Effective Saturday, Jan. 15, 2022, if any of our eligible members buy over-the-counter test kits, they will get reimbursed based on the federal guidance. Please read this information about how this works with your Blue Cross or HMO Louisiana plan.
Rules for over-the-counter COVID-19 test reimbursement:
Best steps to get COVID-19 over-the-counter tests reimbursed:
In Louisiana and nationally, there have been reports of scammers selling fake COVID-19 test kits and claiming you can be reimbursed later if you pay them now. If you buy COVID-19 test kits, it’s best to buy them from a pharmacy or other health supplies store. Make sure the test has a U.S. Food & Drug Administration (FDA) emergency use authorization so you know it’s a real test. And, be wary of anyone who approaches you, cold calls or reaches out by email or text offering to sell you COVID-19 test kits. If you think you’ve been the victim of a scam, report it:
Blue Cross Fraud Help Line: 1-800-392-9249
Federal Fraud Reporting: 1-800-CALL-FBI or Report Fraud.FTC.Gov
To ask questions, please call the Pharmacy number on your Blue Cross or HMO Louisiana ID card. If you do not have a Pharmacy number on the back of your card, please check with your employer or the company who handles your pharmacy benefits.
COVID-19 vaccines are available to Louisianians ages 5 and up. Get vaccinated as soon as you can to take your best shot at ending the pandemic and help build more immunity in our community.
Visit the Louisiana Department of Health website to see a current list of vaccine locations. Nonprofits and local organizations around the state are offering free rides to and from vaccine sites. If transportation is a challenge for you, call the statewide 211 network to ask about programs near you.
Things to Know About Getting Your COVID-19 Vaccine or Booster:
Get the vaccine that’s available to you soonest. There are three types of COVID-19 vaccines being given in Louisiana. The Pfizer vaccine is available to people ages 5 and older, and the Moderna and Johnson & Johnson vaccines are available to people ages 18 and older. All three vaccines were reviewed under the same thorough, scientific process before the U.S. Food and Drug Administration (FDA) authorized them to be given to patients. And, all three were found safe and effective at preventing deaths and severe outcomes from COVID-19. The main difference is the dose amount – Pfizer and Moderna vaccines require two shots to get maximum protection, and the Johnson & Johnson vaccine is a single shot. Unless your healthcare provider has advised you to get a specific vaccine type because of age, allergies or other concerns, get whichever shot you can. The FDA has given full approval to the Pfizer vaccine. The Moderna and Johnson & Johnson vaccine are available under emergency use authorization. Those vaccine makers are also applying for full FDA approval.
Health officials recommend boosters for everyone 12 and older. Boosters enhance the protection from your original COVID-19 vaccine so your immune system stays prepared to recognize and fight off COVID-19. How soon you need a booster shot depends on which type of COVID-19 vaccine you got. If you got the one-dose Johnson & Johnson vaccine, you can get a booster if it’s been two months or longer since your vaccine. If you got the two-dose Pfizer or Moderna vaccine, you can get a booster if it’s been six months or longer since your second shot. If you are 18 or older, you can choose which type of vaccine you get for your booster – you can stick with the same type as your original vaccine or choose a different type. Ask your healthcare provider if you’re not sure which type of booster you should get. People ages 12-17 will need to get the Pfizer vaccine booster because it is the only one available to those younger than 18.
You will not pay anything out of pocket for the vaccine or booster. Patients on individual and employer health insurance plans, Medicare and Medicaid can get any FDA-approved COVID-19 vaccine or booster for $0. This no-cost coverage is included in the Coronavirus Aid, Relief and Economic Security (CARES) Act, which also allows uninsured patients to get the vaccine or booster for $0. Blue Cross will cover the vaccine’s administration without any member cost-share (deductible, copay or coinsurance) on most health plans. If you have questions about vaccine coverage on your health plan, contact Customer Service at the number on your member ID card.
It’s important to get information about COVID-19 and the vaccine from trustworthy sources. Do not just go by what you hear others talking about or see posted online. Some sources you can visit are:
Slow the Spread
It is very important that Louisianians 5 and older get the COVID-19 vaccine as soon as they can, especially if you have family members younger than 5 or who cannot get the vaccine for other reasons. If you have concerns or questions about the vaccine, ask your healthcare provider for guidance. Even if you’ve had COVID-19, you should still get the vaccine. Medical experts advise that the vaccine provides longer and more effective protection than any natural immunity those who have had COVID-19 build up.
It’s also important that everyone, vaccinated or not, takes steps to prevent spreading COVID-19.
In addition to getting the vaccine as soon as you can and wearing a face mask in public, take these steps to prevent getting or spreading COVID-19:
We now consider COVID-19 not a temporary, but a long-term health problem we can expect to face for an unknown time. New advancements in treatment and prevention have caused health plans to end some temporary changes made early in this public health emergency and move back toward normal ways of covering care.
Starting Jan. 1, 2021, Blue Cross will no longer waive cost-sharing for COVID-19 associated medical treatment. This includes hospitalization and additional office visits, urgent care visits and emergency department visits beyond those where a COVID-19 test was ordered except as required by law.
This means members, who must get care related to a COVID-19 diagnosis, will be responsible for the normal cost-share (copay, deductible or coinsurance) that applies to their plans.
The waived cost-share for COVID-19 associated medical treatment applied to most members who buy their own healthcare coverage (individual members) and those who are members of fully insured groups.
If you are looking for COVID-19 testing, you can contact your healthcare provider to ask about which test you should have and where you can get one.
Hospitals, clinics, pharmacies and other facilities are offering free community testing for COVID-19 across the state. You can find out where and when testing is taking place by visiting the Louisiana Department of Health (LDH) Community Testing Centers page, where you can find testing locations by parish. Testing sites are usually open for only a few days at a time, so check the LDH’s COVID-19 Newsroom for the latest announcements. And, check community calendars on newspaper and local TV station websites to find out about testing in your area.
You can also call 211, text LACOVID to 898-211 or visit www.LA211Help.org to reach the statewide information network and ask for more information about COVID-19 testing.
Blue Cross will cover diagnostic viral detection and antibody COVID-19 testing with a healthcare provider’s order. You should talk to your healthcare provider about testing and what is best for you. Without a doctor’s order, you may have to pay out of pocket for the test.
If you received a diagnostic or antibody COVID-19 test with a healthcare provider and paid that provider directly, you may submit the bill to Blue Cross for reimbursement. We will pay up to 100% of an in-network provider’s fee (allowable charge) for the test and evaluation. We will pay non-participating and out-of-network testing as required by law.
If you get a COVID-19 test and the healthcare provider files it with a sick or regular visit, you may still have to pay a copayment or deductible for the visit.
Blue Cross is not covering tests done for public health surveillance, or tests required to return to work, recreational groups, camp, athletics or school. This policy is consistent with our insurance contracts and is consistent with from the departments of Labor, Health and Human Services and Treasury, as well as Louisiana state law.
There is a state law that requires health plans to cover antiviral drugs, including monoclonal antibodies, and vaccines that are approved by the FDA or officially recommended by a government authority to treat or prevent COVID-19 through Dec. 31, 2021.
The FDA has issued Emergency Use Authorizations (EUA) for several monoclonal antibody treatments. The federal government is currently covering the full cost for these drugs. Blue Cross will cover the administration cost without any member cost share for our fully insured members through Dec. 31, 2021, if the drug is administered in strict compliance with the FDA emergency use authorization (EUA) requirements. At this time, prior authorization is not required. Some self-funded employer groups may opt out of this member cost share waiver. Blue Cross will cover the administration costs for additional monoclonal antibody treatments as soon as they receive an EUA from the FDA for their administration.
If you have questions about how this is covered on your health plan, contact Customer Service at the number on your member ID card.
When talk of a virus outbreak hits close to home, it’s normal to feel stressed about a potential pandemic and emerging health crisis. Try these tips if you are feeling overwhelmed or fearful about an outbreak. No matter how you're feeling, you can get help from New Directions, the independent company that provides behavioral health services to eligible Blue Cross members.
Need to speak to someone? Call the behavioral health number listed on your health insurance ID card.
To meet members' needs and changing regulations, Blue Cross must be agile with our processes to ensure access to needed care and medications. We will continue to follow CDC, federal and state recommendations regarding the coronavirus; and will make the following changes effective Aug. 20, 2021, until further notice:
If you have any questions about these processes or what is covered on your health plan, call Customer Service at the number on your member ID card.
Three ways you can get your over-the-counter COVID-19 tests at no cost:
If you pay for the tests out of pocket, ask for a pharmacy receipt. Click below for instructions on how to submit a reimbursement claim.
COVID Defense App
The state of Louisiana has an app that alerts you if you were in close contact with someone who tested positive for COVID-19. The app is available for Apple and Android devices.
Visit the Baton Rouge Health District’s COVID-19 vaccine site to get information from local health leaders. Use the digital toolbox to jazz up your vaccine social posts.
Vaccine Social Graphics