The Next Phase in COVID-19 Healthcare Coverage

• COVID-19 vaccines will be covered under preventive benefits at applicable plan cost-sharing, typically $0.
• COVID-19 PCR testing will be covered under the outpatient diagnostic lab benefit at the applicable plan cost-sharing.
• COVID-19 over-the-counter (OTC) antigen tests will not be covered, consistent with current plan coverage that does not cover OTC tests.
• COVID-19 treatment will be covered under the drug benefit with applicable plan cost-sharing.
• Out-of-Network (OON) Services for COVID-19 (e.g., OTC antigen tests, treatment, and vaccines) will only be covered for urgent care and emergency services when legally required.

• Covered as Preventive:
  COVID-19 vaccines will be covered under the preventive benefit, same as the flu shot, at 100 percent in-network only at a doctor’s office.
• Covered as medically necessary/appropriate with an applicable cost share based on plan design and place of service:
  • PCR lab testing: coverage under your lab benefit
  • FDA-approved antivirals and therapeutics
  • COVID treatment
• No longer covered:
  Over-the-counter (OTC) COVID-19 tests. The Internal Revenue Service does consider these tests eligible medical expenses reimbursable under health savings accounts and flexible spending accounts. Customers may use funds to pay for OTC kits separate from the health plan.