How is testing and treatment of COVID-19 covered by my medical plan?

ANSWER

At the outset of the pandemic, the Trust elected to waive member cost share for treatment related to COVID. As average daily COVID-19 cases and hospitalizations continue to drop amid widespread vaccine adoption, we’re at an important turning point for our country and community. CareFirst Administrators has revisited with the Trust some of the benefits we enacted at the height of the pandemic.

Effective September 1, 2021, the Trust is ending member cost share waivers for COVID-19 treatment. Providers may collect the appropriate member cost share (copay, coinsurance, and deductible) for treatment rendered on and after September 1, 2021.

In keeping with local and federal requirements, the cost share waiver (that means no cost to members) will continue for the following until further notice:

  • Visits (in all settings) associated with diagnostic COVID-19 testing
  • Diagnostic COVID-19 tests
  • FDA-authorized COVID-19 antibody tests

The COVID-19 vaccination is not considered treatment and will remain at zero cost share for members.