COVID-19 Coverage Updates

COVID-19 Coverage Updates

Provided by BlueCross BlueShield Nebraska

Update January 23rd, 2023:

Please click on the Link Below:

**New COVID-19 Educators Health Alliance Members

Vaccinations


The U.S. Food & Drug Administration (FDA) has approved three COVID-19 vaccines, from Pfizer-BioNTech, Moderna and Johnson & Johnson. Blue Cross and Blue Shield of Nebraska (BCBSNE) members are able to get the vaccine at no cost during the COVID-19 PHE.
Coverage for Testing

BCBSNE is continuing to waive member cost-sharing for medically appropriate in-network COVID-19 testing and related services through July 14, 2022.* This means members will pay nothing for medically appropriate in-network testing and related services in a telehealth session, doctor’s office, urgent care facility or emergency room.
This waiver of cost shares applies to all fully insured and self-funded groups and individual health plan members, along with those who receive their insurance through our Medicare Supplement and Medicare Advantage plans.


Medically appropriate COVID-19 tests must be ordered by a doctor or health care provider for the purpose of diagnosing COVID-19. This includes COVID-19 drive-through test sites or home test kits purchased with an order from a doctor.

Typically, the most appropriate test is the single component rapid (antigen) or PCR test, which tests only for COVID-19. Members should avoid having multiple or unnecessary tests, including large panel tests. Many conditions are tested for in large panel tests, only one of which is COVID-19. These may not be covered under your health plan and your employees could be responsible for the entire fee (approximately $1,000).
*The Department of Health and Human Services will provide a 60-day notice before lifting the PHE.

 

Over-the-Counter COVID-19 Testing
Blue Cross and Blue Shield of Nebraska is actively working toward implementation of the over-the-counter (OTC) COVID-19 testing guidance in partnership with our pharmacy benefits manager, Prime Therapeutics.

BCBS COVID UPDATE LINK

 

Past Updates

Beginning Jan. 15, 2022, there will be a $0 cost share for up to eight individual OTC COVID-19 tests per member per 30 days through the member’s pharmacy benefits. 

Prime Therapeutics has established a preferred network of pharmacies to support members in obtaining at home tests without member cost share. This network includes approximately 65,000 pharmacies nationwide.

Members will be able to obtain OTC COVID-19 tests at no cost through any of these preferred pharmacies. A list of the preferred pharmacies will be available on our website on Jan. 15, 2022.

Tests purchased from a non-preferred pharmacy, online retailer or retail store can be submitted for reimbursement through the existing pharmacy paper claims process. These claims will be reimbursed at a maximum of $12 per individual OTC COVID-19 test.

We will keep you informed on our progress toward compliance, and additional information will be available soon. 

 

Update: August 4, 2021

COVID-19 testing at no cost has been extended to October 17, 2021. Click here to download the flyer. 

How Blue Cross and Blue Shield of Nebraska is responding to the coronavirus pandemic —and what you need to know

Information for members with high deductible health plans

Recent federal legislation allows high deductible health plans linked to an HSA to waive member cost shares for the following without tax penalty:

COVID-19 testing, including the office/urgent care/emergency room visit
Telehealth (for both COVID-19 and non-COVID-19-related services)

In addition, the legislation allows individuals to use HSA/FSA funds for the purchase of over-the-counter medical products without requiring a doctor’s prescription.

Prevention tips

Currently, a vaccine is not available for COVID-19. CDC recommends the following preventive actions:

  • Maintain proper hygiene:
    Wash your hands frequently with soap and water for at least 20 seconds. Cover your cough or sneeze with a tissue, then throw it away. Disinfect surfaces that are touched often.
  • Limit exposure:
    Stay home if you are sick and avoid close contact with people who are ill.
  • Protect yourself and others:
    Wear a mask and practice social distancing when you are in public spaces.

Resources and information from our local provider partners

Bryan Memorial Hospital: bryanhealth.com/coronavirus
CHI Health: chihealth.com/coronavirus
Children’s Hospital and Medical Center: childrensomaha.org/COVID
Methodist Hospital: bestcare.org/covid-19
Nebraska Medicine: nebraskamed.com/COVID

Frequently asked questions

What is COVID-19?
COVID-19 is a coronavirus first identified during an investigation into an outbreak in Wuhan, China. While other coronavirus strains have sickened people before, this is the first time this strain has been seen in humans.

How does the virus spread?
The first infections of COVID-19 were linked to a live animal market, according to the CDC. The virus now spreads from person-to-person through droplets when an infected person coughs or sneezes. If the droplets are inhaled or land in the mouth or nose of another person, they may become infected.

What are the symptoms?
COVID-19 symptoms include fever, cough and shortness of breath, according to the CDC.

What should I do if I think I have the virus?
Don’t panic. Call your doctor or use telehealth services if you have symptoms and have been in close contact with a person known to have COVID-19 or if you live or have recently traveled to an area with COVID-19 cases.

If you need to go to your doctor’s office, urgent care or the emergency room, it’s important to call ahead, so health care staff can prepare for your arrival and prevent you from accidentally exposing other patients to the virus should you have the disease.

In the event of an emergency, call 911 and tell emergency services that you might have COVID-19.

What should I do to prepare?
You should prepare for a COVID-19 outbreak in Nebraska just like you would for any other emergency. Make a backup plan for work and childcare and keep extra staples, including food and medical supplies, on hand.

Where can I find the most up-to-date information?
For the most up-to-date information about COVID-19, visit the CDC.gov/Coronavirus.

The Nebraska Department of Health and Human Services is keeping track of COVID-19’s impact on Nebraska. Visit DHHS.NE.gov.