Mail-in claim forms allow you to submit a claim for multiple members with one form. (function(){var g=function(e,h,f,g){ 7 insurers (Anthem, Blue Cross Blue Shield of Michigan, Blue . Further questions To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. OTC tests, also known as self-tests, detect if you are currently infected with COVID-19. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. "We have tests, treatments, and vaccines that can . In Virginia, CareFirst BlueCross BlueShield, CareFirst MedPlus, and CareFirst Diversified Benefits are the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). For more information about Pharmacy Prior Approval and the required forms visit the Prior Approval page. Test kit cost $ Commercial Health Plans, Northeast Region. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. See the list of participating pharmacies and healthcare providers. // ]]>. 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. As of Jan. 15, 2022, people with private health insurance can get reimbursed by their insurer for the cost of up to eight at-home COVID tests per month. Once you receive a confirmation from CVS Pharmacy, your order will be waiting for you at the front store register. You will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022. O=>WNW% Once you reach the limit of eight tests per member per calendar month, we will not reimburse claims for additional tests. Submit a claim only when you are billed for services from a provider that does not directly submit a claim to the local Blue Cross Blue Shield plan. 2023 copyright Anthem Insurance Companies, Inc. Stay informed by checking these resources for up-to-date information about COVID-19, especially if youre thinking about traveling. The Blue Cross Blue Shield companies partner with state and federal agencies, as well as advocacy organizations, to report, investigate and reduce the incidence of healthcare fraud. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. By continuing to use this website, you consent to these cookies. You can be reimbursed (paid back) for both: Medi-Cal members: Do NOT use this page for test reimbursement. We use cookies on this website to give you the best experience and measure website usage. Waiving cost-sharing for COVID-19 testing and treatment. To pay no out-of-pocket costs, order your tests online through cvs.com or the CVS Pharmacy mobile app for store pickup1. As hospitals and emergency departments are overwhelmed, avoid going to the emergency room (ER) if you need to get tested. qO;,lH Thats why were providing you with information to help alleviate concerns about your children receiving a COVID-19 vaccine. Some people may be eligible for a second booster, including: Adults ages 50 years and older. Today, the Blue Cross Blue Shield Association (BCBSA) announced that independent and locally-operated BCBS companies across the country and the BCBS Federal Employee Program (FEP . Submit a separate form for each patient. In this case, you should fill out three claim forms one for each member. Complete this claim form for any pharmacy services received. For members of BCBSRI Medicare Advantage and Plan 65, For members of all other BCBSRI health plans. Diagnostic tests are performed if you are experiencing COVID-19 symptoms or have been recently exposed. To print and mail your claim, download theclaim form (PDF). endstream endobj 465 0 obj <>/ProcSet[/PDF]>>>>stream Please note: Your receipt must be dated January 15, 2022 or later to be eligible for reimbursement. You can only use your $0 coverage at pharmacies and healthcare providers participating with this specific program. Pumj(jlG_E>;j+/ Get started with your reimbursement request. Use this form to select an individual or entity to act on your behalf during the disputed claims process. Contact your local health department to learn about free COVID-19 testing locations or pickup sites. Log in to blueshieldca.com (Engagement Point users at engagementpoint.com) Choose "Claims" Select "File a claim" Please enter the NDC or UPC number from the cash register receipt. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, . For help with these documents, please call 1-800-975-6314. . If the test is less than $12, reimbursement will be the cost of the test. Overseas members should use the Overseas Medical Claim Form. Findings. Attach an original itemized bill from your provider (required information & example on the back) . Insurers must cover the cost of eight tests per insured individual. To find an in-network pharmacy, click here or download the fepblue app. Please note that this network may be different than your plans standard pharmacy network. If you purchase a test kit that includes two rapid tests, that will count as two of your eight covered tests. Read Full Story Communities Yes, home test kits can be purchased with your quarterly OTC allowance ($25-$275, available with most BCBSRI Medicare Advantage plans). Your commercial plan will reimburse you up to $12 per test. For members of BCBSRI Medicare Advantage and Plan 65 qGm1UCk3Ht}uh>.ky!R'@ E All Rights Reserved. If you are a Medicare Advantage, Medigap, Medicaid or Dual Eligible Special Needs Plan member, please call the number on the back of your member ID card for benefit information. People ages 12 years and older who are moderately or severely immunocompromised. Then, complete and submit the online form. Here are four ways you can get tests for you and your family: Visit covidtests.gov to get free tests delivered to your home by the U.S. 2Some pharmacies may not be able to process claims for OTC tests at the pharmacy counter. Important Please provide what is on your member card, failure to provide at least one of these fields can lead to failure in claim approval. Dylan Scott covers health care for Vox. this.set=function(a,c){var b="",b=new Date;b.setTime(b.getTime()+6048E5);b="; expires="+b.toGMTString();document.cookie=a+"="+c+b+"; path=/; "}; Fill Online, Printable, Fillable, Blank COVID-19 Testing Member Reimbursement Form Non-Medicare Advantage (Blue Cross Blue Shield of Michigan) Form Use Fill to complete blank online BLUE CROSS BLUE SHIELD OF MICHIGAN pdf forms for free. Members need to submit a separate claim form for each family member. endstream endobj 470 0 obj <>/Subtype/Form/Type/XObject>>stream Visit covidtests.gov, and click the blue "Order Free At-Home Tests" button. All Rights Reserved. Reimbursement requests take up to 4-6 weeks to process Questions? Should you wish to request to recruit a facility or physician into the GMMI network, please complete this nomination form. Tests detect COVID, but vaccination remains the best way to protect yourself from severe illness. By continuing to use this website, you consent to these cookies. // ]]>, // =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}; This policy will remain in effect for the duration of the Federal Public Health Emergency. The New to Market FDA-Approved Medication Review Exception Process allows a member to apply for coverage of an excluded drug at a tier 3 cost share if the member has met the requirements outlined. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. With each claim form, you should include the same receipt. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. But I called @BCBSTX as a consumer, and asked . What Impacts the Cost of Health Insurance? The Formulary Exception process allows members to apply for coverage of a non-covered drug if they have tried and failed the covered drug(s). Member Discounts Take advantage of member-only discounts on health-related products and services. Use this order form for specialty medications. Please enter the NDC or UPC number from the cash register receipt or test package. You may have to pay out of pocket at the time of purchase, but keep your receipt to submit a claim online. Pickup cannot happen via drive-thru and tests will not be shipped. Centers for Disease Control and Prevention website: Test for Current Infection (accessed January 2022): cdc.gov. Blue Shield of California has neither reviewed nor endorsed this information. COVID-19 At-Home Test Member Reimbursement Form Please use this form to request reimbursement for actual cost of FDA-approved COVID-19 at-home test(s). Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. [CDATA[ Mail your completed claim form with a copy of your receipt(s) to: Blue Shield of California For example, one box containing two tests counts as two tests. Use this form to order a mail order prescription. While all FDA-authorized COVID-19 rapid tests are covered, and will be reimbursed under the Emergency Rule, only certain tests are likely to process correctly through pharmacy claims systems at the moment. Our Commitment to You What's Covered Coverage will vary based on your plan. D@3[0V Mail claim form and all attachments to BCBSMA, P . People may also access free or affordably priced testing in the community. You do not need health insurance to receive your free tests. 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 BCBSIL/Prime Therapeutics pharmacy benefits. hbbd```b``)n`"EV`U`*8*I2&?tq&e@$E&">I0DjE0!c`) $L*H-`l)`l3Oz's&30t%S! [& Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. Group Hospitalization and Medical Services, Inc., and First Care, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. We generally process claims within 30 days from receiving your completed claim form and receipts. We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex, including sexual orientation, gender identity, or gender expression. The Formulary Exception process allows members to apply for coverage of a non-covered drug if they have tried and failed the covered drug (s). COVID-19 | Blue Cross and Blue Shield of Texas Standing by You Your health, safety and well-being are our top priorities. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Blue Cross Blue Shield of Massachusetts continues our commitment to our members and . To get reimbursed, pleasedownloadthis formand mail it to the address listed,along with a receipt. All rights reserved. The Contraceptive Exception Form allows members to apply for coverage, or formulary tier, exception for a contraceptive drug/product. Find and download forms often used by our members. To access your member services, please visit your BCBS company. COVID-19 | Blue Cross and Blue Shield of Illinois. After choosing BCBS Rhode Island as your health plan, select the Rhode Island Pharmacy Network (which is a national network) and enter your ZIP code. CareFirst of Maryland, Inc. CareFirst Community Partners, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Prime has an established electronic connection with most pharmacies, even those not in their network, and the claim should process successfully. Blue Cross recommends that members contact and work closely with their health care . Ted S. Warren/AP. Once completed you can sign your fillable form or send for signing. H0148_22_003_C_020822. a|VOXHXT:B4 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). W006259 COVID-19 Testing Member Reimbursement Form - Non-Medicare Advantage Please use this form to request reimbursement for COVID-19 tests you have paid for out of your own pocket. Log in to blueshieldca.com (Engagement Point users at, Enter that information as indicated. An attending health care provider may order a test. Read our Nondiscrimination and Language Assistance notice. // ]]>, // /Subtype/Form/Type/XObject>>stream Telehealth. A single Pfizer-BioNTech COVID-19 vaccine booster dose for children is recommended at least 5 months after the primary series is administered. Lets say you made a one-time purchase of up to 24 tests for three members. Here are helpful Service Benefit Plan brochures, claim forms, reference guides and videos. However, you must include all required information requested in the form. Mail-in claim forms allow you to submit a claim for multiple members with one form. Y0118_22_062A_C 02082022 endstream endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream Learn More. 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. No, you dont need an order or prescription unless you are buying more test kits than allowed under your $0 coverage or at a location that is not participating with your Medicare Part B benefit. If you paid out of pocket for a test that was sent to a laboratory, follow the steps below to file a reimbursement claim. . Your signature is also required in the COVID-19 home test kit claim section. You will be reimbursed via check, mailed to the address we have on file within 30 days of Blue Cross Blue Shield of Arizona (BCBSAZ) receiving your reimbursement information. He has reported on health . The protection of your privacy will be governed by the privacy policy of that site. In addition to your benefits, every home in the United States is eligible to orderfree COVID-19 home test kits through the federal government atcovidtests.gov. Then, complete and submit the online form. Complete the Member Request Form for ACA HIV Prevention Coverage. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. Purchase a COVID-19 at-home test kit and submit a claim through the paper-based OTC test claim form. Youll be reimbursed up to $12 per individual test. 2. If you do not have an itemized receipt, you must send us the barcode (UPC code) from your test(s) packaging.
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