All forms are printable and downloadable. Visit the, Reimbursement is limited to OTC COVID-19 at-home tests. Click on Request at-home tests, and enter your ZIP code for details on the closest store and product availability. General Reimbursement Information | Blue Cross and Blue Shield of Texas Today, the Blue Cross Blue Shield Association (BCBSA) announced that independent and locally-operated BCBS companies across the country and the BCBS Federal Employee Program (FEP . As of January 15, 2022, your health plan administrator may have started covering at-home COVID-19 tests. Submit a claim only when you are billed for services from a provider that does not directly submit a claim to the local Blue Cross Blue Shield plan. Blue Cross Blue Shield COVID At-Home Test Reimbursement Form. this.get=function(a){for(var a=a+"=",c=document.cookie.split(";"),b=0,e=c.length;b/ProcSet[/PDF]>>>>stream Making healthcare affordable. If you use a pharmacy in Prime's network, you should not have to submit a separate claim when you buy the tests at the pharmacy counter. You have been exposed or potentially exposed to an individual with COVID-19 (even if you dont have symptoms). The following claims process pertains to CareFirst commercial members* only. If you purchased an OTC at-home test at the direction of your health care provider, please use this form: If you purchased an OTC at-home test for any other reason, please use this form: Send a copy of all your receipt(s) with the form. In addition to your BCBSRI benefits, every home in the United States is eligible to orderfree COVID-19 home test kits through the federal government atcovidtests.gov. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. Sources: Member Discounts Take advantage of member-only discounts on health-related products and services. Here's how to get reimbursed: Submit a claim form You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. It should not be considered current, complete or exhaustive, nor should you rely on such information to recommend any tests, products, procedures, opinions, or a course of treatment for you or any other individual. this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Postal Service. Tests that can be purchased at a retail location or online but are then sent to a lab for processing are not covered unless accompanied by a doctor's order (except for individuals covered by plans based in the District of Columbia). Use this form to select an individual or entity to act on your behalf during the disputed claims process. Mail-in claim forms allow you to submit a claim for multiple members with one form. As of Jan. 15, 2022, people with private health insurance can get reimbursed by their insurer for the cost of up to eight at-home COVID tests per month. You can buy the tests for $0 at a participating pharmacy (at the pharmacy counter) when using your BCBSRI member ID card. Medicare Advantage members: You will need an order for an OTC at-home test from an authorized healthcare provider to get reimbursed at this time. endstream endobj 470 0 obj <>/Subtype/Form/Type/XObject>>stream UPDATE: COVID-19 over the counter testing reimbursement - IBX Newsroom Mail claim form and all attachments to BCBSMA, P . 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 Online claim example 2: If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. How to get free at-home tests: Express Scripts Pharmacy Order up to 8 at-home COVID-19 tests every 30 days from Express Scripts Pharmacy. 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.). Please ask at the pharmacy counter. All of the content provided on this website or on the linked websites is for informational purposes only and is not intended to serve as medical, legal or tax advice. | 8cqy .-mg7b COVID-19 | Blue Cross and Blue Shield of Illinois - BCBSIL %%EOF For more information, view our privacy policy. endstream endobj 462 0 obj <>/ProcSet[/PDF]>>>>stream Submit one form per member. Insurers must cover the cost of eight tests per insured individual. Standard Option Basic Option FEP Blue Focus Tier Exception Member Request Form Coverage for COVID-19 testing | Blue Shield of CA For more information about Pharmacy Prior Approval and the required forms visit the Prior Approval page. PDF Florida Blue Prescription Drug Claim Form CHICAGO - Blue Cross and Blue Shield (BCBS) companies are working closely with state and local governments, as well as partners within the health care system, to address local needs from the COVID-19 outbreak. "We have tests, treatments, and vaccines that can . You can get up to 8 individual tests per calendar month from participating pharmacies and healthcare providers during the COVID-19 public health emergency. What's Covered - COVID-19 | Blue Cross and Blue Shield of Texas - BCBSTX window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { Important Please provide what is on your member card, failure to provide at least one of these fields can lead to failure in claim approval. To access your member services, please visit your BCBS company. All FDA-approved home test kits are covered without a prescription. To be eligible for reimbursement, your test must be . Pregnant members can use this form to request a blood pressure monitor at no cost. // ]]>. Please note: Your receipt must be dated January 15, 2022 or later to be eligible for reimbursement. The frustrating Covid-19 test reimbursement process is a - Vox All trademarks unless otherwise noted are the property of Blue Cross & Blue Shield of Rhode Island or the Blue Cross and Blue Shield Association. 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. As of January 15, Americans with private insurance are supposed to be reimbursed for the cost of the tests. Purchase a COVID-19 at-home test kit and submit a claim through the paper-based OTC test claim form. Blue Cross Blue Shield of Vermont to cover certain take home - VTDigger Telehealth. [CDATA[ What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . Copyright document.write(new Date().getFullYear()) Blue Cross & Blue Shield of Rhode Island. Reimbursement is capped at $12 per test (or the cost of the test, if less than $12). Instead of showing your BCBSRI member ID card at the pharmacy counter, you provide that information online and then pick up the home test kits at a CVS Pharmacy location. SECTION 2 - PATIENT INFORMATION Reason for the test cI was exposed to someone with COVID-19. 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . Yes, home test kits can be purchased with your quarterly OTC allowance ($25-$275, available with most BCBSRI Medicare Advantage plans). H0148_22_003_C_020822. All rights reserved. Findings. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. 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. Reimbursement is not available through medical benefits with BlueCross BlueShield or Cigna. You do not need health insurance to receive your free tests. Over-the-Counter COVID-19 Testing | Producer | Premera Blue Cross Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. Group Hospitalization and Medical Services, Inc., and First Care, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. Starting today, Blue Cross commercial members can walk into any of the 60,000 pharmacies in the national Express Scripts network and buy certain tests at the pharmacy counter for $0: Inteliswab Covid-19 Rapid Test Binaxnow Covid-19 Ag Self Test Quickvue At-Home Covid-19 Test Ellume Covid-19 Home Test Many Blue Cross Blue Shield of Rhode Island plans include $0 coverage for COVID-19 test kits without a prescription. People ages 12 years and older who are moderately or severely immunocompromised. Overseas members will need to complete and file this claim form for any pharmacy services received. To access your member services, please visit your BCBS company. 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. Visit covidtests.gov, and click the blue "Order Free At-Home Tests" button. Youll be reimbursed up to $12 per individual test. To print and mail your claim, download theclaim form (PDF). Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed. independent licensees of the Blue Cross and Blue Shield Association. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. If you are asked to pay for the tests at the regular store checkout, you can let the pharmacy know your coverage is through Prime. endstream endobj 463 0 obj <>/ProcSet[/PDF]>>>>stream This form is for members of non-Medicare plans. The government is committed to ensuring access to OTC tests. Chico, CA 95927-2540. Provide your BCBSRI health plan information and follow the steps to order the tests. Contact your local health department to learn about free COVID-19 testing locations or pickup sites. He has reported on health . If you use a provider outside of the network, you will need to complete and file a claim form for reimbursement. COVID-19 home test kit claim itemized pharmacy receipts to the back of this form. Purchase FDA-authorized OTC tests at a retail location and then submit a Health Benefits Claim Form, providing an itemized receipt that clearly shows that your purchase was for a COVID-19 OTC test to your local BCBS Plan. COVID-19 At-Home Test Member Reimbursement Form Please use this form to request reimbursement for actual cost of FDA-approved COVID-19 at-home test(s). To be eligible for reimbursement, you must submit: 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. 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. If you bought or ordered an at-home COVID-19 test on or after January 15, 2022, you may be able to get reimbursed for the cost. COVID-19 TESTING | Benefits Services Division - Arizona Health Insurance Alabama | Blue Cross and Blue Shield of Alabama For more information, view our privacy policy. Wu3B= e&gZ-h'BR$djC?Wn>2esFdUb'$K6Q We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex, including sexual orientation, gender identity, or gender expression. 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. m]6Us4xgTI0a+yhO,FR~E=KT#NbgA={jAul,WldU/ If a test reader is required, reimbursement is limited to $12. For more information about coverage of over-the-counter tests, view our frequently asked questions. . They are typically easy to use and produce rapid results. This list is subject to change as additional home test kits become available. Complete this form for each covered member, You can submit up to 8 tests per covered member per month, Tests must be purchased on or after January 15, 2022. Medicare Advantage members: Use the claims form for OTC at-home tests with a healthcare provider order. OTC tests are covered with no out-of-pocket costs when purchased at the pharmacy counter for members with . In this case, you should fill out three claim forms one for each member. . Visit the CDC website for the most up-to-date testing guidance. below is required. For help with these documents, please call 1-800-975-6314. . There is a limit of . If you go to another location and pay upfront for a home test kit, you cant submit for reimbursement unless you have a doctors note or prescription. For members of BCBSRI Medicare Advantage and Plan 65 Lets say you made a one-time purchase of up to 24 tests for three members. Starting January 15, 2022, you have $0 coverage for COVID-19 home test kits without a prescription, and each person on your plan is covered for up to 8 individual home test kits every 30 days. Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services, must be purchased on or after January 15, 2022, used to identify the potential COVID-19 infection, will be self-administered with results that can be self-read, will not be resold, given or supplied to persons other than family members covered under the same policy, The purchase receipt documenting the date of purchase and price, UPC** cut-out from the over-the-counter COVID-19 test packaging, Signed, completed attestation confirming and acknowledging that the purchased over-the-counter at-home COVID-19 test meets eligibility guidelines. b&HXR There are 0 fields that need to be corrected. Get reimbursed for your over-the-counter COVID-19 tests OTC tests purchased at retail locations cost, on average, $12 for a single test and $24 for a double test kit. Get started with your reimbursement request. For members of all BCBSRI plans except Medicare How some health insurers are reimbursing the cost of at-home COVID Provider Information on COVID-19 Coverage | Blue Cross and Blue Shield How Are Private Insurers Covering At-Home Rapid COVID Tests? Coverage varies by plan type. Reimbursement is limited to OTC COVID-19 at-home tests authorized for emergency use by the Food and Drug Administration. COVID-19 updates | S.C. PEBA - South Carolina For other FDA-approved home test kits (that are generally not available at pharmacies), you can submit a claim for reimbursement. CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. You can only use your $0 coverage at pharmacies and healthcare providers participating with this specific program. To find an in-network pharmacy, click here or download the fepblue app. // ]]>, //