COVID-19 Coverage for Members

Vaccines | Testing and Treatment | Prescription Coverage | Mental Health Services | Telehealth

Your health is always our priority. Your Blue Cross and Blue Shield of Texas (BCBSTX) health plan gives you access to the care you need during the COVID-19 pandemic.

With a BCBSTX health plan, you have access to care for COVID-19 related health issues. Use the doctors, labs and facilities in your BCBSTX health plan’s provider network for:

• Lab tests to diagnose COVID-19
• COVID-19 testing-related doctor’s visits
• COVID-19 treatment

Most changes will end with the end of the public health emergency. Some may end sooner, depending on your plan. View effective coverage dates.

COVID-19 Vaccines

With a BCBSTX health plan, you have access to COVID-19 vaccines at no cost to you. Talk with your doctor if you have any questions about the vaccines.

While most plans cover COVID-19 vaccines at no cost, some self-funded groups do not cover preventive services, including the COVID-19 vaccines. If you are unsure what your plan covers, contact your company’s benefits administrator or call BCBSTX Customer Service at the number listed on your member ID card.

Testing and Treatment

Getting Tested

If you think you may have the virus or have been exposed to someone who has it:

• Call your doctor right away. Your doctor can order a COVID-19 diagnostic test and coordinate your testing at an in-network lab. 
• If you don’t have a primary care doctor, we can help you find one. Call us at the Customer Service number listed on your BCBSTX member ID card.
• Find an in-network doctor by logging in to Blue Access for Members^SM or downloading the BCBSTX app¹ to use our Provider Finder^®.

Some things to know about testing:

• Your health plan covers FDA-authorized diagnostic testing for the COVID-19 virus.
• Some testing locations may not be in your health plan’s network.
• Some labs may not provide testing without a doctor’s order.

A note about antibody tests: Serology tests detect the presence of antibodies produced after exposure to the virus. While the tests are available, it remains uncertain whether antibodies will protect you against reinfection with COVID-19. The Centers for Disease Control and Prevention (CDC) does not recommend serology tests to determine when it is safe for a person to return to work or school.

Office Visits and Treatment

Your doctor will help guide your care. If you test positive for COVID-19, follow up with your doctor’s office so they can plan next steps. If you start to feel worse, let your doctor know. Telehealth is the most convenient and safest way to get medical care without leaving home.

Your health plan also covers emergency and inpatient hospital care for COVID-19 at your regular benefit level. Seek emergency medical care immediately if you have:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability or difficulty waking or staying awake
• Bluish lips or face

For those times when you can’t get in to see your doctor and it’s not an emergency, you can visit an in-network urgent care center. They offer primary care services and the wait time can be much shorter than an ER visit. And they can let you know if you need emergency care.

COVID-19 Costs

BCBSTX is waiving your share of the costs for COVID-19 testing and testing-related visits until the end of the Health and Human Services COVID-19 public health emergency order.

This means:

• Lab tests to diagnose COVID-19 are covered at no cost.
• Testing-related visits are covered at no cost to you when you see a primary care provider in your health plan’s network, either in person or using telehealth.
• Cost-sharing was also waived for COVID-19 treatment for members in a fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, or Medicaid health plan. The waiver covered treatment from April 1 through Dec. 31, 2020. As of January 1, 2021, members will be responsible for the out-of-pocket costs associated with claims for treatment.

Self-funded customers have some choices about how we administer COVID-19 treatment coverage for their employees. Their dates for cost-sharing waivers may differ.

If you are unsure what your plan covers, contact your company’s benefits administrator or call BCBSTX Customer Service at the number listed on your member ID card.

Remember to use your BCBSTX member ID card for your doctor’s visit and testing to help with the reimbursement process.

Prescription Coverage

It’s important that you have your medicine on hand at all times. Make sure you keep your refills current and reach out to your doctor before the last refill runs out. Your plan also may include the option to get up to a 3-month supply of certain drugs.

Many drug stores may offer delivery options. If part of your plan, you can also sign up online or call the number on your BCBSTX member ID card for mail-order delivery of 90-day supplies with AllianceRx Walgreens Prime².

Talk with your doctor or pharmacist about your options. Remember, your care is always between you and your doctor.

Mental Health Services

Coping with the stress and anxiety of COVID-19 can be overwhelming. Remember to take care of your mental health. Your health plan covers mental health services, including counseling.

• If you need help, call your primary care doctor. They may be able to see you using telehealth. Or they may refer you to someone else. Your health plan covers mental health services, including counseling.
• Many BCBSTX health plans include 24/7 phone access to licensed mental health care specialists as part of the mental health coverage. The number may be listed on your member ID card, or you can call Customer Service to find out if you have this benefit.

Telehealth

Need to see a doctor? Depending on your health plan, you may be able to see a provider in your health plan’s network virtually.

Your telehealth benefits give you access to care while reducing the risk of exposure to COVID-19.

Telehealth benefits may differ based on your plan. Call the Customer Service number on your member ID card if you have questions about your coverage.

Call your doctor’s office to learn more about their telehealth offerings.

If you need help finding an in-network provider, log in to Blue Access for Members^SM to use our Provider Finder^®. Or, you can call us at the Customer Service number listed on your member ID card for help. 

Our Bilingual 24/7 Nurseline³ is also here to discuss any health concerns and can guide you if you think you’ve been exposed to COVID-19 or have symptoms. Nurses are available 24 hours a day, 7 days a week at 800-581-0368.

¹To download the app, text BCBSTXAPP to 33633 or search for BCBSTX in the Apple App Store or Google Play. Message and data rates may apply.

²Blue Cross and Blue Shield of Texas (BCBSTX) contracts with Prime Therapeutics^® to provide pharmacy benefit management and related other services. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is an online resource offered by Prime Therapeutics.

³The 24/7 Bilingual Nurseline may not be available with all plans. Check your benefits booklet for details.