The COVID-19 public health emergency ends May 11, 2023.
In line with California law, COVID-19 vaccines, testing, and treatment will still be covered for most Blue Shield of California members. Please review the tables below for additional details. If you have any questions about your insurance type, please call the Customer Service number on your member ID card.
• For Medi-Cal members, coverage will remain unchanged.
Here are the changes you can expect for the COVID-19 services listed below:
Beginning May 12, 2023
Many self-funded employers will provide the following coverage. To confirm that your employer follows the information below, please call the Customer Service number on your member ID card.
| INSURANCE TYPE | LAB TESTING1 | AT-HOME TEST KITS | VACCINES | TREATMENT |
|---|---|---|---|---|
| Select self-funded or self-insured plans2 | Coverage and out-of-pocket costs apply based on your plan benefits for both in-network and out-of-network provider | Not covered | Covered and $0 cost for in-network providers Out-of-network coverage and out-of-pocket costs based on your plan benefits |
Coverage and out-of-pocket costs apply based on your plan benefits for both in-network and out- of-network providers |
Beginning July 1, 2023
| INSURANCE TYPE | LAB TESTING1 | AT-HOME TEST KITS | VACCINES | TREATMENT |
|---|---|---|---|---|
| Medicare Advantage & Medicare Supplement | Out-of-pocket costs apply based on a member’s plan benefis | Not covered | $0 out-of-pocket costs | Out-of-pocket costs will apply for any new treatments received |
For Medicare Advantage members, early prescription refills for maintenance medications will be no longer available after July 1st, 2023.
Beginning November 12, 2023
| INSURANCE TYPE | LAB TESTING1 | AT-HOME TEST KITS | VACCINES | TREATMENT | |
|---|---|---|---|---|---|
| Fully-insured plans3 | In-network | $0 out-of-pocket costs | $0 out-of-pocket costs for up to eight tests per month4 | $0 cost-share for INN | $0 out-of-pocket costs for COVID-19 specific, prescribed treatments For most other treatments, out-of-pocket costs may apply based on plan benefits |
| Out-of-network | Out-of-pocket costs will apply based on your plan benefits | ||||
1Lab testing includes in-office at your doctor or ordered by your care provider.
2These can be group plans from employers, associations, trusts, etc. If you receive your health insurance through your employer, plan sponsor, or benefits administrator, review your Blue Shield member ID card for the letters “ASO” (Administrative Services Only) to learn if you are on a self-funded or self-insured plan. Otherwise, contact your employer, plan sponsor, or call the customer service number on your member ID card.
3If you receive your health insurance through your employer, association, trust, etc., please contact your employer, plan sponsor, or call the customer service number on your member ID card. to see whether you have a fully-insured plan.
4Members can get reimbursed for up to eight over-the-counter (OTC) COVID-19 tests per month, as long as a timely claim for reimbursement is submitted via Blue Shield of California's claim submission process.
COVID-19 Testing
Find out which COVID-19 tests are available to members and where to get tested.
Medicare coverage for COVID-19
Learn about what coverage and care you can receive through your Blue Shield, Blue Shield Promise Medicare Advantage, or Medicare Supplement benefits.
Medi-Cal coverage for COVID-19
Learn about what coverage and care you can receive through your Medi-Cal benefits.
Last updated: 05/08/2023
Y0118_23_205B1_C 05162023
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