Expanded coverage for COVID-19

In response to the worldwide COVID-19 pandemic, for those with BCBSND coverage, we’re expanding benefits to include: 

Coronavirus testing and treatment

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.

Prescription medications

Effective March 10, BCBSND asked pharmacies to refill prescriptions earlier than typically allowed. In addition, most plans allow members to fill maintenance medications for up to a 90-day supply through local or mail-order pharmacies.

  • BCBSND asked pharmacies to waive “refill too soon” limits on prescriptions
  • In addition, we are working closely with our pharmacy benefit manager, Prime Therapeutics, to monitor a possible shortage of raw materials for prescription drugs. Our pharmacy partner is working directly with our entire network of suppliers, wholesalers, manufacturers and pharmacies (both chains and smaller purchasing entities) to proactively collaborate and identify medication shortages before members are impacted.

Expanded telehealth coverage

To lessen the pressure on our health care system during the pandemic, we are expanding coverage for telehealth for all BCBSND members to include video calls, phone calls, email or online chats, including FaceTime or Skype calls.

In addition, we’re covering cost shares for all telehealth visits for Fully Insured and Individual members. Those services may include, but are not limited to:

  • Urgent Care Visits
  • Office visits for patients
  • Physical therapy (PT) plan evaluation
  • Occupational therapy (OT) plan evaluation
  • Speech therapy (ST) plan evaluation
  • Behavioral health and substance use disorder treatment
  • Diabetes education
  • Nutrition counseling

Extended grace periods for premiums

Effective March 24, 2020, BCBSND is allowing customers to have 62 days to pay their premiums (which is an extension from the current 31-day requirement) for all members with individual plans or small group coverage (businesses with under 50 employees).

In support of the larger businesses (those with 50 or more employees), BCBSND representatives will work with them directly on a case-by-case basis to determine alternative payment plans. 

Advanced Premium Tax Credit program

Members who experience a reduction in income or are laid off due to the pandemic may qualify for premium relief through the federal government’s Advanced Premium Tax Credit (APTC) program as a qualifying event.

BCBSND encourages members to learn more about the program online or by calling BCBSND Member Services at by calling 844-363-8457.

Flexibility in eligibility requirements

As businesses around the country are forced to reduce hours or lay off employees, BCBSND is also allowing greater flexibility in eligibility requirements:

  • As long as premiums are paid, BCBSND will work with employers to keep employees on their health plan, even when their hours fall below current eligibility guidelines;
  • BCBSND will allow employers to remove or reduce current probationary periods for new employees, thereby allowing new employees access to their health plan sooner.