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. You are now leaving the blueshieldca.com website, Do NOT use this page for test reimbursement. People ages 12 years and older who are moderately or severely immunocompromised. bxx,| It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while . Member Benefit Updates. Medical, Vision, Dental Claims and Reimbursement Forms Prescription Drug Forms Coverage and Premium Payment Forms Personal Information Forms Medicare Forms HIPAA. The $0 coverage only applies when you receive your home test kits at participating locations. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Your signature is also required in the COVID-19 home test kit claim section. 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This coverage began on April 4, 2022, and includes anyone with BCBSRI Medicare Advantage or Plan 65 coverage. Medicare member reimbursement amount per test may vary by Medicare plan. Log in to anthem.com, go to Claims & Payment, and choose Submit a Claim. Use our. Should you wish to request to recruit a facility or physician into the GMMI network, please complete this nomination form. See our FAQfor detailed instructions. When filing claims online, you must use a separate claim form for each receipt and for each member. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. You can also include multiple receipts with one form. Health plans are offered by Blue Shield of California. The protection of your privacy will be governed by the privacy policy of that site. A recent announcement from the federal government intends to increase access to COVID-19 testing. The CDC states that home test kits may be used in the following situations: On the CDC website, you can find additional information, including how to use home tests and what to do if your test is negative or positive. The Blue Cross Blue Shield companies partner with state and federal agencies, as well as advocacy organizations, to report, investigate and reduce the incidence of healthcare fraud. [CDATA[ Also, note that all American households can order free COVID-19 tests from the federal government. We've taken steps to lower costs and provide our members easier access to care related to COVID-19. If a test is sold in a package of two, that is considered two tests, and youll be reimbursed $24. *If your pharmacy coverage is not through BCBSRI, your employer may have chosen to offer the home test kit benefit through your pharmacy coverage instead of your BCBSRI health plan. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. SECTION 2 - PATIENT INFORMATION Reason for the test cI was exposed to someone with COVID-19. This list is subject to change as additional home test kits become available. endstream endobj 465 0 obj <>/ProcSet[/PDF]>>>>stream You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. The following resources provide you with the information needed to administer Blue Cross and Blue Shield of Texas (BCBSTX) plans for your patients. You dont need to sign in to search for a pharmacy. Submit a separate form for each patient. Updated April 15, 2022. (function(){var g=function(e,h,f,g){ Call the number located on the back your member ID Card. Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" Member Forms. You can get up to 8 individual tests per calendar month from participating pharmacies and healthcare providers during the COVID-19 public health emergency. Member Reimbursement: If members purchased an OTC COVID-19 test on or after January 15, 2022, they can submit for a reimbursement of up to $12 per test. We generally process claims within 30 days from receiving your completed claim form and receipts. No, you dont need an order or prescription unless you are buying more test kits than allowed under your $0 coverage or at a location that is not participating with your Medicare Part B benefit. To be eligible for reimbursement, you must submit: (To submit a single form for multiple members and/or receipts, use a mail-in form instead. California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. reimbursement through FSA, HRA, or HSA accounts? As of January 15, 2022, you can get reimbursed by your health plan for the costs of over-the-counter diagnostic COVID-19 tests until the end of the Coronavirus Public Health Emergency. Online claims Home test kits are tests you can do at home and read yourself, without the help of a provider or lab. Reimbursement requests take up to 4-6 weeks to process Questions? Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. You have been exposed or potentially exposed to an individual with COVID-19 (even if you dont have symptoms). Home test kits can be an important and convenient tool for diagnosing COVID-19, and BCBSRI members have $0 coverage for these home test kits without a prescription. Your Blue Cross and Blue Shield of Illinois (BCBSIL) health plan gives you access to the care you need during the COVID-19 pandemic. This form is for members of non-Medicare plans. Heres everything you need to know about it. You can submit up to 8 tests per covered member per month Tests must be FDA-authorized Tests must be purchased on or after January 15, 2022 Your commercial plan will reimburse you up to $12 per test. The following claims process pertains to CareFirst commercial members* only. If you use a provider outside of the network, you will need to complete and file a claim form for reimbursement. Complete this claim form for any pharmacy services received. However, you must include all required information requested in the form. See the FAQ below for details.) Leading the way in health insurance since 1929. 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. try{(new g(100,"r","QSI_S_ZN_eQKLROMaB9E1yfz","https://zneqklromab9e1yfz-carefirst.siteintercept.qualtrics.com/SIE/?Q_ZID=ZN_eQKLROMaB9E1yfz&utm_source=Qualtrics")).start()}catch(i){}})(); If you take advantage of Service Benefit Plan dental benefits, you will need to complete and file a claim form for reimbursement. Then, complete and submit the online form. endstream endobj 467 0 obj <>/ProcSet[/PDF]>>>>stream 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. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. window.CE_READY = function () { CE2.listen(window, 'click', function(evt) { if (evt.target.id=== 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } You can get up to 8 individual tests per calendar month from participating pharmacies and healthcare providers during the COVID-19 public health emergency. Please check with your employer if you have questions. Required documentation for this medical claim includes: The attestation included in our claims process ensures our members comply with the spirit of this policyto ensure tests are accessible and affordable for those who need them. This page may have documents that can't be read by screen reader software. Members should complete the OptumRx Over-the-Counter Test Reimbursement Form and include their receipts. Many Blue Cross Blue Shield of Rhode Island plans include $0 coverage for COVID-19 test kits without a prescription. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging. 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. 2023 copyright Anthem Insurance Companies, Inc. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. For help with these documents, please call 1-800-975-6314. . You can submit any number of receipts on a single claim form. 2023 Blue Cross Blue Shield Association. All information . In this case, you should fill out three claim forms one for each member. Each person on your plan is covered for up to 8 individual home test kits every 30 days. Power 2022 award information, visit jdpower.com/awards. Telehealth. Visit the Medi-Cal website for more details. f/4kg>/ProcSet[/PDF]>>>>stream During the federal public health emergency, Blue Shield will continue to waive out-of-pocket costs for copays, coinsurance, and deductibles for: COVID-19 screenings or evaluations done: Virtually using telehealth, In a doctor's office, At an urgent care center, or In a hospital (including emergency room). Thats a big step toward stopping the spread of the virus. While all FDA-authorized COVID-19 rapid tests are covered, and will be reimbursed under the Emergency Rule, only certain tests are likely to process correctly through pharmacy claims systems at the moment. All 35 Blue Cross and Blue Shield companies are fighting against COVID-19, investing more than $12.8 billion in the nations recovery. Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. 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. For more information about coverage of over-the-counter tests, view our frequently asked questions. For example, a physician, a nurse practitioner, or a physician assistant. Health plans are offered by Blue Shield of California. No, the home tests provided by the government do not count toward your $0 coverage. You can find a list of community-based testing sites here. This coverage cant be used for workplace screening or travel. If the test is less than $12, reimbursement will be the cost of the test. 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. The process we've put in place empowers our members to buy and submit claims for tests purchased through online vendors and retail locations of their choosing. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Then, complete and submit the online form. If the pharmacy continues to direct you to pay at the regular store checkout, please consider paying for the test kit and submitting for reimbursement or trying to use a different pharmacy. Testing and Treatment Coverage Reimbursement is not available through medical benefits with BlueCross BlueShield or Cigna. Here are four ways you can get tests for you and your family: Visit covidtests.gov to get free tests delivered to your home by the U.S. At a participating pharmacy, go to the pharmacy counter (not the store checkout) and. 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. Member Discounts Take advantage of member-only discounts on health-related products and services. 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.). Postal Service. Please note that taxes and other fees are not covered. If you have questions about reimbursement of at-home tests, contact Express Scripts at 855.612.3128. W006259 COVID-19 Testing Member Reimbursement Form - Non-Medicare Advantage Please use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket. Here is the process: If you prefer to have your home test kits shipped to your house, you can pay out-of-pocket and submit for reimbursement using this form. At-home testing options and costs By continuing to use this website, you consent to these cookies. OTC COVID test kit claim. The number one priority for Blue Cross Blue Shield (BCBS) companiesespecially as the nation faces this unprecedented health crisisis getting their members across the country the care they need. People may also access free or affordably priced testing in the community. Check out the changes and updates to our plan in 2023. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. CareFirst continues to cover the cost of COVID-19 tests administered by a healthcare provider for diagnostic purposes. 2. Once we process your claim, well mail the contract holder a reimbursement check. If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. Mail claim form and all attachments to BCBSMA, P . 2023 Blue Cross Blue Shield Association. Lets say you made a one-time purchase of up to 24 tests for three members. Highmark Blue Cross Blue Shield of Western New York is closely monitoring the COVID-19 (Coronavirus) situation. This coverage applies to all BCBSRI health plans except Medicare. In response to the COVID-19 pandemic, Blue Cross is expanding reimbursement for all services delivered through telehealth that meet the coverage criteria in the policy. You will be reimbursed $12 per test. Chico, CA 95927-2540. Here are helpful Service Benefit Plan brochures, claim forms, reference guides and videos. Find answers on our member and employer pages, or contact us. 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 . this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; Blue Cross Blue Shield sent a statement saying: We received updated guidance from the federal government regarding at-home COVID-19 testing coverage late Monday afternoon. Medicare member reimbursement amount per test may vary by Medicare plan. Overseas members will need to complete and file this claim form for any medical services received. For all formulary tier exceptions you will need to complete and file a request form. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. You do not need health insurance to receive your free tests. Sign in or register at Caremark.com (You must be a CVS Caremark member) You can also include multiple receipts with one form. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Fill Online, Printable, Fillable, Blank COVID-19 Testing Member Reimbursement Form Non-Medicare Advantage (Blue Cross Blue Shield of Michigan) Form Use Fill to complete blank online BLUE CROSS BLUE SHIELD OF MICHIGAN pdf forms for free. endstream endobj startxref 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. "We have tests, treatments, and vaccines that can . You can find provider manuals, reimbursement documents and procedures. COVID-19 TESTING AND REIMBURSEMENT. Use this form to request reimbursement for Medicare Part B premium expenses. To be reimbursed for a COVID home test kit purchased at any pharmacy . O=>WNW% 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. Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov. You can also submit reimbursement for home test kits. Y0118_22_062A_C 02082022 Your member ID card is your key to using your medical plan benefits. Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide, including CVS Pharmacy, Walgreens, Walmart, and Costco. Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. See the list. The Contraceptive Exception Form allows members to apply for coverage, or formulary tier, exception for a contraceptive drug/product. After choosing BCBS Rhode Island as your health plan, select the Rhode Island Pharmacy Network (which is a national network) and enter your ZIP code. Important information about expanded coverage. Use the claims form for OTC at-home tests with a healthcare provider order. Mail-in claims If multiple tests are sold in one package, i.e., if one package includes two tests, it counts as two tests and not one test package toward the quantity limit. . You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. All Rights Reserved. Blue Cross recommends that members contact and work closely with their health care . H0148_22_003_C_020822. You can view a complete list ofparticipating pharmacies in Rhode Islandor search thenational directoryfor participating pharmacies. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. At a participating pharmacy, go to the pharmacy counter (not the store checkout) and use your red, white, and blue Medicare card. If you are a Medicare Advantage, Medigap, Medicaid or Dual Eligible Special Needs Plan member, please call the number on the back of your member ID card for benefit information. The vaccines are free, safe and effective and widely available for anyone age 5 and up. 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. 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. These enhancements include covering services not previously covered and waiving fully insured member costs for select services related to COVID-19. The IRS no longer requires us to automatically mail Form 1095-B to members. We recognize the important role testing, along with vaccines and boosters, has played in the effort to battle the pandemic. Visit the CDC website for the most up-to-date testing guidance. Once you receive a confirmation from CVS Pharmacy, your order will be waiting for you at the front store register. All rights reserved. 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. 1Orders not picked up within 72 hours (about 3 days) will be cancelled. All information below is required. With each claim form, you should include the same receipt. You can find detailed instructions on how to file an appeal in the Disputed Claims Processdocument. 454 0 obj <> endobj On July 31, one day remains to file the claim. From January 15, 2022 until the end of the Coronavirus Public Health Emergency, each individual on your plan can get up to eight over-the-counter tests each month. What you need to know about the disease and our coverage commitment. 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. With each claim form, you should include the same receipt. . 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.
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