COVID-19: Coronavirus Update for U.S. Insureds
Updated: January 20, 2022
About Coronavirus (COVID-19)
Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.
Minimum Essential Coverage (MEC) Plan
The U.S. Department of Health & Human Services (HHS) has issued a revised FAQs stating that “essential health benefits” generally include coverage for the over the counter (OTC) test for the coronavirus (COVID-19). This means the OTC test would be paid like all “essential health benefits” at 100% with no deductible, copays or co-insurance. As a reminder, while the MEC plan requires that you use a First Health Network provider (Providers can be located at www.firsthealthlbp.com), in the case of the OTC tests, there is no national network for acquiring the OTC tests, but you may submit receipts up to the monthly limits for those tests to obtain a reimbursement.
Limited Benefit Medical Plans with MEC
If your plan provides a MEC and a Limited Benefit Medical Plan, the costs of the OTC test for COVID-19 will be covered under the MEC if you are enrolled in it. As a reminder, the MEC plan requires that you use a First Health Network provider (Providers can be located at www.firsthealthlbp.com). You may submit your receipts for OTC tests for reimbursement up to the monthly limit set by the HHS. All other costs for treatment will be covered like any other illness subject to the benefit limits of the policies in your plan.
Limited Benefit Medical Plans Only
If your plan does not include MEC and is a Limited Benefit Medical Plan only, the benefit for the OTC COVID-19 test is listed in the Diagnostic, Lab and X-ray section of the benefit schedule of your Certificate. The specific benefit amount for Class I Laboratory lab tests will be listed according to the plan that you have elected. If you are required to get an X-ray, it will be addressed as a Class 2 X-ray in the benefit schedule of your Certificate.
If your plan provides access to telemedicine, we strongly recommend you consider accessing this service.
PLEASE REVIEW YOUR PLAN OR CALL US FOR DETAILS
Coverage or claims questions
The federal government has created a website to order OTC Covid-19 tests to be delivered to your home with no cost to you. These tests may be ordered at https://www.covidtests.gov/
For further information about the coronavirus, please visit the sites below: