Medicare Advantage Members

Last Updated on June 28, 2023

We’ve created a guide to answer questions you may have about the COVID-19 vaccines. Here’s what you need to know.

Member benefits changed with the expiration of the COVID-19 public health emergency (PHE) on May 11, 2023. Here’s what you need to know about COVID-19 and your benefits.

Your Health Plan

Yes, if your provider offers this service. We’ll support telehealth visits with providers in our networks who offer this service for members who get their coverage through their employers or get it on their own for themselves and family. This includes visits with your primary care physician, specialists, behavioral health providers, ABA providers, and physical, speech and occupational therapists. This visit will cost you the same as a face-to-face visit with your provider, so any copay or cost-share you would normally have will still apply. If you have this kind of visit with a provider out of your network, they may bill you for the difference between their visit charge and our payment to them.

Yes. We’ll cover and waive member costs for any US FDA-approved tests, as well as those currently pending FDA approval, if your doctor recommends it. We’re also waiving member copays and deductibles for the visit to your provider, urgent care center or emergency room related to a COVID-19 test, as long as the provider is in your network. We’ll still cover the COVID-19 testing and services if you see a provider out of your network, but that provider may bill you for the difference in their visit charge and our payment to them. Please note that, if you receive additional services or testing in addition to just COVID-19 related testing or treatment, your normal copayment for that setting will apply.

Yes. If your provider gives you treatments in the hospital or while at their office to help with the symptoms of COVID-19, we’ll cover those at your normal cost share. Any prescriptions your doctor recommends for at-home symptom treatment will have your normal copay or cost share. Some OTC medications are available through your OTC benefit. Your 2023 BlueAdvantage Over-the-Counter Catalog lists what’s available.

Throughout much of the pandemic, we’ve allowed early refills on many prescriptions. On Sept. 1, 2021, we reverted to our standard refill timeline if your pharmacy benefits are covered through BlueCross. However, you can get 90-day fills for many medications to treat chronic conditions. Your plan may also have mail-order benefits if you don’t want to go out to a pharmacy to get your medications.

COVID-19 and Fraud

Unfortunately, some people are using the threat of coronavirus to defraud others, especially our senior population.

Your Health

The first step is to stay home and separate yourself from other people or animals as much as possible. That’ll help keep germs from spreading until you can get tested and advice from a doctor.

Next, check with your county health department to schedule at a free testing site or call your primary care provider. If your doctor thinks you need to be tested, they can give you instructions for where to go for testing if their office doesn’t offer it. Many pharmacies and urgent care centers offer testing.

Other than for testing, please stay at home, wear a mask and isolate yourself from others in your home, if possible.

If you’re up to date with vaccination or had confirmed COVID-19 within the past 90 days:

Wear a high-quality mask or respirator (e.g., N95) as soon as you find out you were exposed and any time you are around others inside your home or indoors in public . You don’t need to stay home unless you develop symptoms.
Get tested five days after exposure, even if you don’t get symptoms. Start counting from Day 1:
- Day 0 is the day of your last exposure to someone with COVID-19
- Day 1 is the first full day after your last exposure
Watch for symptoms for 10 days following your exposure.
If you develop symptoms, isolate immediately, get tested, stay home until you know your results, and wear a mask around others.

If you’re unvaccinated:

Wear a high-quality mask or respirator (e.g., N95) as soon as you find out you were exposed and any time you are around others inside your home or indoors in public . You don’t need to stay home unless you develop symptoms.
Get tested five days after exposure, even if you don’t get symptoms. Start counting from Day 1:
- Day 0 is the day of your last exposure to someone with COVID-19
- Day 1 is the first full day after your last exposure
Watch for symptoms for 10 days following exposure.
If you develop symptoms, isolate immediately, get tested, stay home until you know your results, and wear a mask around others.

The first step is to stay home and separate yourself from other people or animals as much as possible. That’ll help keep germs from spreading until you can get advice from a doctor.

Next, check with your county health department to schedule at a free testing site or call your primary care provider. If your doctor thinks you need to be tested, they can give you instructions on where to go for testing if their office doesn’t offer it. Many pharmacies and urgent care centers offer testing.

Other than for testing, please stay at home, wear a mask and isolate yourself from others in your home, if possible.

If you test positive, stay home for five days, and wear a mask if you have to be around others in your home. Day 1 of five is the first full day after you got symptoms or when you tested. Wear a mask around others until Day 10.

If you have symptoms:

You can end isolation after Day 5 if you haven’t had a fever for at least 24 hours – without using a fever-reducing medicine – and your symptoms are improving.

If you didn’t have symptoms:

You may end your isolation after Day 5 of a positive test.

If you had severe symptoms:

Isolate for 10 days. Talk to your doctor before ending isolation.

Yes. Providers are following some safety social distancing guidelines, so be sure to call their office before your appointment to know what extra safety steps they’ll want you to follow when you get there. You also should take some personal safety measures, including wearing a mask if you’re not fully vaccinated and making sure you don’t have a fever or any signs of COVID-19 before going in person. If you are vaccinated and do not have any symptoms, be sure to consult the level of risk in your area to see the CDC’s guidelines for mask-wearing. If you have any symptoms or have been exposed to someone with COVID-19, you’ll need to reschedule your appointment.

If you have health issues that put you at higher risk of COVID-19 complications or simply don’t feel comfortable going out in person, many providers are still offering telehealth appointments.

Protecting Yourself and Others

Getting a vaccine is your best protection against COVID-19. Until you’re fully vaccinated, social distancing and wearing a mask are the best ways to protect yourself. Even if you’re vaccinated, the CDC recommends wearing a mask in many situations, depending on the level of risk in your area. Stay up to date on the latest mask guidelines here.

Wash your hands with soap and water frequently, especially if you’re out of your home. Hand sanitizer can help when soap and water are unavailable.

Clean all frequently touched surfaces in your home, car and workspace.

Cover your coughs and sneezes, and immediately throw away the used tissues.

If someone in your house is sick or has symptoms, have them self-isolate away from others in the house. Call their provider for instructions on what to do next.

BlueCross Working for You

No. We’re considered essential, so we’ll remain open. However, we have taken steps to help keep our employees well while ensuring our members see no lapse in service. In early 2020, we transitioned many of our customer service, care management, and claims and billing employees to work from home. Since March 16, 2020, the majority of our workforce has been working full time from their homes to allow them to practice social distancing. We’ve not experienced any reduction in service to you, nor do we expect any.