CORONAVIRUS RESOURCE CENTER
Your Place for COVID-19 Answers and Assistance
COVID-19 Vaccination: Vaccines that receive emergency use authorization from the Food and Drug Administration (FDA) are covered at no cost. Medicare Advantage and Medex®' members are covered when vaccines are administered by any provider who accepts Medicare. For more information see frequently asked questions.
Important update: After thorough safety review, CDC and FDA recommend use of the Johnson & Johnson vaccine resume. Learn more at CDC.gov.
The vaccines: what you need to know
Find out where to get vaccinated, and why it's safe.
Blue Cross members are covered for the COVID-19 vaccination. We’ll cover any costs related to administration of vaccines, with no member cost share. Medicare Advantage and Medex®' members are covered with no cost share when vaccines are administered by any provider who accepts Medicare.
All U.S. residents 16 and older are now eligible for COVID-19 vaccination.
Those who live, work, or study in Massachusetts can now preregister for a COVID-19 vaccine appointment at one of the state’s mass vaccination sites. Sign up to be notified when it’s your turn to schedule an appointment. To register for a COVID-19 vaccination at other locations—like retail pharmacies, health care providers, or other community locations—visit vaxfinder.mass.gov.
For our out-of-state members, please visit your state's health department website for local distribution plans.
For more information, see our frequently asked questions.
Yes, the vaccines are safe. The U.S. vaccine safety system works to make sure all vaccines are as safe and effective as possible. Learn more about how government health experts are ensuring COVID-19 vaccines are safe and effective by visiting the Centers for Disease Control.
Your guide to getting tested
Should I get tested, where can I get tested, and what it will cost me?
We’re covering the full cost of diagnostic tests for COVID-19, as long as the test is ordered by a health care provider and meets CDC guidelines.
Testing is not covered for things like return to work or school, without a doctor’s order. See our frequently asked questions for guidelines for testing.
Medicare members, please refer to Medicare coverage details in the frequently asked questions.
First, talk to your doctor or health care provider. They can guide you to the best place to go. If you want to find a testing site on your own, your state’s health department website should provide details.
COVID-19 Helpline
For any questions or concerns related to COVID-19, call our dedicated member COVID-19 Helpline.
Ways to access Care from the Safety of home
Copayments, co-insurance, and deductibles for these in-network visits are waived for the duration of the Massachusetts Public Health Emergency.
Remote doctor visits
Call your primary care provider or mental health specialist to see if they offer remote visits, by phone or video. Need to find a doctor? Use our Find a Doctor & Estimate Costs tool. Be sure to sign in to find one in your network.
Well connection visits
If your plan includes a telehealth benefit,* get medical or mental health care virtually with our Well Connection platform. Connect to licensed providers, whenever you need care, using your computer or mobile device.
*Many plans include Well Connection, but some, like Medicare, do not.
24/7 nurse line
Speak with a registered nurse, day or night. You don’t have to wait for office hours to get an expert opinion. And there’s no additional cost for this service. Because your health comes first.
Don’t skip your regular care
Avoiding your health checkups and routine medical care because of the pandemic can affect your overall health. Talk to your doctor about continuing these vital appointments.
Stay on top of new symptoms
Don’t put off seeing your doctor if you aren’t feeling well, even if it’s not COVID-19. Chest discomfort, confusion, numbness, and other symptoms may feel manageable but can be signs of a serious condition. The sooner you get them checked out, the better. Talk to a doctor today.
Keep routine exams and preventive care
Routine health checkups, children’s checkups, consultations for things like mammograms and colonoscopies can be conducted by video or phone. Call your doctor’s office for more information.
Don’t delay chronic care
Care for many conditions like diabetes, COPD, asthma, heart, kidney, liver disease, hypertension, cancer, behavioral health conditions, and more can happen over the phone or video. Stay in touch with your doctor to stay healthy.
Get your routine immunizations
Immunizations for diseases like measles, chicken pox, HPV, pneumonia, shingles and tetanus, are still very important. Talk to your doctor about which vaccinations you need and the best way to keep up to date.
The pandemic and your mental health
You don’t need to have COVID-19 to feel the stress and anxiety it causes. That’s why we’re expanding support for mental health and waiving remote therapy costs during the public health emergency.* Self-guided programs, wellness offerings, substance use support options and more. Discover how to get started and what options may be available to you.
We’ve enhanced your benefits during the pandemic
Here’s how to access your medical, mental health, and dental care with as few barriers as possible. Because this public health emergency demands nothing less.
We're covering the full cost of FDA-approved COVID-19 diagnostic testing with no cost sharing, as long as the test is ordered by a health care provider and meets CDC guidelines.
Medicare members, please refer to Medicare coverage details below.
For the duration of the Massachusetts health emergency, we’re also removing member cost share (copayments, co-insurance, and deductibles) for COVID-19-related inpatient care at both in- and out-of-network acute care facilities for our fully insured members.
Until further notice, simply arrange for your care as always, and your claims will be processed to reflect this coverage.
To access vital information and updates sign in to MyBlue or create an account.
Note: Self-insured accounts make their own plan cost-share decisions and may have chosen not to waive this inpatient cost share. If you have any questions about your plan, call Member Service at the number on your ID card.
For the duration of the Massachusetts health emergency, we’ll cover virtual consultations, by phone or video, between Dental Blue® members and their participating dental providers with no member cost share (copayment, co-insurance, deductible, up to the member's existing annual dollar maximum). These additional virtual dental exams are available to all members who already have coverage for this service in a dental office setting.
We’ve also enhanced routine care benefits so members can now get fully covered, routine dental checkups twice a year, without having to wait six months between them.
These additional virtual dental exams are available to all members who already have coverage for this service in a dental office setting.
Get the Toothpic®' Teledentistry App
Get oral care recommendations from a licensed dentist. For a limited time, we’re offering Dental Blue members access to the Toothpic teledentistry app, at no cost. Download the app, submit a picture of your teeth and gums, then get a comprehensive report in as little as six hours, including oral care recommendations, from a licensed dentist. Learn more.
For the duration of the public health emergency, here’s how we’re enhancing Medicare benefits.
- Testing for COVID-19 is covered
Medicare Part B (medical insurance) covers testing for COVID-19, with no cost share when your doctor or other health care provider orders it, if you were tested on or after Feb. 4, 2020. - COVID-19 out-of-pocket costs are waived
For members in our Medicare Advantage HMO Blue and PPO Blue, Managed Blue for Seniors, and Medex plans, we’ve waived the cost share related to medically necessary coronavirus testing, counseling, vaccinations, and treatment at doctor’s offices, ERs, and urgent care centers, in accordance with CDC and Massachusetts DPH guidelines.
Simply arrange for your care as usual, and your claims will be processed to reflect this coverage.
For the duration of the Public health emergency, we’re removing copayments, co-insurance, or deductibles for all medically necessary COVID-19-related care received at:
- doctor’s offices
- urgent care centers
- emergency departments
This follows Centers for Disease Control and Prevention (CDC) and Massachusetts Department of Public Health (DPH) guidelines. Any medically necessary treatment for COVID-19 is covered under a member's health plan within the United States or internationally.
We’re also removing member cost share (copayments, co-insurance, and deductibles) for COVID-19-related inpatient care at both in- and out-of-network acute care facilities for our fully insured members.
Simply arrange for your care as always, and your claims will be processed to reflect these waived costs.
Note: Self-insured accounts design/customize their plans and benefits and may require inpatient cost share. If you have any questions about your plan, call Member Service at the number on your ID card.
All members can talk to a licensed doctor or provider from the comfort and safety of home, limiting the potential exposure to, and spread of, the virus. For the duration of the Massachusetts Public health emergency, we’ve waived member cost share* (copayments, co-insurance and deductibles) for all covered medically necessary medical and mental health services, provided via phone or video (telehealth) with in-network providers.
Call your provider to request remote visits by phone or video, and your claims will be processed to reflect these waived costs.* Members with our telehealth benefit are encouraged to use our Well Connection platform.
For Medicare HMO Blue and Medicare PPO Blue members:
For Medicare HMO Blue and Medicare PPO Blue members: Until further notice, telehealth cost share will be waived for primary care visits, urgently needed visits, health risk assessments and outpatient mental health visits. In addition, cost share will be waived for telehealth visits by a specialist if the visit is related to COVID-19.
*Benefits may vary by plan
We’ve removed any administrative barriers, such as prior authorizations and referrals, for medically appropriate care for COVID-19. We still require providers to notify us when a member is admitted to the hospital.
Simply make arrangements for care as usual, now with faster access.
The CARES Act passed by Congress includes a provision that allows members to use financial account funds to pay for over-the-counter (OTC) medications, without a prescription, as well as menstrual care products.
Claims must be for purchases made on or after January 1, 2020.
Merchants and financial account administrators are working to allow for payment for these products at the point-of-sale.
In the meantime, members can manually submit claims to their financial account administrator for reimbursement.
Important note: Plans vary by employer, and these changes don't necessarily change the benefits available under an employer's plan. Members should review plan documents carefully or consult their employers for information about their companies’ benefits.
Your COVID-19 Questions
Vaccines work by simulating a virus, which trains your body’s immune system to attack and eliminate the virus before it can make you sick.
Vaccines made by Pfizer/BioNTech, Johnson & Johnson, Cambridge-based Moderna have received emergency use authorization from the U.S. Food and Drug Administration and are being distributed. The vaccines have been found to be safe and extremely effective at preventing severe illness or death from COVID-19.
To be fully protected from COVID-19 you need two doses of both the Moderna and Pfizer vaccines, given three to four weeks apart. It is very important to schedule your second vaccination appointment while on site receiving the first dose. The Johnson & Johnson vaccine requires only one dose. The vaccines are considered fully effective two weeks after completed vaccination.
Providers administering the Johnson & Johnson vaccine should follow the company’s Vaccine Fact Sheet for Healthcare Providers Administering Vaccine and patients and family should read the Fact Sheet for Recipients and Caregivers, which have been revised to include information about the rare risk of blood clots that may be connected to the Johnson & Johnson vaccine.
There is no cost for the COVID-19 vaccine. The federal government has purchased millions of doses of the vaccine and will provide it for free. Any costs related to administration of the vaccine will be covered by us, with no member cost share.
All U.S. residents 16 and older are now eligible for COVID-19 vaccination.
Those who live, work, or study in Massachusetts can now preregister for a COVID-19 vaccine appointment at one of the state’s mass vaccination sites. Sign up to be notified when it’s your turn to schedule an appointment. To register for a COVID-19 vaccination at other locations—like retail pharmacies, health care providers, or other community locations—visit vaxfinder.mass.gov.
For our out-of-state members, please visit your state's health department website for local distribution plans.
The vaccines authorized for use have undergone rigorous clinical trials in which tens of thousands of volunteers received a vaccine with no serious side effects. These vaccines have also undergone the U.S. Food and Drug Administration’s (FDA's) emergency use authorization (EUA) process. An EUA provides quicker access to critical medical products—like medicines and tests—when there are no other adequate, approved, and available options. In granting an EUA, the FDA balances the known risks of the product with the known benefits. You can learn more about EUA in this FDA video.
In Massachusetts, infectious disease specialists also review the EUA data, and provide an independent opinion about vaccine safety and efficacy.
Data from the clinical trials show that the vaccines provide strong protection against severe disease and death from COVID-19, and may reduce the spread of the virus by vaccinated people. Researchers will continue to monitor safety as these vaccines are administered.
Yes. The CDC maintains that two doses of the Moderna and Pfizer vaccines are required to create the most effective immune response.
You won't get COVID-19 from the vaccine.
As is common with many vaccines, the COVID-19 vaccines can cause short-term side effects, which are signs that your immune system is developing the response, or antibodies, to fight the virus. Side effects may include aches, fatigue, or even a fever for a day or two after receiving a dose of COVID-19 vaccine.
Both the Pfizer/BioTech and Moderna vaccines require two doses to be fully effective so don’t let side effects keep you from getting the vaccine. There have been rare instances of people having an allergic reaction after being vaccinated.
If you're concerned about side effects, talk to your health care provider.
You'll need to make an appointment, to confirm your vaccine availability, and to maintain capacity limits at the vaccination site. Your health care provider may reach out to you when they have vaccine available.
Those who live, work, or study in Massachusetts can preregister for a COVID-19 vaccine appointment at a mass vaccination location by visiting the state’s preregistration site. To register for a COVID-19 vaccination at other locations—like retail pharmacies, health care providers, or other community locations—visit vaxfinder.mass.gov.
There is high demand for vaccines. The appointment websites are extremely busy and may at times be unavailable. We recommend you be patient and visit the site often.
Studies show the vaccines are effective against newer strains of the virus. In some instances, a booster shot might be needed.
Information about new strains of the virus, including those identified in the United Kingdom, South Africa, and Brazil is rapidly emerging and scientists are working to learn more. To learn more about the emerging variants of the virus and how scientists are working to better understand how to stop the spread, visit the CDC.
Vaccines are usually tested on adults first and if found to be safe, then clinical trials involving children begin. The Pfizer vaccine is authorized for those as young as 16. Moderna's vaccine is authorized for people 18 and older.
Clinical trials are currently underway for children, the results of which will be reviewed by the FDA.
These vaccines have not been well researched among women who are pregnant or breastfeeding. Studies are underway.
If you're pregnant or breastfeeding, you should discuss vaccination with your health care provider. The CDC says that pregnant women are at higher risk of severe illness if infected with the coronavirus.
If you're not feeling well, call your doctor and discuss your symptoms. You may be asked about your travel history and about those with whom you've been in close contact.
According to medical experts, symptoms of COVID-19 may include fever, dry cough, and shortness of breath. These symptoms are similar to the flu or other respiratory diseases.
To help you make decisions and seek medical care if necessary, use this symptom checker tool.
You should check with your doctor's office. Be prepared to share with them where you have traveled and with whom you've been in close contact.
When it is your turn, get vaccinated. Your loved ones need you. Get the COVID-19 vaccine to make sure you can be there for them. You should follow the guidance of your doctor, the governor, and federal and state health experts: avoid large gatherings, work from home if your business allows it, and practice social distancing—keeping six feet away from people you don’t know. Avoid travel. This will help slow the spread of the disease. To learn more about how to protect yourself and others, visit the CDC.
For the latest information from the Massachusetts Department of Public Health, click here.
Our doctors and most clinicians recommend that everyone should take basic precautions to avoid infection with any virus:
- Wear a mask or face covering in indoor public places, or when you can't socially distance outdoors
- Wash your hands often with soap and water
- When coughing or sneezing, cover your nose and mouth with a tissue or sleeve
- Avoid touching your mouth, nose, and eyes
- Disinfect commonly touched services
Talk to your doctor. You doctor will determine if you should be tested in accordance with Centers for Disease Control (CDC) guidelines.
If you want to find a testing site on your own, your state’s health department website should provide details. To find test sites in Massachusetts, visit Mass.gov.
The Massachusetts Department of Public Health, the Centers for Disease Control and Prevention, and the World Health Organization all provide regular updates on their websites:
In addition to our Coronavirus Resource Center, we’re providing information on our health news site, Coverage.
Our HMO, POS, PPO, and Indemnity plans cover both viral (also known as antigen) and antibody (also known as serologic) tests, when ordered by a health care provider who is making an individualized clinical assessment of the patient in according to current standards of medical practice, including Centers for Disease Control and Prevention (CDC) and Massachusetts Department of Public Health (DPH) guidelines.
Medicare plans: Blue Cross Blue Shield of Massachusetts follows Centers for Medicare and Medicaid Services (CMS)-mandated requirements, as well as state-mandated requirements related to coverage of SARS CoV-2 (COVID-19) testing, for our Medicare HMO and Medicare PPO members.
Blue Cross will cover viral and antibody Food and Drug Administration (FDA)-approved tests when ordered by any health care professional authorized under state law for the diagnosis of COVID-19 infection.
In keeping with CMS guidance issued September 2, 2020, and for the duration of the COVID-19 public health emergency, Blue Cross will cover, without a health care professional’s order, the cost of one diagnostic test for COVID-19 and one diagnostic test each for influenza virus or similar respiratory condition for Medicare members, when performed in conjunction with a COVID-19 test and needed to obtain a final COVID-19 diagnosis. Subsequent tests will require the order of an authorized health care professional.
Note regarding Medex®' plans: Because Medicare provides primary coverage for Medex members, standard Medicare rules as outlined above apply for one-time coverage of tests without a health care professional’s order.
Your health plan covers both viral (also known as antigen) and antibody (also known as serologic) tests, when ordered by a health care provider who is making a medically necessary clinical assessment of the individual patient, following Centers for Disease Control and Prevention (CDC) or Department of Public Health (DPH) guidelines.
Please note that CDC guidelines regarding antibody tests indicate that this type of test shouldn't be used to:
- Determine if someone can return to work;
- Group people together in settings such as schools, dormitories, and correctional facilities;
- Determine the immune status in individuals, since medical experts aren't sure that the presence of antibodies creates immunity or how long any potential immunity may last.
Talk to your doctor about the best location for you to get tested. Blue Cross will cover tests when conducted at, but not limited to, the following sites:
- Drive-through testing sites
- Emergency rooms
- Medical provider offices
- The patient’s home (using a testing kit—a patient self-swab)
Remember that the test must be ordered by a health care provider, who is making an individualized clinical assessment of the patient according to current standards of medical practice, including Centers for Disease Control and Prevention (CDC) and Massachusetts Department of Public Health (DPH) guidelines. The test must be Food and Drug Administration (FDA)-approved, or must have received Emergency Use Authorization from the FDA; or the manufacturer (maker) intends to request Emergency Use Authorization.
The Commonwealth of Massachusetts has created an interactive map of testing sites on its COVID-19 resource web page. Please visit Mass.gov.
Your health plan covers medically necessary services to diagnose or treat illness.
Blue Cross isn't required to cover routine screenings to determine an individual’s fitness to return to work, school, or for public health surveillance purposes.
Your health plan covers medically necessary services to diagnose or treat illness.
Testing is covered when ordered by a health care professional. Some examples of when testing may be ordered by a provider include, but are not limited to:
- When a person has symptoms consistent with COVID-19, such as fever, cough, shortness of breath, chills, muscle pain, sore throat, no sense of smell, and gastrointestinal distress
- If a person has had direct exposure to another individual with a confirmed case of COVID-19
- Those people who have been identified by contact tracing as being at risk of exposure
- Symptomatic or asymptomatic patients who require testing prior to a medical procedure or surgery
- People who are admitted to a health care facility, including but not limited to a hospital operated or licensed by the Department of Public Health or Mental Health, a long-term acute care hospital, or a skilled nursing facility
For Medicare members, in keeping with CMS guidance issued September 2, 2020, and for the duration of the COVID-19 public health emergency, Blue Cross will cover, without a health care professional’s order, the cost of one diagnostic test for COVID-19 and one diagnostic test each for influenza virus or similar respiratory condition for Medicare members when performed in conjunction with a COVID-19 test and needed to obtain a final COVID-19 diagnosis. Subsequent tests will require the order of an authorized health care professional.
Your health plan doesn't cover tests:
- Requested for general screening purposes such as return-to-work or for public health surveillance purposes
- Used as routine screenings for such individuals as people who live or work in residential facilities such as skilled nursing homes
- That have been denied FDA approval, or tests that don't have Emergency Use Authorization from the FDA, or tests whose developers haven't requested Emergency Use Authorization within a reasonable time frame
- Antibody tests aren't covered for screening purposes, such as eligibility to donate plasma
Your health plan will cover COVID-19 tests for each individual, when ordered by a health care provider who is making an individualized clinical assessment of the patient according to current standards of medical practice, including Centers for Disease Control and Prevention (CDC) and Massachusetts Department of Public Health (DPH) guidelines.
Effective March 16, 2020, and for the duration of the Massachusetts state of emergency, you may receive all medically necessary covered services from an in-network provider via telehealth or by telephone.*
We're waiving all member cost share (copayments, co-insurance, or deductibles) for members who receive care via phone, video, or telehealth in place of an office visit, for COVID-19- and non-COVID-19-related services received from an in-network provider.*
You're temporarily eligible to receive services by telephone or other chat application if available from your provider.
Well Connection Telehealth Visits
Many members may also have an existing telehealth benefit included as part of the Blue Cross health plan. For members with this telehealth benefit, we're waiving cost sharing for telehealth visits conducted through Well Connection. To find out if you're covered, call Member Service at 1-800-262-BLUE (2583), or sign in to MyBlue and click Review My Benefits. Be sure to include your insurance information when registering for Well Connection.
For Federal Employee Program (FEP) members:
Effective March 10, 2020, we’ve removed the member cost share for all telehealth services (COVID-19 and non-COVID-19 related) received through the Teladoc®'' network. Members can register for Teladoc by visiting fepblue.org/coronavirus. For other providers offering telehealth services not on Teladoc, the applicable office visit cost share will apply (unless COVID-19 related).
Our 24/7 Nurse Line also is available at no cost to FEP members, and offers a safe and convenient clinical resource for questions or minor ailments. Call the 24/7 Nurse Line at 1-888-258-3432 or learn more.
For Medicare HMO Blue and Medicare PPO Blue members:
Until further notice, telehealth cost share will be waived for primary care visits, urgently needed visits, health risk assessments and outpatient mental health visits. In addition, cost share will be waived for telehealth visits by a specialist if the visit is related to COVID-19.
*Benefits may vary by plan.
Effective March 10, 2020, we’ve removed the member cost share for all telehealth services (COVID-19 and non-COVID-19 related) received through the Teladoc network. Members can register for Teladoc by visiting fepblue.org/coronavirus. For other providers offering telehealth services not on Teladoc, the applicable office visit cost share will apply (unless COVID-19 related).
Our 24/7 Nurse Line also is available at no cost to all members and offers a safe and convenient clinical resource for questions or minor ailments. The number for the Nurse Line is 1-888-247-2583.
If you're eligible, coverage for yourself and your dependents can be purchased directly from Blue Cross or any other health insurer, or through the Massachusetts Health Connector.
If you're interested in a Blue Cross plan, or to find out if you're eligible, please visit getbluema.com or call 1-800-422-3545.
If you have coverage through Dental Blue®, and until further notice, you can receive care from your dentist via telephone or video if your dentist offers virtual services. There will be no member cost share up to the member's existing annual dollar maximum. Services provided by non-participating dentists could be subject to balance billing.
Our members are covered for emergency medical care while traveling internationally. If someone were to be hospitalized while traveling, costs would be covered according to the terms of your plan.
You can purchase additional health insurance designed for travelers from any number of companies. Blue Cross offers health insurance for travelers that provides extended coverage, called GeoBlue®. You can learn more at geobluetravelinsurance.com/bcbsma, or by calling 1-855-481-6647.
Yes, Blue Cross Blue Shield has temporarily lifted limits on early refills of prescription medications, allowing members to obtain one additional fill of their existing prescription.
Please note: the prescribing doctor or pharmacy filling the prescription may decide to continue to impose limits at their discretion.
Certain medications, such as opioids and medications with quality care dosing limits, are excluded.
Members can get a two-month supply of a medication for two copayments at the retail pharmacy of their choice, as benefits allow. Additionally, members can use the Express Scripts®'' (ESI) mail order pharmacy to get three-month supplies of medications.
Members enrolled in Smart90®''are eligible for 90-day supplies at retail pharmacies for certain maintenance medications.
We won't allow for greater than a 90-day supply, to avoid stockpiling or potential shortages.
We recommend that you consider our mail order delivery option for your maintenance medications—those you take for the long term. It’ll be one less trip that you need to take. Visit Express Scripts®' Pharmacy, our third-party partner, or call 1-800-892-5119. For short term prescriptions, ask your pharmacy about delivery or curbside pickup.
Our members are covered for emergency medical care while traveling internationally. If someone were to be hospitalized while traveling, costs would be covered according to the terms of your plan.
You can purchase additional health insurance designed for travelers from any number of companies. Blue Cross offers health insurance for travelers that provides extended coverage, called GeoBlue®. You can learn more at geobluetravelinsurance.com/bcbsma or by calling 1-855-481-6647.
You should follow guidance from the Centers for Disease Control or the U.S. State Department concerning personal travel outside of the United States.
The State Department provides guidance on travel at travel.state.gov and has advised U.S. citizens to avoid all international travel, and that U.S. citizens traveling abroad should return to the United States.
The CDC website provides regular updates and a global risk assessment of the virus.
Government officials haven't issued any guidance about domestic travel.
Our standard plans provide only for urgent or emergency care for people traveling overseas. However, given the public health emergency, we'll cover the cost of vaccination of our members living and working overseas. The vaccine must be FDA authorized or FDA approved.
The member may need to pay for these services and then file for reimbursement.
Members who have enrolled in our Blue Cross Blue Shield Global Expat plan are covered.
Our standard student plans only cover health care services provided to members while studying in the United States. However, given the public health emergency, we'll cover the cost of vaccination of members receiving the vaccine in their home country. The vaccine must be FDA authorized or FDA approved.
The member may need to pay for these services and then file for reimbursement.
For the duration of the Massachusetts state of emergency:
We will waive all member cost share for medically necessary COVID-19 testing, counseling, vaccines (when available), and treatment and supportive care at in-person doctor's offices, urgent care centers and emergency departments (excluding inpatient care) in accordance with CDC and DPH guidelines.
Any medically necessary treatment for coronavirus is covered under a member's health plan within the United States or internationally.
Blue Cross also has waived cost share for all covered services (COVID-19 and non-COVID-19 related) delivered by an in-network provider via telehealth or telephone (both medical and behavioral) services, not just those related to COVID-19. This is effective as of March 16, 2020.
We will also cover the cost of vaccination when a COVID-19 vaccine is available.
Members with a COVID-19 diagnosis who receive medically necessary out-of-network care in a doctor’s office, urgent care center, or emergency department will be covered as in-network, cost shares would be waived, and the member would be protected against balance billing. The cost share protections do not extend to in-patient care.
Please understand that your health care provider may perform additional tests and procedures during the same visit in which they test for COVID-19. Copay, co-insurance and deductible may apply for those other tests and services.
For Medicare HMO Blue and Medicare PPO Blue members:
Effective January 1, 2021, Telehealth visits will include a member cost share as described in the Evidence of Coverage.
You doctor will determine if you should be tested in accordance with Massachusetts Department of Public Health guidelines.
No, opt outs are not allowed. This is consistent with state and federal guidance (including specific Division of Insurance guidance) aimed at preventing the spread of the coronavirus by allowing remote health care access.
Yes, accounts can add telehealth services via our provider, Well Connection off cycle. The cost is 50-cents per employee per month.
It may take several weeks to add this benefit.
Please contact your account executive for details.
No, accounts are still responsible for the paying for telehealth services. The cost is 50-cents per employee per month.
Our company is considered an essential business and is prepared to continue to operate during this outbreak in Massachusetts. We have stress-tested disaster readiness and pandemic plans in place. We have convened a cross-functional group of leaders and associates who are evolving our plans to meet the needs of this event. Strategic elements of our plan include:
- The ability operate our business when are buildings are closed. More than 90% of our associates are equipped to work remotely.
- Our Virtual Private Network is redundant and is built to meet the demands placed on it should all associates wind up working remotely
- Our company is financially stable and has a healthy reserve fund, should we need it, to finance our operations.
If you have additional questions about our preparations, please speak to your account executive.
Yes, we expect to cover all claims for medically necessary covered services provided to members we insure.
Accounts that self-insure remain responsible for covered health care costs incurred by their employees.
Our message to our associates is based on the latest information from the CDC, the Massachusetts Department of Public Health and state government.
With the rise in cases in Massachusetts and the Governor’s declaration of a state of emergency, the majority of our associates are working from home to ensure their health and wellbeing and to support of public health efforts to prevent the spread of COVID-19.
We urge associate to practice social distancing and basic hygiene that helps prevent the spread of viruses:
- Wash your hands frequently with soap and water
- Don’t touch your mouth nose or eyes
- Cover your nose and mouth with a tissue or crook of your arm when you sneeze or cough
- Stay home when you are sick
We share the latest information with our associates as appropriate through a variety of channels including email, intranet and our public news site Coverage
The Massachusetts Department of Public Health, the Centers for Disease Control and Prevention, and the World Health Organization are all providing regular updates on their websites:
- https://www.cdc.gov/coronavirus
- https://www.mass.gov/orgs/department-of-public-health
- https://www.who.int/
In addition to our coronavirus resource center we’re also providing information on our health news site, Coverage
Yes, Blue Cross Blue Shield has temporarily lifted limits on early refills of prescription medications allowing members to obtain one additional fill of their existing prescription.
Please note: the prescribing physician or pharmacy filling the prescription may decide to continue to impose limits at their discretion.
Certain medications, such as opioids and medications with quality care dosing limits, are excluded.
Members can get two-month supply of a medication for two copays at the retail pharmacy of their choice, as benefits allow. Additionally, members can use the ESI mail order to get three month supplies of medications.
If a member is enrolled in Smart90, they are eligible for 90-day supplies at retail for certain maintenance medications.
We will not allow for greater than a 90-day supply to avoid stockpiling or potential shortages.
We understand some pharmacies may not understand Blue Cross has lifted restrictions on early refills.
We are working with our pharmacy benefits manager to resolve this issue
If your employees are being told Blue Cross is denying refills the employee can call our member service line for assistance while in the pharmacy.
Please remember, prescribers and pharmacies can maintain these limits at their discretion.
No, we can’t allow accounts to opt out of this program. This is in keeping with state guidance during this state of emergency and is our standard process anytime there is a disaster such as tornado, hurricane, or other emergency.
We are in close contact with our pharmacy benefit manager, Express Script and our specialty pharmacy network. There is no supply issue at this time. In collaboration with our pharmacy partners we will continue to monitor the supply of medications and will be flexible in allowing alternative medications should a there be a shortage of medications in our formulary.
We have created the COVID-19 Information Center for our Clinical Partners. It is continually updated with the latest key information our health care partners need regarding our approach to telehealth and telephonic care, COVID-19 testing and treatment, referrals and authorizations, cost share, prescription medications, dental care, and more. This page is available at Provider Central. No login is required.
There are no prior authorizations and referrals required for members receiving medically necessary care for COVID-19. To help us expedite all COVID-19 cases, we’ve asked providers to please continue to notify us of all inpatient admissions. No supporting clinical information and no medical necessity reviews will be required.
Detailed information on billing and codes, as well as updates to our policies are available on Provider Central. We also posted specific articles for medical and dental providers on March 24.
The Centers for Disease Control and Prevention have issued an interim set of coding guidelines available here.
Blue Cross is financially stable. We maintain a reserve fund that, if needed, will fund our operations.
We are following guidance from the state, which has declared a state of emergency and taken a number of steps to slow the spread of the virus.
Regularly updated information is available on this site and on our health news site, Coverage.
Our message to our associates is based on the latest information from the CDC, the Massachusetts Department of Public Health and state government.
With the rise in cases in Massachusetts and the Governor’s declaration of a state of emergency, the majority of our associates work from home to ensure their health and wellbeing and to support of public health efforts to prevent the spread of COVID-19.
We urge associate to practice social distancing and basic hygiene that helps prevent the spread of viruses:
- Wash your hands frequently with soap and water
- Don’t touch your mouth nose or eyes
- Cover your nose and mouth with a tissue or crook of your arm when you sneeze or cough
- Stay home when you are sick
We share the latest information with our associates as appropriate through a variety of channels including email, intranet and our public news site Coverage.
For the duration of the Massachusetts state of emergency and effective for dates of service retroactive to March 16, 2020, in-network providers may deliver all medically necessary covered services (COVID-19 AND non-COVID-19 related) via any modality. This includes telehealth, telephonic, video chat or in-person to all Blue Cross Blue Shield of Massachusetts members including members in our Medicare Advantage, Managed Blue for Seniors and Medex plans.
Starting immediately, Blue Cross will cover visits by telephone (“telephonic visits”). Providers may offer telehealth services as long as they are contracted and credentialed by Blue Cross Blue Shield of Massachusetts. There are no additional credentialing or contracting processes providers need to follow to offer these services.
We will reimburse medically necessary telehealth and telephonic visits at the same rate as an in-person visit, for all provider specialties, including ancillary.
Removing all member cost share (copayments, co-insurance, and deductibles) for a medically necessary telephone (telephonic) call visit in place of an office visit, and a virtual/video appointment (telehealth) services for COVID-19 and non-COVID-19-related services.
For Federal Employee Program (FEP) members:
Effective March 10, 2020, we’ve removed the member cost share for all telehealth services (COVID-19 and non-COVID-19-related) received through the Teladoc network. Members can register for Teladoc by visiting fepblue.org/coronavirus. For other providers offering telehealth services not on Teladoc, the applicable office visit cost share will apply (unless COVID-19 related).
Please visit Provider Central for the latest information on coding and billing. We have created a COVID-19 Information Center for our Clinical Partners on Provider Central.
For Medicare HMO Blue and Medicare PPO Blue members:
Effective January 1, 2021, Telehealth visits will include a member cost share as described in the Evidence of Coverage.
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MORE RESOURCES AND ANSWERS
Here are additional resources everyone can use.
COVID-19 Symptom Checker
This easy guide will help you make decisions and seek medical care, if necessary.
Centers for Disease Control
Get the latest updates on the virus and what you can do to minimize exposure and spread.
MA Department of Public Health
See how Massachusetts is coordinating response, and how we can all do our part.
COVID-19 Health Literacy Project
Find COVID-19 information in 30+ languages, created in partnership with Harvard Health Publishing.
For Medicare HMO Blue and Medicare PPO Blue members: Until further notice, telehealth cost share will be waived for primary care visits, urgently needed visits, health risk assessments and outpatient mental health visits. In addition, cost share will be waived for telehealth visits by a specialist if the visit is related to COVID-19.