Your coverage for COVID-19

Does my plan cover COVID-19 screening and testing?

During the federal public health emergency, Blue Shield will continue to 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).
• 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 treatments received.

If you have Medicare, Medi-Cal or Cal-MediConnect plans, visit our Medicare coverage and Medi-Cal coverage pages to learn more.

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 have virtual visits available. Virtual visits are covered. Standard office visit copays may apply based on your plan benefits.

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

Not all plans have access to these services.* Login to find out what options are available to you.

* Please refer to your Evidence of Coverage or plan documents for information about standard out-of-pocket costs for your plan. You can also log in to your online account to learn what benefits your plan covers or call the customer service number at the number on your ID card.
 

What if I seek care from an out-of-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. This helps 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 treatment benefits during this time.

However, please note that out-of-network providers may charge more than the covered benefit amount. In that case, you may be responsible for paying the difference.

For HMO plans that do not have an out-of-network benefit, there is no coverage for non-emergency COVID-19 treatment received from out-of-network providers.

Be sure to seek non-emergency care from in-network providers if you have an HMO plan.

How can I continue seeing my mental health care provider?

If you are currently seeing a mental healthcare provider, you can continue to see that provider virtually. For example, over the phone or by video. Your standard coverage and out-of-pocket costs apply.

If you would like to find a new 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.

Blue Shield Coverage for COVID-19 Testing

Find out when Blue Shield covers COVID-19 tests and whether or not you'll have a copay.

Last updated: 8/16/2022

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