COVID-19 Vaccines, Testing and Treatment

As mentioned in the Sept. 24 Employer Update, when the COVID-19 public health emergency (PHE) is lifted, the services required to be covered (with cost shares waived) by the CARES Act will return to the plan’s standard cost shares.

View the Update

The U.S. Food & Drug Administration (FDA) has approved three COVID-19 vaccines, from Pfizer-BioNTech, Moderna and Johnson & Johnson. Blue Cross and Blue Shield of Nebraska (BCBSNE) members are able to get the vaccine at no cost during the COVID-19 PHE.

Coverage for Testing

BCBSNE is continuing to waive member cost-sharing for medically appropriate in-network COVID-19 testing and related services through Jan. 15, 2022. This means members will pay nothing for medically appropriate in-network testing and related services in a telehealth session, doctor’s office, urgent care facility or emergency room.

Medically appropriate COVID-19 tests must be ordered by a doctor or health care provider for the purpose of diagnosing COVID-19. This includes COVID-19 drive-through test sites or home test kits purchased with an order from a doctor. Test kits that do not require a doctor’s order are considered over-the-counter and are not covered by your BCBSNE plan; these may be submitted for reimbursement under flex or health savings accounts (FSA or HSA).

Typically, the most appropriate test is the single component rapid or PCR antigen test, which tests only for COVID-19. Members should avoid having multiple or unnecessary tests, including large panel tests. Many conditions are tested for in large panel tests, only one of which is COVID-19. These may not be covered under your health plan and your employees could be responsible for the entire fee (approximately $1,000).

This waiver of cost shares applies to all fully insured groups and individual health plan members, along with those who receive their insurance through our Medicare Supplement and Medicare Advantage plans. If your group is enrolled in a self-funded group health plan, your employees should check with you about their benefits.

Starting Nov. 1, 2020, COVID-19 testing for public surveillance or employment is not covered. This includes testing for work, school, travel and other public surveillance reasons, unless required by law.

Coverage for Treatment 
  • Fully insured and BlueFlex products
    • Starting Jan. 1, 2021, BCBSNE will apply member cost shares for treatment of COVID-19.  
  • Self-funded (traditional ASO and ASO Block)
    • Groups that previously waived member cost shares for treatment of COVID-19 had the opportunity to extend their cost share waiver past Dec. 31, 2020. If your group did not indicate by Nov. 30, 2020, that it would like to continue to waive cost shares for COVID-19 treatment, cost shares for COVID-19 treatment went into effect on Jan. 1, 2021.
Additional Resources 

Two fliers are available to help you share COVID-19 testing and treatment benefits with your employees:

  • Download and distribute this copy to supply employees with information on receiving medically appropriate COVID-19 tests.
  • Use this copy to share the importance of using in-network providers for vaccinations and testing. Note: self-funded groups that are waiving cost shares for vaccinations, testing and treatment should email a member of their BCBSNE account team for another version of the flier.

Follow our vaccines updates on our Newsroom.

If you have any questions, contact a member of your BCBSNE account management team.