OTC test.  

Will all members be eligible for OTC test coverage?

OTC testing coverage applies to members of Blue Cross NC’s fully-insured (individual and group), Administrative Services Only (ASO) group health plans and the Federal Employee Plan (FEP).

For Medicare plans, we are awaiting further guidance from the Centers for Medicare and Medicaid (CMS) and will implement guidelines as quickly as we can. The requirements do not apply to excepted benefits (such as stand-alone vision or dental) or retiree-only plans.  

If the back of your Blue Cross NC ID card doesn’t list Prime as your prescription drug plan, you may have a different pharmacy benefit manager. If this is the case, please ask your employer or benefits manager about your OTC testing reimbursement options.

COVID-19 tests for general workplace health and safety (such as employee “return to work” programs) are not required to be covered.

Members should contact the Blue plan listed on their ID card for information about their COVID-19 benefits.

Will the Federal Employee Plan (FEP) cover OTC COVID-19 tests?

Yes. FEP will cover member submitted claims at zero cost share for COVID-19 tests with emergency use authorization available over the counter (OTC) without a physician order through the medical benefit. Member submitted claims must include a copy of an itemized receipt indicating the specific testing performed. For more information, visit https://www.fepblue.org/.

Do these new OTC COVID-19 test requirements apply to Medicare plans?

For Medicare plans, we are awaiting further guidance on OTC COVID-19 test coverage from the Centers for Medicare and Medicaid (CMS) and will implement guidelines as quickly as we can. In the meantime, Medicare members are eligible to receive COVID-19 testing methods performed in labs or at-home when ordered by a provider, are consistent with current CDC guidance and have been cleared, approved or given emergency use authorization (EUA) by the FDA, at no cost-share (copayments, deductibles and coinsurance).  
In addition, according to Medicare.gov, Medicare members can pick up free at-home tests from community health centers and Medicare-certified health clinics Or, visit COVIDtests.gov to order a free COVID-19 at-home test.

How can I determine if an OTC test is FDA approved?

For the most updated information on tests that have emergency use authorization from the FDA to test for COVID-19, visit the FDA website: Individual EUAs for Antigen Diagnostic Tests for SARS-CoV-2 and search “OTC.”

How do I use an OTC COVID-19 test?

For general guidance on using at-home tests, including OTC tests, and what to do after you have your result, please review the At-Home Testing Guidance for the General Public (Spanish) from NCDHHS.

Is there a reimbursement limit for OTC tests?  

If members present their Blue Cross NC prescription benefits card at an in-network pharmacy counter, they will pay no out-of-pocket costs. Reimbursement for test kits received from out-of-network pharmacies and retailers (any location other than a pharmacy counter) is limited to no more than $12 per individual test.  

Will Blue Cross NC cover the full cost of all OTC tests, or will they only reimburse a certain dollar amount per test?

Blue Cross NC will cover OTC tests that have been approved or received emergency use authorization (EUA) by the FDA. Members are eligible to receive up to eight (8) OTC COVID-19 tests per month. Each test is counted separately regardless of how many tests are sold in one package.

If members present their Blue Cross NC member ID card at an in-network pharmacy counter, they will pay no out-of-pocket costs. Reimbursement for test kits received from out-of-network pharmacies and retailers (any location other than a pharmacy counter) is limited to no more than $12 per individual test.

Will Blue Cross NC reimburse me for sales tax and shipping costs for OTC tests when submitting a claim form?

The maximum reimbursement members are eligible to receive per individual test is $12. This includes any applicable sales tax and shipping costs. If the cost of a test is less than $12, the member is eligible to be reimbursed for the cost they paid for the test in addition to the sales tax and shipping costs, up to a total of $12.  

Does the OTC testing quantity impact my ability to have a test covered that is ordered by a health care provider?

While members are only eligible to receive coverage for eight (8) OTC tests each month, Blue Cross NC will continue to cover at no cost-share to members (copayments, deductibles and coinsurance), COVID-19 testing methods performed in labs or at-home when ordered by a provider, are consistent with current CDC guidance and have been cleared, approved or given emergency use authorization (EUA) by the FDA.

Can I mail a paper claim to Blue Cross NC?

No. The address to mail the OTC COVID-19 test claim is:

Prime Therapeutics
Mail route: Commercial
PO Box 25136
Lehigh Valley, PA 18002-5136

Upon receipt of the required materials, pharmacy benefits manager Prime will issue a check reimbursing the member. The standard turnaround time for reimbursement is 21 days. Depending on volume, additional time may be needed to process reimbursement requests. Purchasing the tests through your pharmacy will eliminate the need for reimbursement.

Why did my paper claim get returned?

You must complete the correct OTC COVID-19 test claim form and mail to Prime at:

Prime Therapeutics
Mail route: Commercial
PO Box 25136
Lehigh Valley, PA 18002-5136

Upon receipt of the required materials, pharmacy benefits manager Prime will issue a check reimbursing the member. The standard turnaround time for reimbursement is 21 days. Depending on volume, additional time may be needed to process reimbursement requests. Purchasing the tests through your pharmacy will eliminate the need for reimbursement.

What is the timing to be reimbursed for OTC tests?

The standard turnaround time for reimbursement is 21 days. Depending on volume, additional time may be needed to process reimbursement requests. Purchasing the tests through your pharmacy will eliminate the need for reimbursement.

Are OTC tests covered for members through their medical or pharmacy benefits?

For Blue Cross NC’s fully-insured (individual and group) and Administrative Services Only (ASO) group health plans, Blue Cross NC covers OTC Tests under its prescription drug plan, which is administered by Prime. 
 
If the back of the member's Blue Cross NC ID card doesn’t list Prime as its prescription drug plan, the member may have a different pharmacy benefit manager. If this is the case, members should ask their employer or benefits manager about their OTC testing reimbursement options. 

For Federal Employee Plan (FEP) members, FEP covers this under their medical plan. Members must submit their claim for reimbursement along with a copy of an itemized receipt indicating the specific testing performed. 

For Medicare plans, we are awaiting further guidance from the Centers for Medicare and Medicaid (CMS) and will implement guidelines as quickly as we can. The requirements do not apply to excepted benefits (such as stand-alone vision or dental) or retiree-only plans.  

Can I use my HSA, FSA, or HRA to cover the cost of a COVID-19 OTC test?

While the cost of at-home testing for COVID-19 is an eligible medical expense that can be paid or reimbursed under health flexible spending arrangements (health FSAs), health savings accounts (HSAs), health reimbursement arrangements (HRAs), or Archer medical savings accounts (Archer MSAs), federal tax law does not allow a consumer to use HSA, FSA or HRA funds for purchases that are covered or reimbursable under a member's health plan.

If a member needs additional OTC test kits (beyond the 8 tests, per member per month covered by Blue Cross NC), they can use HSA, FSA or HRA funds to purchase the tests. 

Am I eligible for reimbursement if I purchased an OTC test before Jan. 15?

No. Blue Cross NC will reimburse for over-the-counter (OTC) tests that have been approved or received emergency use authorization (EUA) by the FDA when purchased on or after January 15, 2022.

Why have some members reported pharmacies not being able to adjudicate at point of sale?

While this partnership with pharmacy benefits manager Prime expands access to OTC COVID-19 tests and minimizes costs for members, Blue Cross NC is not able to control the supply of tests or operations at pharmacy and retail locations.

Prime is in the process of reaching out to pharmacy partners to understand their inventory, supply chain plans, how members will be directed to the pharmacy rather than the retail counter, and to confirm understanding that COVID at-home test kits required by employers are not eligible for reimbursement.

Most pharmacies contacted to-date have shared they plan to have the COVID OTC test kits available at the pharmacy counter for insured patients. Kits will also be available in the retail space for members not using insurance.

Prime is educating the pharmacies, and in standard member communication, that members should obtain COVID-19 OTC test kits from the pharmacy counter to obtain $0 coverage at the point of sale without the need to submit a paper claim. Pharmacies will be allowed to limit quantities based on their inventory management protocols to service all members. These pharmacy specific limitations may be less than 8 individual tests per person.

Who should I contact if I suspect unethical business practices?

To report price gouging, visit https://ncdoj.gov/file-a-complaint/price-gouging/. To report suspected fraud, waste or abuse, contact Blue Cross NC at SIU@bcbsnc.com or (800) 324-4963. or (800) 324-4963.


Continued Care and Telehealth

How is telehealth covered?

Blue Cross NC will cover all telehealth visits at the same cost as face-to-face visits through September 30, 2022. This means, what you normally pay when you visit a doctor in-office is what you’ll pay for a telehealth visit.

How do I know if my provider offers telehealth?

Virtual (or telehealth) visits can be used with your primary care doctors, specialists, and behavioral health providers. Or any licensed NC provider who can provide telehealth services. Call your doctor before going into the office to see if telehealth is available.


Providers

Are there differences in coding for different segments?

For Traditional Medicare and Medicare Advantage members: During the Public health emergency, providers should file claims related to the vaccine and administration of the vaccine directly to Traditional Medicare. If providers file vaccine-related Medicare claims with Blue Cross Blue Shield of North Carolina (Blue Cross NC) during the emergency, the system will deny the claim and recommend that the provider file with Traditional Medicare for Medicare Advantage members.

For customers on a grandfathered group plan, vaccines will be available at no member cost-share. Blue Cross NC and Administrative Services Only (ASO) groups will cover vaccine administration fees during the public health emergency. For grandfathered plans, providers should submit claims to Blue Cross NC.

For all other member segments: Providers should follow the coding below and submit claims to Blue Cross NC as usual.

For commercial members, retail pharmacies are able to file all vaccine claims under the medical or pharmacy benefits for commercial members.

Where can I find the latest information for providers?

Read our latest provider news updates here or contact the Provider Blue Line at 800-214-4844 from 8:00AM – 5:00PM, Monday – Thursday and 8:00AM – 4:00PM on Fridays.

Providers will need to direct all claim inquiries to Provider Service by calling 1-800-214-4844.

How do providers code the vaccine?

The American Medical Association (AMA) has provided this table to link the COVID-19 vaccine product codes to their associated immunization administration codes, manufacturer name, vaccine name(s), 10 and 11-digit National Drug Code (NDC) Labeler Product ID, and interval between doses. These codes are also located in the Medicine section of the CPT code set.


Treatment

If I am treated for COVID-19, what will I be responsible for paying?

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. We continue to closely monitor and re-evaluate policies to best serve our customers and communities.

For Medicare Advantage plans offered or administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the COVID-19 treatment cost-sharing waiver will remain in place through December 31, 2021.

What treatment options are available?

According to the CDC, treatments used for COVID-19 should be prescribed by your healthcare provider. For the most up-to-date information on COVID-19 treatment, visit cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html.

Up-to-date information and resources for our members can be found at BlueCrossNC.com/Coronavirus.