Information for members regarding changes to COVID-19 coverage

Friday, April 21, 2023

COVID-19 or CORONAVIRUS UPDATE text with stethoscope, medical swab and vial on black background.

The Department of Health and Human Services (HHS) has announced that it is planning to allow the federal Public Health Emergency (PHE) declaration for COVID-19 to expire on May 11, 2023. Upon the expiration of the PHE, the Board of Trustees has decided that the following changes regarding coverage for COVID-19 testing and vaccines will take effect:

  • Immunizations and routine vaccinations that are intended to prevent or mitigate COVID-19 will continue to be covered at no-cost to members, provided that an in-network provider is utilized. The use of an out-of-network provider will no longer be covered.

  • As a reminder, the FDA approved the Bivalent COVID boosters to replace the monovalent boosters. The bivalent boosters are recommended for use at least two months after completing a primary or booster vaccination. The bivalent vaccines will continue to be covered at no-cost to members when administered by an in-network TeamCare provider.

  • Medically necessary diagnostic tests for COVID-19 will be covered under the outpatient lab benefit.

  • COVID-19 diagnostic testing provided through the QuestSelect network will continue to be covered at no-cost to members.

  • COVID-19 diagnostic testing not provided through the QuestSelect network will be covered under the outpatient lab benefit after the Plan Deductible is met. Please refer to the corresponding Plan Benefit Profile for the appropriate benefit level.

  • Over-the-counter COVID-19 tests will no longer be covered by the Plan.

It is important to note that the above changes to TeamCare benefits will become effective upon the expiration of the PHE. If, as expected, the PHE ends on May 11, 2023, the above changes will take effect on May 12, 2023.

The health and safety of our members remains important to the Board of Trustees. Although the PHE is set to expire, we encourage all members to stay safe and vigilant. As a reminder, TeamCare partners like Teladoc and CVS MinuteClinic are effective means to evaluate and treat respiratory flu-like symptoms.

Click below to download a PDF version of this special bulletin.

TeamCare Benefit Changes for COVID-19 Special Bulletin

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