Your Medicare coverage for COVID-19

Does my plan cover COVID-19 screening and testing?

Yes. During the public health emergency, Blue Shield of California will 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 (ER).
• COVID-19 testing that’s ordered by a healthcare provider who is licensed to order these tests.

There are no prior approvals needed for COVID-19 screenings, evaluations, or testing.

What if I need treatment for COVID-19?

There are no prior approvals needed to receive COVID-19 treatment. 

Standard out-of-pocket costs will apply for any new treatments received. 

This applies to the following plan types:  

• Medicare Advantage plans 
• Medicare Supplement plans
   

To find out which plan you have, call the customer service number on your member ID card. 

To learn more about treatments and medications, visit the Centers for Disease Control and Prevention’s web page.

What virtual care options does my plan cover?

Contact your primary healthcare provider to find out if they offer virtual visits. Virtual visits are covered. Standard office visit copays may apply based on your plan benefits. 

Some plans may have access to Teladoc or NurseHelp 24/7SM as other options for virtual care. These services can help you learn if your symptoms may be related to COVID-19 or something else. However, they cannot order a COVID-19 test for you. 

Not all plans have access to these services. 

* Please refer to your Member Handbook/Evidence of Coverage or plan documents for information regarding access to these programs. You can also call Customer Care at the number on your ID card or log in to your online account to see what benefits your plan covers.

What if I seek care from a non-network provider for COVID-19? Will it be covered?

In the case of a medical emergency, care provided by in-network and out-of-network providers will be covered for all plans. 

Outside of an emergency situation, you should seek care from in-network providers to save money and make sure you don’t have to pay more out-of-pocket. 

If you have a plan with out-of-network covered benefits, Blue Shield will cover both in-network and out-of-network copays, coinsurance, and deductibles for COVID-19 covered benefits during this time. Medicare Supplement Plan members may see any provider accepting Medicare.

What if I need to refill my prescriptions?

If you are worried you might run out of prescribed medications, Blue Shield allows early refills on your prescriptions as long as there are refills available with your prescription. This is for all members with pharmacy benefits through Blue Shield. 

If you have questions about the medicine you take, call the Customer Care number on your member ID card.

To meet your needs and promote social distancing, many retail pharmacies are waiving fees for home delivery of prescriptions. Visit your pharmacy’s website or call your local pharmacy for more information. Also, if available, use the drive-thru window when picking up your prescriptions.

You can also fill a prescription for an extended day's supply of maintenance medications at retail pharmacies as well as our mail service pharmacy.

How can I continue seeing my mental healthcare provider?

If you are seeing a mental healthcare provider right now, you can keep seeing that provider virtually, such as over the phone or by video. Your standard coverage and out-of-pocket costs apply.

If you would like to find a mental healthcare provider in your network, learn how to find one.

Questions about medical or prescription coverage?

Call the number on your member ID card.

Last updated: 8/16/2022

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