EHA News

EHA News

2024-25 Rates & Benefits Released

Omnify | Your New COBRA Administration Team

The team at Omnify, powered by Union Bank & Trust, is excited to be your provider for COBRA administration. We’ll make the transition as seamless and easy as possible. 

Visit the COBRA page for more information

2023-2024 Rates & Benefits Released

NEW!! Over-the-counter COVID-19 testing

Test kits that do not require a doctor’s order or a lab to read the results are considered over-the-counter (OTC). 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. This applies to all fully-insured and self-funded groups that utilize BCBSNE’s pharmacy benefits manager, Prime Therapeutics, as well as individual health plan members. This does not apply to Medicare Advantage, Medicare Supplement or Medicare Part D members.

The current list of eligible OTC COVID-19 tests is below. Only these tests are eligible for reimbursement. Tests purchased prior to Jan. 15, 2022, are not eligible for reimbursement.

Blue Cross Blue Sheild Flier:  Over-the-counter (OTC) COVID-19 Testing

Eligible OTC COVID-19 Tests:

 NDC/UPC    Brand Name
 Tests/ Pack
 56964000000     ELLUME COVID-19 HOME TEST                            1
 11877001140     BINAXNOW COVID-19 AG CARD HOME TEST      2
 50021086001     ELLUME COVID-19 HOME TEST                            1
 08337000158     INTELISWAB COVID-19 RAPID TEST                     2
 14613033968     QUICKVUE AT-HOME COVID-19 TEST                   5
 14613033972     QUICKVUE AT-HOME COVID-19 TEST                   2
 60006019166     ON/GO COVID-19 ANTIGEN SELF-TEST                2
 82607066026     FLOWFLEX KIT HOM TEST                                     1

Our pharmacy benefits manager, 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. These preferred pharmacies can bill OTC COVID-19 tests directly to your insurance, resulting in no cost to you.

Click On Below Link:
**View The List OF Participating Nebraska Pharmacies

Tests purchased from a non-preferred pharmacy, online retailer or retail store can be submitted for reimbursement through the pharmacy paper claims process for OTC COVID-19 tests. These claims will be reimbursed at a maximum of $12 per individual OTC COVID-19 test. For example, a box that includes two tests would be reimbursed at a maximum of $24. Shipping and tax are not reimbursable.

Click on CovidTest.gov Link:

Beginning Jan. 19, 2022, free tests will also be available to order at CovidTests.gov

COVID-19 testing for public surveillance or employment purposes is not covered. This includes testing for work, school, travel and other public surveillance reasons, unless reimbursement becomes required by law.

Update: 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.

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 the Blue Cross Blue Shield  website on Jan. 15, 2022. You can also find these links below.

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.

Please click on the below link for more information from Blue Cross Blue Shield of Nebraska:

**BCBS Covid News Link**

Pleas click on the below link to find pharmacies in Nebraska:

**Nebraska Pharmacies Link**

First quarter 2022 prescription drug lists now available

Blue Cross and Blue Shield of Nebraska’s Prescription Drug Lists (PDLs) are updated on a quarterly basis by the Prime Therapeutics National Pharmacy and Therapeutics Committee. This committee develops clinically appropriate PDLs that meet the needs of our members by focusing on prescription drug safety, effectiveness, unique qualities, and cost. Members may view our PDLs at NebraskaBlue.com/DrugList.

2022-23 Rates & Benefits Released

Mental Health Benefit Change Beginning September 1st, 2021

Starting Sept. 1, 2021, in-network behavioral health office services will be covered at 100% of BCBSNE’s allowable amount, whether in-person or by using the telehealth benefit. (Out-of-network telehealth visits will continue to be non-covered.) HSA-eligible High Deductible Health Plans are still subject to deductible and coinsurance for in-person and telehealth behavioral health office visits. Per IRS regulations, except for preventive health benefits, insurance carriers cannot pay first dollar coverage on HSA-eligible HDHP plans. First dollar coverage means insurance pays expenses beginning with the first dollar charged for health care, without copayments or deductibles having to be paid.  The current definition of preventive health benefits does not include behavioral health treatment.

 

Blue Cross Blue Shield Settlement Notice

We were just made aware of an email notice that was sent to our members regarding a Class Action Settlement with the Blue Cross Blue Shield Association. The email came from the Blue Cross Blue Shield Claims Administrator at this email address: Notice@BCBSsettlement.com.

There is a summary at this link:  April 6, 2021 H&W Compliance Quarterly.

The notice provides additional resources with more details and contact information:

 

Coverage for COVID-19 Related Treatment

Working in conjunction with Blue Cross Blue Shield of Nebraska, EHA’s medical plans have followed the guidance of local and federal health officials regarding coverage for coronavirus testing and treatment.  Last week, in their continued effort to invest in the health of their members, the EHA Executive Committee voted to further extend 100% coverage of COVID-19 related testing and  treatments through March 31st, 2021. Any extension beyond this date will be based on an evaluation of the situation by the full EHA Board in February.

This means members with medical coverage who present with symptoms or have been exposed to others who have tested positive for COVID-19 will pay nothing for medically appropriate, in-network testing and treatment related services in a telehealth session, doctor’s office, urgent care facility or emergency room.

If members have questions about their claims or coverage, please have them call the Member Services Department at the number on the back of their BCBSNE ID card.

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