May 4, 2023
The federal government has rescinded many of the requirements put in place during the COVID-19 Public Health Emergency (PHE). The following changes will be effective May 11, 2023.
- At Home Test Kits
At Home Test Kits will no longer be covered as a medical expense and no longer available at no cost through pharmacies. Coverage for OTC tests will end on May 11, 2023. - COVID lab tests
Molecular and antigen lab tests for COVID and related office visits will continue per standard plan benefits. Members may be responsible for cost sharing after May 11, 2023 for any diagnostic testing. Testing for other purposes, including return to work, is not covered. - COVID treatment
Treatment for COVID-related illness will continue per standard plan benefits with cost sharing. - COVID prescription treatment
Prescription drugs for treatment of COVID will be covered under standard plan benefits, with members responsible for cost sharing. Until the current government supply runs out, we will continue to cover administrative costs. We’re waiting for pricing of treatments. At that time, providers and pharmacies can bill for cost of prescription. Member cost shares will apply. We will follow FDA approval process as treatments move from EUA to full approval. - COVID vaccines
COVID vaccines are covered under the Affordable Care Act as preventive benefits. Members with preventive benefits coverage will continue to receive vaccinations with no cost shares; member cost shares may apply under some plans after May 11, 2023. Until the current government supply runs out, we will continue to cover administrative costs. We’re waiting for pricing of vaccines. At that time, providers and pharmacies can bill for cost of the vaccine. We will follow FDA approval process as treatments move from EUA to full approval. Vaccine and monoclonal treatment pricing is currently unknown, with some reports of pricing as high as $130.00 per vaccine dose. As current government supplied vaccines run out, we’ll begin to see the commercial prices posted.
For additional information about the end of the public health emergency for COVID-19, the US Department of Health & Human Services published a fact sheet (Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap | HHS.gov). You can also follow our COVID-19 FAQs for updates.