Updated March 31, 2023
How to get virtual care
During the federal COVID-19 Public Health Emergency (PHE), we temporarily expanded our benefit coverage to make it easier for you to access the care you needed during the pandemic. The PHE ended May 11, 2023, and these expanded benefits returned to being covered under your normal health plan benefits. That means any applicable cost shares, such as copays and coinsurance, now apply.
Here's a look at how the changes might affect you and how we’ll be covering COVID-19 care and treatment moving forward:
- If you have a Preferred Provider Organization (PPO) plan, out-of-network services, including medical and dental, will be covered as out-of-network. If you use out-of-network providers, you will pay a higher cost for your care. If you have out-of-network dental services, you will be subject to balance billing by the provider for any amount that we don’t cover.* If you need help finding an in-network provider, use the provider search by clicking on “Find a doctor”.
- If you have a Health Maintenance Organization (HMO) plan, most out-of-network services, including medical and dental, won’t be covered and you may be responsible for the full cost of services. Referrals from your primary care provider to receive specialist care may be required. If you need help finding an in-network provider, use the provider search by clicking on “Find a doctor”.
- COVID-19 vaccinations, including boosters, will continue to be covered at no cost if received from an in-network provider. Talk to your doctor or pharmacist about when and where you should get vaccinated.
- COVID-19 lab tests, if ordered by an in-network provider, will include a cost share, such as a copay or coinsurance. Just as we don’t cover drug testing for employment, we don’t cover COVID-19 testing for purposes of employment, surveillance, tracking or extracurricular activities such as travel or sports.
- Medicare will no longer provide any free over-the-counter at-home COVID-19 tests. Purchasing these tests from pharmacies or other participating entities will be an out-of-pocket cost.
- We cover the cost of FDA-approved treatment prescribed by your provider for COVID-19. Treatments will be covered in the same way as other normal health plan benefits and cost shares may apply.
- If you have a PPO plan and are travelling, you can get in-network medical benefits in most states and Puerto Rico with the Blue Medicare Advantage PPO Network program. To find a participating provider, use the National Doctor and Hospital Finder at bcbs.com/find-a-doctor. In-network providers may be available only in some portions of the state.
- If you have an HMO plan and are travelling, you are covered for the following services received outside of the service area:
- Emergency services
- Urgently needed services
- Kidney dialysis at a Medicare-certified facility
*If your coverage is through a Medicare Retiree Group plan, please refer to your Evidence of Coverage for benefit information.
If you also have a Medicaid plan: With the end of the PHE approaching, we encourage you to update your contact information with your Managed Medicaid plan, which is separate from your Medicare Advantage plan. Your Managed Medicaid plan uses your current contact information for your State’s Medicaid assistance redetermination process. Your Managed Medicaid plan’s contact information is on your Medicaid Plan ID card.
Last updated 07/05/2023