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COVID-19 NATIONAL EMERGENCY & PUBLIC HEALTH EMERGENCY ENDING

The COVID-19 National Emergency will end on May 11, 2023, but includes an additional 60-day period to extend deadlines for COBRA elections/payments, HIPAA Special Enrollment, Appeals, and member submitted Claims. These deadlines will return to normal timeframes starting July 11, 2023.

The COVID-19 Public Health Emergency will end on May 11, 2023, removing the federally mandated coverage requirements for COVID-19 testing, related services, treatments and vaccinations. A summary of changes that will begin May 12, 2023, can be found here.

Blue Medicare Advantage summary of changes that will begin May 12, 2023, can be found here.

COVID-19 Information

Costs & Coverage

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Symptoms

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Testing

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Vaccine

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GETTING TESTED FOR COVID-19

There are two kinds of tests available for COVID-19. A viral test will indicate a current infection. An antibody test might tell if you had an infection in the past.

FREE AT-HOME COVID-19 TESTS

The federal government has provided free at-home COVID-19 tests when funding has been available. Please visit COVIDtests.gov to check current availability.

REIMBURSEMENT FOR OVER-THE-COUNTER COVID-19 TESTS

On January 10, 2022, the Biden Administration released new guidance requiring health plans to reimburse covered individuals for over-the-counter (OTC) COVID-19 diagnostic tests. This policy went into effect on January 15, 2022, and is applicable through the end of the public health emergency on May 11, 2023. Starting May 12, 2023, there will be no coverage for OTC COVID-19 home tests. Members may use their Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to purchase these OTC tests.

Coverage is limited to eight tests per covered individual per 30-day period for OTC rapid antigen diagnostic tests. Tests must be purchased from pharmacies, retail stores or online retailers. Tests must be for personal use, not for employment purposes, have not or will not be reimbursed by another source and may not be resold. Specifically, Blue KC may disallow reimbursement for tests that are purchased by a participant, beneficiary, or enrollee from a private individual via an in-person or online person-to-person sale, or from a seller that uses an online auction or resale marketplace. OTC COVID-19 tests purchased prior to January 15, 2022, are not eligible for reimbursement.

Tests must be authorized or approved by the FDA. For a list of EUA authorized tests, go here and enter OTC into the list search box located under the article titled Individual EUAs for Antigen Diagnostic Tests for SARS-CoV-2 and above the table. The list may be subject to change. Please note, tests must be self-administered and self-read. Any COVID-19 test that requires a healthcare provider to administer or read is not eligible under this OTC benefit but may be eligible under your medical benefits.

Members who purchase OTC COVID-19 tests and pay out-of-pocket can be reimbursed as described below. Additional tests are limited to eight per 30-day period per member. You will be reimbursed for 100% of the cost of the test purchased between January 15, 2022 through May 11, 2023. Sales tax and delivery charges are not covered and will not be reimbursed. If members choose to use their HSA or Section 125 plan to pay for OTC COVID-19 tests, they cannot submit those tests for reimbursement due to IRS rules.

Members who do not have pharmacy benefits through Blue KC should contact the customer service number listed on your pharmacy benefits ID card to inquire about test reimbursement.

Blue Medicare Advantage members visit MedicareBlueKC.com/covid19 for information about free at-home COVID -19 test.

Protect yourself by practicing social distancing, wear a mask, and wash your hands.

When to seek a test

  • You have COVID-19 symptoms.
  • You’ve been in close contact (within 6 feet for a total of 15 minutes or more) with someone with confirmed COVID-19.
  • You’ve taken part in a high-risk activity such as travel, attending a large social or mass gathering, or been in a crowded indoor setting.
  • You’ve been referred to get a test from a healthcare provider or state health department.

How to get a test

You have a variety of in-network options if you’re interested in receiving a COVID-19 test. The following locations work with your plan, meaning you won’t have to pay out of pocket to receive a test ( please note that testing sites not included below may require you to pay higher out of pocket fees and submit a claim for reimbursement):

IMPORTANT: In accordance with federal guidance, these tests will not be covered to screen for general workplace health and safety (such as employee ”return to work” program(s) or for public health surveillance for SARS-CoV-2 or for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-19.

If you have questions about COVID-19 or testing, please contact your primary care provider.

Frequently Asked Questions

Have questions about COVID-19 testing? We’ve got answers. For a closer look at important things to know, refer to the FAQs below.

When should I get a COVID-19 test?

First, contact your primary care physician or healthcare provider if you have symptoms of COVID-19. Alternatively, you can also use Blue KC Virtual Care 24/7 through Amwell, our virtual care provider, for a safe and secure virtual visit.

According to the CDC, other considerations for when you should get tested include if you have had close contact (within 6 feet for a total of 15 minutes or more) with someone with confirmed COVID-19 or taken part in activities that put you at higher risk for COVID-19 because you couldn’t socially distance as needed, such as travel and attending large social or mass gatherings in crowded indoor settings.

You have a variety of in-network options if you’re interested in receiving a COVID-19 test. The following locations work with your plan, meaning you won’t have to pay out of pocket to receive a test (please note that testing sites not included below may require you to pay higher out of pocket fees and submit a claim for reimbursement):

Where can I get a COVID-19 test?

First contact your primary care physician or healthcare provider if you are experiencing COVID-19 like symptoms.

Alternatively, you can also use Blue KC Virtual Care 24/7 through Amwell, our virtual care provider, for a safe and secure virtual visit. Using your computer or smartphone with your camera and microphone enabled, you can go to BlueKCVirtualCare.com.

You have a variety of in-network options if you’re interested in receiving a COVID-19 test. The following locations work with your plan, meaning you won’t have to pay out of pocket to receive a test (please note that testing sites not included below may require you to pay higher out of pocket fees and submit a claim for reimbursement):

What should I know about COVID-19 testing?

Information is changing by the hour and science is evolving daily to bring us a better understanding of the behavior of this virus, how we can most effectively test for it and react to the results of those tests.

Here is a helpful breakdown of current terms and information related to COVID-19 testing:

  • Diagnostic testing for COVID-19 is intended to identify a current infection in individuals and is performed when a person has signs or symptoms of COVID-19, or when a person is asymptomatic but has recent known or suspected exposure to COVID-19. Diagnostic tests are medically necessary to guide clinical decision-making for individuals. Current diagnostic tests are PCR or antigen tests–find more information about testing types in the question below on this page.
  • Public health screening for COVID-19 is intended to identify infected people who are not showing symptoms and don’t know or think they’ve been exposed to COVID-19. Public health screenings are performed to identify people who may be contagious so that measures can be taken to prevent further transmission. Scientists are still studying which type of COVID-19 test is most appropriate as a public health screening. Public health departments are charged with making this decision for their respective communities.
    • Find more information from the CDC.
    • Learn more about public health testing in our area in the question below on this page.
  • The positivity rate is increasingly being used as a marker to guide community decisions like school openings. The positivity rate is defined as the percentage of COVID-19 tests performed that are positive in a given population. Many public health experts believe that our communities should aim for a positivity rate of 5 percent in order to consider resuming “normal” activity. The positivity rate gives us an idea of how well we are controlling the spread of the virus AND how many people are being tested.
  • Testing accuracy is also important to consider. COVID-19 testing results are not 100 percent accurate and there are many false negative test results—meaning you may get a negative result when you do, in fact, have COVID-19. False negative test results are especially common with antigen testing, though this testing option is increasingly being used by healthcare providers because of its results can be determined more quickly. To make matters even more complicated, the accuracy of COVID-19 test results is impacted by when in the course of a person’s illness or exposure the test is performed—for example, PCR tests appear to be most accurate 5-7 days after exposure.
  • Symptoms may help guide your doctor’s recommendations more than test results due to questions of testing accuracy. For example, when flu season arrives each year and patients show key symptoms of influenza, medical providers are likely to treat the illness as the flu, regardless of the results of the flu test—the same is true with COVID-19.
  • Testing capacity is something healthcare professionals continue to focus on as well. At any given time, our communities have different capacity to conduct an appropriate number of diagnostic and public health screening tests to properly manage the pandemic. In an ideal scenario, testing would be available for all members of a community on a regular basis, offering the ability to identify those who should isolate from others to prevent transmission of the virus. In the absence of an ideal testing scenario, the importance of social distancing and wearing masks cannot be over-emphasized.

What are the different types of COVID-19 tests?

Here is a breakdown of the three main categories of current COVID-19 tests. Again, Blue KC recommends you contact your primary care physician or healthcare provider if you are experiencing COVID-19 like symptoms or to discuss testing options.

  • PCR (Polymerase Chain Reaction) testing, a form of diagnostic testing, is designed to capture the DNA of the virus and amplify it so that it can be identified. Due to its high level of accuracy and low level of false negative results, PCR testing is the most effective way to determine if a person has COVID-19. Unfortunately, turnaround times for PCR testing results have been slow in some areas, making it very difficult to use in making medical decisions. Blue KC is hopeful that these turnaround times will improve in our service area.
  • Antigen tests, another form of diagnostic testing, aim to identify small proteins that sit on the outer layer of the virus. Antigen tests produce rapid results but suffer from accuracy problems and a high rate of false negative results—meaning a significant number of test results will come back as negative when, in fact, an individual is infected with COVID-19. Scientists are working to improve the accuracy of antigen tests.
  • Antibody testing for COVID-19 looks for the presence of antibodies, which are specific proteins the immune system manufactures in response to infections like COVID-19 and can tell you if you had a previous infection. Antibody test results are affected by many things, including the health of a person’s immune system. For these reasons, most experts believe we cannot rely on antibody testing in day-to-day medical practice. We do not know if the antibodies that result from a COVID-19 infection will provide someone with protection (immunity) from getting infected again. If antibodies do provide immunity, we don’t know how what antibody level is needed to provide protection or how long that protection may last. CDC scientists are currently conducting studies to answer these questions in this rapidly evolving set of circumstances. Early in the pandemic, some healthcare providers were using antibody tests in an attempt to learn as much as possible about the virus and its behavior. Some providers may still have medical reasons to order antibody testing, but this practice is becoming more infrequent.

How long does it take to get COVID test results?

This depends on the type of test:

  • PCR (Polymerase Chain Reaction) testing (a form of diagnostic testing that captures the DNA of the virus): Typically same day results at some locations or it could take up to week. Results might take longer than a week in some locations with many tests.
  • Antigen tests (another form of diagnostic testing): Typically gives you very fast results (15-30 minutes), depending on the test.
  • Antibody testing (also known as serological test, serology, blood test, serology test): provides same day results at many locations or it could take 1-3 days.

Can you test positive for COVID-19 without symptoms?

Yes, studies show that at least 40-50 percent of people who test positive have no symptoms. This is why medical experts say wearing masks and following other preventive behaviors, such as maintaining at least six feet of distance from others, is important for everyone, regardless of symptoms.

What should I do about an unexpected charge I received after getting a COVID-19 test?

If you received an unexpected bill for COVID-19 testing (for instance, you were charged for an office visit for the testing), please call the Customer Service number on your Blue KC member ID card and we can help.

How much does a COVID-19 test cost?

You have a variety of in-network options if you’re interested in receiving a COVID-19 test. The following locations work with your plan, meaning you won’t have to pay out of pocket to receive a test (please note that testing sites not included below may require you to pay higher out of pocket fees and submit a claim for reimbursement):

How can I learn more about COVID-19 variants?

Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. New variants of the virus that causes COVID-19 are being confirmed around the country, and the first cases of the B.1.1.17 COVID-19 variant, which was originally identified in the United Kingdom, have been confirmed in Kansas and Missouri. Information about the characteristics of these variants is rapidly emerging. Scientists are working to learn more about how easily they spread, whether they could cause more severe illness, and whether currently authorized vaccines will protect people against them. To learn more about these new COVID-19 variants, please consult the CDC website for the most up-to-date information.