COVID-19-related testing and treatment are covered

BCBSND will waive out-of-pocket costs for medically necessary laboratory COVID-19 testing—that includes co-pays, deductibles and co-insurance. Currently, there is no coverage for asymptomatic individuals for public health surveillance screening purposes. COVID-19 antibody or serological testing will be covered at 100% when medically indicated. COVID-19 antibody or serological testing is not covered for those who have previously tested positive for COVID-19.

• In addition, BCBSND will also waive cost-sharing for the office visit associated with COVID-19 testing, including an in-network provider office visit, urgent care center or emergency room visit.
• BCBSND will cover services and testing performed during a visit related and resulting in COVID-19 testing at no cost-share to the member. Services must be in accordance with accepted standards of current medical practice and medically appropriate for the individual.
• Cost-shares may be waived on a retrospective basis.

BCBSND will waive out-of-pocket costs for the treatment of COVID-19, including hospital stays and outpatient treatment. This applies to BCBSND members on fully insured, employer-sponsored plans and individual plans.

• Out-of-pocket costs include incremental medical co-pays, deductibles and co-insurance charges related to the treatment for COVID-19 and will be paid at in-network rates.

Symptom check and doctor visits from home are covered

If members are experiencing COVID-19-like symptoms, please direct them to a telehealth visit to have symptoms evaluated. BCBSND will waive cost-shares on those visits when members seek care from in-network providers or our telehealth partner, Amwell. Not familiar with telehealth? Start here.

In an effort to keep members safe, we are also temporarily expanding coverage on many types of visits unrelated to COVID-19. Learn more.

Early prescription refills are covered 

BCBSND is asking pharmacies to refill prescriptions earlier than typically allowed for members who have BCBSND pharmacy benefits.

In addition, most plans allow members to fill maintenance medications for up to a 90-day supply through local pharmacies or home-delivery pharmacies through the mail.

In addition, we are working closely with our pharmacy benefit manager, Prime Therapeutics, to monitor a possible shortage of raw materials for prescription drugs. Prime is working directly with our entire network of suppliers, wholesalers, manufacturers and pharmacies to proactively collaborate and identify medication shortages before members are impacted.