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


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 duration of the public health emergency (through May 11, 2023):

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

Beginning May 12, 2023 member cost share for these services will be applied.

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