If you have any questions about your reimbursement claim submission, call . Additionally, the federal government now requires commercial health plans to cover the cost of over-the-counter COVID-19 tests for members. If you think you may have the virus or have been exposed to someone who has it: Not all testing sites are the same. follow the latest CDC guidance for isolation. Medicare Advantage COVID-19 Testing Member Reimbursement Form ro?gu?"t6Vr K?K@n}r`TyEycB". At-home diagnostic tests can be purchased over the counter, online, at a local pharmacy, or from a big-box store. Read Full Story Audience Communities We have a nationwide network of providers that participate with Blue Cross Blue Shield of Michigan. OTC tests purchased at retail locations cost, on average, $12 for a single test and $24 for a double test kit. If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. This page may have documents that cant be read by screen reader software. testing after you received an initial COVID-19 test. How Your Benefits Work COVID-19 vaccination coverage after the Public Health Emergency Coverage for COVID-19 testing COVID-19 treatment If you have Medicaid, you can go to https://mss.empireblue.com/ny/home.html for information about your plan. Provide an itemized receipt that clearly shows that your purchase was for a COVID-19 test. If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. qGm1UCk3Ht}uh>.ky!R'@ E For additional COVID-19 information, visit the Blue Cross Blue Shield Coronavirus Resource Center. . Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. The Blue Cross Blue Shield companies partner with state and federal agencies, as well as advocacy organizations, to report, investigate and reduce the incidence of healthcare fraud. We are committed to making sure members get the care they need when they need it. You can also include multiple receipts with one form. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. For example, you have to see an out-of-network doctor that doesnt accept your insurance. Find your BCBS company. 454 0 obj <> endobj The government is committed to ensuring access to OTC tests. This new site may be offered by a vendor or an independent third party. 1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue . Check the state-by-state list of Blue Cross Blue Shield companies to get started. Some labs may not provide testing without a doctors order. The Biden administration announced that it intends to end the COVID-19 national and public health emergency (PHE) declarations on May 11, 2023. Visitcovidtests.gov, and click the blue "Order Free At-Home Tests" button. See our FAQfor detailed instructions. this.start=function(){var t=this;"complete"!==document.readyState?window.addEventListener?window.addEventListener("load",function(){t.go()},!1):window.attachEvent&&window.attachEvent("onload",function(){t.go()}):t.go()};}; endstream endobj startxref COVID-19 diagnostic tests will be covered at your regular benefit level after the end of the public health emergency. Log in to blueshieldca.com (Engagement Point users at, Enter that information as indicated. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. All rights reserved. Mail-in claim forms allow you to submit a claim for multiple members with one form. Waiving all prior authorization requirements for COVID-19 testing and related covered services. 2023 Blue Cross Blue Shield Association. this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. According to the Centers for Disease Control (CDC) recommendations, if your over-the-counter test has a positive result, you should follow the latest CDC guidance for isolation, wear a well-fitted mask if you have contact with others and call your healthcare provider. In addition, some sites may require you to agree to their terms of use and privacy policy. Everyone qualifies. endstream endobj 461 0 obj <>/ProcSet[/PDF]>>>>stream endstream endobj 463 0 obj <>/ProcSet[/PDF]>>>>stream If you were on a cruise, you'll use the same claim form for reimbursement of medical expenses. 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. See below.). All rights reserved. Your health plan covers FDA-authorized COVID-19diagnostic testingat no cost until the end of the public health emergency on May 11, 2023. If you recently visited a doctor outside of your network and you need to submit a claim, you can use one of these claim forms. The protection of your privacy will be governed by the privacy policy of that site. [CDATA[ 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. Some labs and hospitals may not provide testing without a doctors order. If your employer has asked you to submit receipts to your pharmacy benefit plan, please dont submit them here. In this case, you should fill out three claim forms one for each member. Blue Cross Blue Shield of Michigan PPO: 1-800-762-2382 Blue Care Network HMO: 1-800-482-5982 Medicare Plus Blue PPO: 1-888-803-4960 BCN Advantage HMO and HMO-POS: 1-800-431-1059 Or, learn more about all the mental health options available to you. By continuing to use this website, you consent to these cookies. if (evt.target.id === 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } You will be reimbursed via check, mailed to the address we have on file within 30 days of Blue Cross Blue Shield of Arizona (BCBSAZ) receiving your reimbursement information. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. // ]]>, // . Member Discounts Take advantage of member-only discounts on health-related products and services. this.check=function(){var a=this.get(f);if(a)a=a.split(":");else if(100!=e)"v"==h&&(e=Math.random()>=e/100?0:100),a=[h,e,0],this.set(f,a.join(":"));else return!0;var c=a[1];if(100==c)return!0;switch(a[0]){case "v":return!1;case "r":return c=a[2]%Math.floor(100/c),a[2]++,this.set(f,a.join(":")),!c}return!0}; Register Now. In Virginia, CareFirst BlueCross BlueShield, CareFirst MedPlus, and CareFirst Diversified Benefits are the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). 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. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. We use cookies on this website to give you the best experience and measure website usage. cRequired for employment purposes. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. You can download the claim form hereor call the number on the back of your member ID card to receive one by mail. When filing claims online, you must use a separate claim form for each receipt and for each member. Pickup cannot happen via drive-thru and tests will not be shipped. Blue Shield of California has neither reviewed nor endorsed this information. endstream endobj 464 0 obj <>/ProcSet[/PDF]>>>>stream To submit a claim online, log in to, or register forMy Account, click My Documents, then Forms and select Over-the-Counter COVID-19 Test Online Claim to get started. a|VOXHXT:B4 Some testing locations may not be in your health plans network. You can use these claim forms to ask us for reimbursement. If a test is sold in a package of two, that is considered two tests, and you'll be reimbursed $24. Some testing locations may not be in your health plans network, particularly if they arent part of a medical group or facility. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. Please mail completed form with copy of purchase receipt(s) to: Blue Shield of California P.O. If you have any questions, please contact customer service at the phone number on your Blue Shield member ID card. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. How can I resolve a problem with my PPO or HMO claim? Use our. // ]]>, // ;j+/ All Rights Reserved. Chico, CA 95927-2540. 1Orders not picked up within 72 hours (about 3 days) will be cancelled. endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream The aforementioned legal entities (excepting First Care, Inc. of Maryland), CareFirst BlueChoice, Inc., and The Dental Network, Inc., are independent licensees of the Blue Cross and Blue Shield Association. this.get=function(a){for(var a=a+"=",c=document.cookie.split(";"),b=0,e=c.length;bstream Just choose the form based on your group or plan and the service. 1To download the BCBSTX app, text BCBSTXAPP to 33633 or search for BCBSTX in the Apple App Store or Google Play. If you have employer coverage, or an individual or family plan, you can get over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSTX/Prime Therapeutics pharmacy benefits until the end of the public health emergency on May 11, 2023. For full details onbenefits, services and network coveragewhich may vary by health planfind each BCBS companys statement below: The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. You can also include multiple receipts with one form. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Li@ c;8tH$0Neh,````1A88Co&) W e#f`lF|kQN2qC,`j` ` ;v Call your doctor. 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. You are now leaving the blueshieldca.com website, Do NOT use this page for test reimbursement. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { Please call OptumRx customer service toll-free at (855) 828-9834 (TTY:711) or see the COVID-19 test kit FAQ under "Which tests are covered" for the most up to date list of covered tests. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. Individuals attempting unauthorized access will be prosecuted. If you have Medicare, you can go to www.empireblue.com/medicare for information about your plan. We are expanding access to vaccines, educating communities, and meeting ongoing healthcare and social needs in communities across the country. Only visit the ER or call 911 if youre experiencing life-threatening symptoms. 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=/; "}; To make sure the associated costs for getting diagnostic tests are covered by your BCBSTX plan: 1To download the BCBSTX app, textBCBSTXAPPto33633or search for BCBSTX in the Apple App Store or Google Play. If you are a Medicare Advantage, Medigap, Medicaid or Dual Eligible Special Needs Plan member, please call the number on the back of your member ID card for benefit information. endstream endobj 455 0 obj <>>>/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 (To submit a single form for multiple members and/or receipts, use a mail-in form instead. To access your member services, please visit your BCBS company. endstream endobj 460 0 obj <>/ProcSet[/PDF]>>>>stream Site Map|Feedback|Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, COVID-19 Testing Member Reimbursement Form (PDF), Forms for Blue Cross Blue Shield of Michigan (PPO) members, Forms for Blue Care Network (HMO) members, Prescription drug claim forms (PPO and HMO). (To submit a single form for multiple members and/or receipts, use a mail-in form instead. [CDATA[ Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" For the Health of America. Your doctor can order a COVID-19 diagnostic test and coordinate your testing at an in-network lab or pharmacy. Costco, Wal-Mart, Amazon), please attach itemized register receipts to the back of this form. If you have any questions, call the phone number on the back of your subscriber ID card, also known as enrollee ID, or contact us and we'll help. If you are covered by a group or individual and family health plan, you can get reimbursed for your purchase of FDA-authorized, at-home testing kits at $12 per test, or $24 for a box that includes two tests, for up to 8 tests per person every 30 days. In addition, some sites may require you to agree to their terms of use and privacy policy. Visit the CDC website for the most up-to-date testing guidance. %PDF-1.7 % You can also go to any other in-network retail pharmacy and purchase the test kits at the pharmacy counter2. Leading the way in health insurance since 1929. Get access to your member portal. Box 272540, Chico, CA 95927-2540 Questions? We recognize the important role testing, along with vaccines and boosters, has played in the effort to battle the pandemic.

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