11/9/2023
California
While the federal COVID-19 public health emergency (PHE) officially ended on May 11, 2023, fully-insured members can expect the following changes after November 11, 2023 (six months after the official end of the PHE):
• Out-of-network cost-share waivers are no longer required, and cost-share may apply. There are, however, no changes to in-network coverage, and member cost-share for services received in-network will be waived.
• For those without out-of-network coverage, Blue Shield made a decision to continue to waive cost-shares.
• While members can continue to request reimbursement for up to 8 test kits per month, reimbursement will be limited to $12 per test.
The member COVID-19 End PHE landing page is currently undergoing updates to reflect the changes in coverage. Brokers and employers can direct members to this page for the latest information on coverage.
• Out-of-network cost-share waivers are no longer required, and cost-share may apply. There are, however, no changes to in-network coverage, and member cost-share for services received in-network will be waived.
• For those without out-of-network coverage, Blue Shield made a decision to continue to waive cost-shares.
• While members can continue to request reimbursement for up to 8 test kits per month, reimbursement will be limited to $12 per test.
The member COVID-19 End PHE landing page is currently undergoing updates to reflect the changes in coverage. Brokers and employers can direct members to this page for the latest information on coverage.
Source: Blue Shield of California