This page may have documents that cant be read by screen reader software. To find an in-network pharmacy, click here or download the fepblue app. Please mail completed form with copy of purchase receipt(s) to: Blue Shield of California P.O. People may also access free or affordably priced testing in the community. If you have any questions about your reimbursement claim submission, call . 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. endstream
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See below.). Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. this.check=function(){var a=this.get(f);if(a)a=a.split(":");else if(100!=e)"v"==h&&(e=Math.random()>=e/100?0:100),a=[h,e,0],this.set(f,a.join(":"));else return!0;var c=a[1];if(100==c)return!0;switch(a[0]){case "v":return!1;case "r":return c=a[2]%Math.floor(100/c),a[2]++,this.set(f,a.join(":")),!c}return!0}; The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month. Medicare Advantage COVID-19 Testing Member Reimbursement Form Important Legal and Privacy Information|Important Information About Medicare Plans|Privacy Practices Ask your doctor to refer you to an in-network testing site. endstream
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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. . Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. This policy will remain in effect for the duration of the Federal Public Health Emergency. The site may also contain non-Medicare related information. If you dont have a primary care doctor, we can help you find one. PDF COVID-19 Testing Member Reimbursement Form Non-Medicare Advantage - BCBSM If this happens, you can pay for the test and then submit a claim for reimbursement. The aforementioned legal entities (excepting First Care, Inc. of Maryland), CareFirst BlueChoice, Inc., and The Dental Network, Inc., are independent licensees of the Blue Cross and Blue Shield Association. %%EOF
Postal Service. If your employer has asked you to submit receipts to your pharmacy benefit plan, please dont submit them here. We ask everyone to respect and protect community health as the supply chain and our health and retail partners catch up with demand. 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. Please enter the NDC or UPC number from the cash register receipt or test package. **The UPC (Universal Product Code) is the barcode and 12-digit-number that typically runs below it. Each test within a package is counted individually. endstream
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When filing claims online, you must use a separate claim form for each receipt and for each member. And if you use a pharmacy in Prime's network and check out at the pharmacy counter, you shouldn't have to pay upfront or submit a claim . 2023 Blue Cross Blue Shield Association. Member Discounts Take advantage of member-only discounts on health-related products and services. // ]]>. Even if you have medical, vision, dental or prescription drug coverage through Blue Cross Blue Shield of Michigan or Blue Care Network, there may be occasions when you have to pay for services yourself. [CDATA[ (For example, you can buy 4 boxes that include 2 over-the-counter COVID-19 tests.). Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. if (evt.target.id === 'QSIFeedbackButton-btn' || (evt.target.matches && evt.target.matches('#QSIFeedbackButton-btn *')) ) { CE2.set(1, 'feedback'); } }); } If you purchase at-home tests without an order from your healthcare provider, you can be reimbursed for up to eight individual tests per member, per month. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. If you have employer coverage, or an individual or family plan, you can get FDA-authorized, over-the-counter COVID-19 tests for diagnosing COVID-19 through your BCBSTX/Prime Therapeutics. Using facts from the CDC, we hope to answer your questions and arm you with the knowledge you and your children deserve so you can feel confident in your decision. To be eligible for reimbursement, the purchased over-the-counter at-home COVID-19 tests: must be purchased on or after January 15, 2022 must be for personal diagnostic use used to identify the potential COVID-19 infection not be used for employment purposes not used for surveillance testing Then, complete and submit the online form. We are committed to making sure members get the care they need when they need it. As the COVID-19 pandemic continues, testing is an important way to limit the spread of the disease. For more information about coverage of over-the-counter tests, view our frequently asked questions. You are leaving this website/app ("site"). Log in to blueshieldca.com (Engagement Point users at, Enter that information as indicated. That means members will pay nothing out-of-pocket to take care of their COVID-19-related health needs. Blue Shield of California PO Box 272540 Chico, CA 95927-2540 COVID-19 laboratory tests (PCR tests) If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. If you use a pharmacy in Primes network, you should not have to submit a separate claim when you buy the tests at the pharmacy counter. endstream
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If you have health coverage through a large employer, we recommend you contact your Benefits or HR Administrator to determine if your over-the-counter COVID-19 testing claim should be submitted to CareFirst as a medical claim or to your employers Pharmacy Benefit Manager as a pharmacy claim. 454 0 obj
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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. Please call OptumRx customer service toll-free at (855) 828-9834 (TTY:711) or see the COVID-19 test kit FAQ under "Which tests are covered" for the most up to date list of covered tests. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Looking for COVID-19 coverage and benefit information? 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. In this case, you should fill out three claim forms one for each member. With a BCBSTX health plan, you have access to care for COVID-19 related health issues. They are typically easy to use and produce rapid results. Most PDF readers are a free download. F2g5 :s+Jc
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If you have any questions, call the phone number on the back of your subscriber ID card, also known as enrollee ID, or contact us and we'll help. -60kWX6Ejr,@)wQGte^>2WUViq zn=`8REgLh`EsF53&5oc027R9 New User? 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. Y0118_22_062A_C 02082022 The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. All Rights Reserved. One option is Adobe Reader which has a built-in screen reader. If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. CVS Caremark is part of the CVS Health family of companies. If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. 1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue . Additional details about at-home COVID-19 testing can be found on the Blue Cross Blue Shield website. endstream
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California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Some labs may not provide testing without a doctors order. Your plan covers up to 8 tests every 30 days per covered person. These may include your doctors office, a pharmacy or health clinic, or an urgent care center. For example, a physician, a nurse practitioner, or a physician assistant. If you were on a cruise, you'll use the same claim form for reimbursement of medical expenses. endstream
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Health plans are offered by Blue Shield of California. If you paid for a COVID-19 test and think you might qualify for reimbursement, read the COVID-19 Testing Member Reimbursement Form (PDF) to find out more. Blue Shield and Blue Shield Promise cover these types of tests: 1Tests ordered by a healthcare provider means that a licensed and authorized healthcare provider has requested that you obtain a test for COVID-19. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. To be eligible for reimbursement, the purchased over-the-counter at-home COVID-19 tests: Members must complete a claim form to be reimbursed for over-the-counter COVID-19 testing. Mail-in claim forms allow you to submit a claim for multiple members with one form. Coronavirus (COVID-19) Updates | bcbsm.com How Your Benefits Work COVID-19 vaccination coverage after the Public Health Emergency Coverage for COVID-19 testing COVID-19 treatment If you have Medicaid, you can go to https://mss.empireblue.com/ny/home.html for information about your plan. You can also find an in-network doctor by. Under federal guidelines, the plan covers only specific tests. 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.
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