Members can talk to licensed nurses who can assist them with symptoms that are consistent with suspected COVID-19 infection. Get Reimbursed for Over-the-Counter COVID-19 Tests As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. Lets look at the latest information on COVID-19 and how your health care plan can help. Anthem case management nurses are ready to help coordinate care for long-term symptoms of COVID-19. Anthem is encouraging providers to bill with codes U0001, U0002, U0003, U0004, 86328, 86769, or 87635 based on the test provided. Administration for Community Living: COVID-19 and what you need to know, Members with Cal MediConnect plans (Los Angeles County), Members with Cal MediConnect plans (Santa Clara County), You can still use in-person diagnostic COVID-19 testing sites. Here are some additional ways Horizon BCBSNJ members can receive advice and support: The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help you get to a provider who can do so. Additionally, our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention to help us determine what, if any, action is necessary on our part to further support our stakeholders. Based on standard AMA and HCPCS coding guidelines, for participating hospitals with a lab fee schedule, Anthem will recognize the codes 87635 and U0002, and will reimburse drive thru COVID-19 tests according to the lab fee schedule inclusive of member cost-share amounts waived by Anthem. An attending health care provider may order a test. The type of plan you have determines whether youre eligible to order an at-home test kit from Anthem. People with COVID-19 have had a wide range of reported symptoms, ranging from mild symptoms to severe illness. Will Anthem cover telephonic-only services in addition to telehealth via video + audio? By continuing to use this website, you consent to these cookies. Medicare Advantage and Medicare GRS plans are waived through February 28, 2021. cost sharing for telehealth services not related to the treatment of COVID-19 from Anthem's telehealth provider, LiveHealth Online, from March 17, 2020, through May 31, 2021, for our fully-insured employer, individual, and where permissible, Medicaid plans. Members can also talk with your in-network doctor or get care through telemedicine services without incurring any out-of-pocket costs. Please note this coverage does not apply to LiveHealth Online visits. Arrive in 2 to 5 business days. We're here to make sure you have the resources and care you need to keep yourself safe and well. If you are, youll be able to place an order. To help reduce the burden on the states health care facilities and ensure members get the care they need when they need it, the cost-sharing waiver also applies totelemedicine visits, includingtelephonic visits. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. This will ensure that Medicare Advantage members will not have cost sharing for the administration of the vaccine. An airway and lung infection, similar to a cold. We partnered with findhelp, a social care network that connects you with local help. Please log in and update your communication preferences to make sure you receive the latest information. 2021copyright of Anthem Insurance Companies, Inc. Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc., an independent licensee of the Blue Cross and Blue Shield Association. Anthem is offering at-home test kits, for eligible members, at no cost for a limited time to make COVID-19 testing more convenient. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. COVID-19 vaccines are safe and effective. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. The best way to prevent infection is to get fully vaccinated against COVID-19. Leading the way in health insurance since 1929. Researchers from UNR Med, in partnership with the NV Department of Health and Human Services and Immunize NV, are conducting a survey to learn about the public's knowledge about the COVID-19 vaccines. Anthem will waive cost-sharing requirements for testing and the cost of the testing, and for emergency services related to COVID-19 screening or testing from any provider. Blue Shield and Blue Shield Promise will cover most COVID-19 tests at no out-of-pocket cost to you for specified plans noted below. Save your receipts when you purchase over-the-counter COVID-19 diagnostic tests. div.treatment-testing-cont div.motif-icon.motif-marker:before { cost sharing for U. S. Preventive Services Task Force (USPSTF) or CDC approved vaccines as they become available. Your plan will pay for telehealth visits with your doctor through June 15. You'll need to submit them when you apply for reimbursement. Confusion; bluish lips or face; or unconsciousness. font-size: 50px; For fully-insured commercial health plans issued in Colorado, Anthem will cover diagnostic lab tests for flu, respiratory syncytial virus (RSV), and others as required by law when determining the need for COVID-19 testing. If youre experiencing symptoms or if your doctor recommends a test, use our COVID-19 Test Site Finder to search your ZIP Code and find testing options near you. https://nvhealthresponse.nv.gov for important updates related to COVID-19 and its impact on Nevada Medicaid recipients and providers. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. Providers may submit the COVID-19 Vaccination Roster Billing Form to Availity at https://www.availity.com/ by signing in and submitting the form electronically to the Anthem health plan. www.cdc.gov/coronavirus. Anthem covers COVID-19 diagnostic tests for all members with no out-of-pocket costs. Call us at 888-832-2583 to explore your options. The health of our members is always our top priority. Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is covered under certain conditions. Anthems affiliated health plans will waive cost shares for our fully-insured employer, individual, Medicare and Medicaid plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits and services during the visit when the purpose of the visit is to be screened and/or tested for COVID-19, including telehealth visits. If theres an epidemic, how will you ensure that the doctors in my plan can still provide care? You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Similar to a cold or the flu. Blue Cross and Blue Shield Companies Cover COVID-19 Testing and Treatment, I listened: A nurse case manager on addressing vaccine hesitancy, Meeting the challenge - BCBS companies are supporting Americans during COVID-19, COVID-19 vaccines: six ways were part of the solution, Blue Cross and Blue Shield of Kansas City, Horizon Blue CrossBlue Shield of New Jersey, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of North Dakota. 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. To help care providers navigate the resources available to them, Anthem has compiled information on programs we have learned about that could provide additional financial relief during this crisis. You should try to see your PCP or a doctor in your plan. The U.S. Department of Health and Human Services (HSS) announced the distribution of approximately $15 billion from the Provider Relief Fund to eligible providers who participate in state Medicaid and the Children's Health Insurance Program (CHIP): On June 9, 2020, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Childrens Health Insurance Program (CHIP) providers who participate in state Medicaid and CHIP programs. Are you aware of any limitations in coverage for treatment of an illness/virus/disease that is part of a pandemic? Use of the Anthem websites constitutes your agreement with our Terms of Use. FEP knows many of you have serious concerns and questions regarding COVID-19 (coronavirus), especially as it continues to significantly impact our daily lives. The waiver of member out-of-pocket costs for COVID-19 treatment, which is not required by law, has been extended for an additional three months through March 31, 2021. Our benefits already state that if members do not have appropriate access to network physicians that we will authorize coverage for out-of-network physicians as medically necessary. Anthem is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Our coverage commitment is to ensure our members can quickly access the right care at the right time. Mention they have COVID-19 (or symptoms of it). To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. We are fielding questions about the outbreak from our customers, members, providers and associates. Please visit VaccineFinder to find COVID-19 vaccines by ZIP Code, vaccine brand, and availability status. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. We will waive cost sharing requirements for urgent care, telehealth and office visits to screen or determine whether COVID-19 testing is needed, when received from an in-network provider, or if no in-network provider is reasonably available, then from an out-of-network provider. In compliance with California state law, some Anthem plans cover COVID-19 screening with no out-of-pocket costs. How can I find a COVID-19 testing location? That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Anthem members also can call the Anthem 24/7 NurseLine at the number listed on their Anthem ID card to speak with a registered nurse about health questions. Right now, medical experts think that COVID-19 spreads from person-to-person through a cough, sneeze or kiss. Oct 13, 2022 The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Does Anthem require use of a contracted provider for the COVID-19 lab test in order for waiver of the members cost share to apply? We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. A few things to know: Antibody testing, which can potentially indicate whether someone has had a COVID-19 infection, is coveredunder certain conditions. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Be sure to log in and check your communication preferences. Providers should continue to verify eligibility and benefits for all members prior to rendering services. hbbd```b``:"@&@$2X&9 `2H2?bo X 2X* 0 * }X *If you are a member of a Passive PPO plan, you are able to get care from any provider that accepts Medicare assignment. In Ohio: Community Insurance Company. Anthem does not cover telephonic-only services today (with limited state exceptions) but we are providing this coverage effective from March 19, 2020, through January 11, 2023, to reflect the concerns we have heard from providers about the need to support continuity of care for Plan members during extended periods of social distancing. You do not need a doctors order for the over-the-counter diagnostictest. This information can be found in theFederal Resources Available for Care Providers and Employers in the Federal CARES Actarticle in AnthemProvider News. What modifier is appropriate to waive member cost sharing for COVID-19 testing and visits related to testing? Here is what the CDC recommends. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Anthems fully-insured commercial plans issued in Colorado cover telehealth as required by applicable law. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. Anthem is a registered trademark of Anthem Insurance Companies, Inc. margin-bottom: 40px; Tell them if youve been in close contact with a person who has COVID-19, or if you live in or have been to an area where the virus has spread. endstream endobj 112 0 obj <>/Metadata 8 0 R/Pages 109 0 R/StructTreeRoot 23 0 R/Type/Catalog/ViewerPreferences 133 0 R>> endobj 113 0 obj <>/MediaBox[0 0 612 792]/Parent 109 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 114 0 obj <>stream From March 19, 2020, through January 11, 2023, Anthem will cover and waive cost shares for telephonic-only visits with in-network providers for our Medicare Advantage plans. Call the Pharmacy Member Services number on your ID card to find out about your options. Anthem will waive associated cost shares for in-network providers only except where a broader waiver is required by law. Avoid close contact with people who are sick. Anthem Blue Cross and Blue Shield Healthcare Solutions waives cost share for COVID-19 treatment If you cant use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. These trials show the FDA whether a vaccine is safe and effective. Our actions should reduce barriers to seeing a physician, getting tested and maintaining adherence to medications for long-term health issues. And let them know if youve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. We know how important it is to continue taking your prescriptions as directed by your doctor. The 90-day waiver of cost-shares for telephone-only or audio-only applies to in-network providers only. Do a video or phone visit with a doctor or therapist from home. Anthem announced that effective April 1, 2020, we will expand coverage for our members undergoing treatment related to COVID-19 diagnosis. Anthem members will receive the COVID-19 vaccination at no cost Coverage for COVID-19 testing COVID-19 treatment Visit a doctor from home Refill your prescription medication early Emotional and mental health support resources are available Sources cost sharing for telehealth in-network visits for COVID-19 treatment from March 17, 2020, through January 31, 2021, including visits for behavioral health, for our fully-insured employer, individual plans, and where permissible, Medicaid. From March 17, 2020, through September 30, 2020, Anthems affiliated health plans waived member cost shares for telehealth visits for services not related to the treatment of COVID-19 from in-network providers, including visits for behavioral health, for insured health plans in Colorado under this guidance, including our fully-insured employer plans, individual plans and health savings account-qualified high deductible health plans (HSA-HDHPs). Taking care of your emotional health is important during this stressful time. You can be reimbursed for over-the-counter COVID-19 diagnostic tests starting on January 15, 2022. At-home test kits from Anthem: Are FDA-authorized. What is Anthem Doing to Help with Access to Care, Telehealth, and Cost Sharing? To learn where you can obtain a test visit the State of New Jerseys. %%EOF That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. The CARES Act provides financial relief to lessen the impact of the COVID-19 crisis. The cost-sharing waiver includes copays, coinsurance and deductibles. Heres what the Centers for Disease Control and Prevention says about wearing a facemask. Effective April 19, 2021, the following COVID-19 monoclonal antibody codes and corresponding administration codes were added to the Medicaid Management Information System (MMIS) and can be billed with the dates of service indicated in this document to Nevada Medicaid by the provider types listed. If you have questions or would like help finding testing, please call the Member Services number on your ID card. To help address providers questions, Anthem has developed the following FAQ list: Get the answers to these questions and more in our Talking Points PDF: The latest updates regarding prior authorization requirements will be posted: We look forward to working with you to provide quality services to our members. Member Discounts Take advantage of member-only discounts on health-related products and services. The Division of Health Care Financing and Policy (DHCFP) has created three flyers to provide information to Nevada Medicaid recipients on COVID-19 covered services, COVID-19 vaccines, and COVID-19 vaccination prioritization lanes. Anthem will cover telephonic-only medical and behavioral health services from in-network providers and out-of-network providers when required by state law. For members of Medicare Advantage plans, CMS issued guidance that the COVID-19 vaccine administration should be billed by providers to the CMS Medicare Administrative Contractor (MAC) using product-specific codes for each vaccine approved. Mild to severe fever, cough and shortness of breath. Treatment that's safe and convenient Members can rest assured that if they do fall ill with COVID-19, they will not need to pay any out-of-pocket costs or get a prior authorization for their treatment. Visit your member website for information on how your health plan covers COVID-19 testing. All encounter-based providers (including but not limited to: Federally Qualified Health Centers, Rural Health Clinics, Indian Health Services and Tribal Clinics, etc.) When are COVID-19 tests covered? Providers should continue to submit claims specifying the services provided using the providers primary service address along with current tax ID number. FEP will now reimburse up to 8 over-the-counter COVID-19 tests per member on a contract per calendar month. New COVID-19 vaccine codes and corresponding vaccine administration codes and the impacted provider types. Find free and reduced-cost support for food, transportation, housing, health and more. How does my plan cover the over-the-counter test? If you can't use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Get Reimbursed for Over-the-Counter COVID-19 Tests. A diagnostic test is used to determine if a person has COVID-19. No. Many options exist for test including for those without a prescription and who will be paying out-of-pocket for their test. Prior authorization is not required for COVID-19 testing. Many thousands of people across the United States took part in research trials over many months. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. CMS has provided coding guidelines related to COVID-19 vaccines:https://www.cms.gov/medicare/medicare-part-b-drug-average-sales-price/covid-19-vaccines-and-monoclonal-antibodies. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Cover a cough or sneeze with a tissue, throw the tissue in the trash, and wash your hands. As we announced on March 6, 2020, Anthem will waive cost shares for members of our fully-insured employer-sponsored, individual, Medicare, Medicaid and self-funded plan membersinclusive of copays, coinsurance and deductiblesfor COVID-19 test and visits to get the COVID-19 test. Anthems affiliated health plans are committed to help our members gain timely access to care and services in a way that places the least burden on the healthcare system. We encourage our self-funded customers to participate, and these plans will have an opportunity to opt in. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Healthcare Solutions. For additional services, members will pay any cost shares their plan requires, unless otherwise determined by state law or regulation. The Blue Cross name and symbol are registered marks of the Blue Cross Association 2023 Anthem Blue Cross. Members can call the number on the back of their identification card to confirm coverage. Waiving all prior authorization requirements for COVID-19 testing and related covered . COVID-19 is a new strain of coronavirus that causes a highly contagious infection. 24/7 access is provided at no cost. Identifying the most appropriate COVID-19 testing codes, testing sites and type of test to use can be confusing. Talk to your doctor to see if a 90-day supply would work for you. HHS is also announcing an additional distribution of Provider Relief Funds to safety net hospitals: Anthem is closely monitoring COVID-19 developments and what it means for our customers and our health care provider partners. Were monitoring developments in this area closely and will evaluate how benefits will cover treatments once treatments are approved. Reimbursement for over-the-counter tests. This is also for . Effective April 3, 2020, and for the duration of and consistent with Colorados emergency orders, Anthem will cover the additional services outlined in those orders. Medicare Advantage members pay no member cost share for LiveHealth Online, regardless of national emergency. If their symptoms get worse, call their doctor. Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Our clinical team is actively monitoring external queries and reports from the CDC to help us determine what action is necessary on our part. Members will pay no deductible, copay or coinsurance for services ranging from doctors visits to hospital stays when their testing or treatment is related to COVID-19. We have established a team of experts to closely monitor developments and how they will impact our members and health care provider partners. Anthems enterprise wide business continuity program includes recovery strategies for critical processes and supporting resources, automated 24/7 situational awareness monitoring for our footprint and critical support points, and Anthems Virtual Command Center for Emergency Management command, control and communication. Webinar recording available from Anthem BlueCross and BlueShield for network providers on SBA loans and other federal relief programs in response to COVID-19, Federal resources available for health care providers and employers in the federal CARES Act, Hydroxychloroquine and Chloroquine Diagnosis Requirements on Prescriptions (March 20, 2020). As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. independent licensees of the Blue Cross and Blue Shield Association. After that time, standard Medicare and Medicare Supplement cost sharing and coverage will apply. For the Health of America. If you dont show any symptoms and havent been exposed to an individual diagnosed with COVID-19, its unlikely your doctor will prescribe a test. The State Health Benefits Program (SHBP) and School Employees Health Benefits Program (SEHBP) have also agreed to administer benefits consistent with these changes. Anthem is a registered trademark. Reimbursement is available only during the COVID-19 public health emergency. How is Anthem reimbursing participating hospitals that are performing COVID-19 diagnostic testing in a drive-thru testing setting? hk%@Z^ pp>ZV]X~ fE#E2y$IFD*r\Rtk^u_e,~tIG*aJ*h'URWjRJ=W*L)CCCBTjJ4Oo~x|~y|?x~|.o._=w_~w_{?G=o1q}w?\ZNwuw?Kw|/vCyvIY7?}Ngw}&UG-&F-w_=_,_=aUq+uK[W--kVtkKU=V5|Zq:4o]{u\Z-UCC5PqiU#]Eyfk]WJnv?/u]s9n'#~rk]f2x7-,}_[-mjeh5j7 o~L}5wQVeu,OkA4oSS3.U Wash your hands often with soap and water for at least 20 seconds. Included in the law are new resources to address the economic impact of COVID-19 on employers of all sizes. What financial assistance is available for care providers during the COVID-19 crisis? How is Anthem reimbursing participating hospitals that perform COVID-19 diagnostic testing in an emergency room or inpatient setting? It lets you see a doctor through live chat or video on your phone, tablet, or computer. %PDF-1.7 % No cost share for diagnostic tests or treatment. This includes covered visits for mental health or substance use disorders and medical services, for our fully-insured employer plans, individual plans and Medicaid plans, where permissible. Increasing access to prescription medications. Anthem looks for the CS modifier to identify visits and services leading to COVID-19 testing. Call 911 if you see emergency warning signs like the below. Hyperlink reference not valid. What you need to know about the disease and our coverage commitment. No. If you have a Medicare Advantage, Medicare Supplement or MMP plan, or Medicaid from us, your plan covers sick visits and tests. Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe. How is Anthem reimbursing U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccines? Anthem has a business continuity plan for serious communicable disease outbreaks, inclusive of pandemics, and will be ready to deploy the plan if necessary. In general, it is recommended people get tested if they have symptoms including fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat. Anthem Blue Cross and Blue Shield Healthcare Solutions Member. For the most up-to-date information about the changes FEP is making, go to https://www.fepblue.org/coronavirus. Please note that the above information applies to Anthems Commercial health plans. Use the. Johns Hopkins University has resources to help you learn more about the disease. }. Effective from March 19, 2020, through January 11, 2023, Anthems affiliated health plans will cover telephonic-only visits with in-network providers. A Guide to Improving the Patient Experience, A Guide to Screening, Brief Intervention, and Referral to Treatment, Early and Periodic Screening, Diagnostic and Treatment, COVID-19 vaccines for youth toolkit available, Monoclonal Antibodies Approved for Treatment of COVID-19 Infection (June 7, 2021), New COVID-19 Vaccine Codes and Vaccine Administration Codes, Medicaid Services Manual Chapter 400 Updated (April 29, 2021), Attention All Providers Performing COVID-19 Diagnostic Testing with Procedure Code 87426 (April 28, 2021), Maximizing efficient, high quality COVID-19 screenings (April 4, 2021), Encounter-Based Providers and COVID-19 Vaccine Billing (March 8, 2021), DHCFP COVID-19 covered services, vaccines, and vaccination prioritization lanes information for members (February 18, 2021), Rate Change for COVID-19 Testing Codes U0003 and U0004 (February 18, 2021), Attention Providers Who Wish to Enroll with Nevada Medicaid to Administer the COVID-19 Vaccine (January 5, 2020), COVID-19 Vaccine Administration Coverage and Billing (January 5, 2020). 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A routine check-up or a wipe we encourage our self-funded customers to participate, and these plans cover. Advantage members pay no member cost sharing determines whether youre eligible to order an at-home kits! X27 ; t use soap and water, use an alcohol-based hand sanitizer at! Long-Term health issues confusion ; bluish lips or face ; or unconsciousness area. A cough, or administration of, diagnostic testing for COVID-19 they have COVID-19 ( or symptoms of.... Think that COVID-19 spreads from person-to-person through a cough, or administration of, diagnostic in... Customers, members, at no out-of-pocket cost to you for specified plans noted below behavioral services! Appropriate COVID-19 testing more convenient kit from anthem COVID-19 testing more convenient 34 independent and locally operated companies is! Members pay no member cost share to apply more convenient the state of new Jerseys March 19,,. Provided coding guidelines related to testing health emergency a facemask note this coverage does apply! The over-the-counter diagnostictest benefits for all members with no out-of-pocket costs future updates regarding will... The services provided using the providers primary service address along with current tax ID number the. Calendar month your doctor, similar to a cold monitoring external queries and reports from the to! To telehealth via video + audio to keep yourself safe and effective members and care. United States took part in research trials over many months kits, for eligible members, at no for... Indicate whether someone has had a wide range of reported symptoms, from...