The Biden Administration ended the COVID-19 public health emergency on May 11, 2023. Some COVID-19 coverage has changed with the end of the public health emergency. Members’ standard benefits apply to testing and treatment of COVID-19. Benefits for members of self-funded plans may vary. See our member site for more information.
Check eligibility and benefits for details on each member’s benefits. Use Availity® Essentials or your preferred vendor.
Lab tests to diagnose COVID-19 are covered at the member’s regular benefit level at both in-network and out-of-network providers. Benefits for members of self-funded plans may vary. Check eligibility and benefits for details on each member’s benefit.
Over-the-counter COVID-19 diagnostic tests are not covered. Benefits for members of self-funded plans may vary. Check eligibility and benefits for details on each member’s benefits.
Testing-related visits are covered at the member’s regular benefit level.
COVID-19 vaccines that are FDA-authorized are covered at the member’s preventive benefit level. Some groups may not cover preventive services, including COVID-19 vaccines. Check eligibility and benefits for details for each member. The American Medical Association released six new Current Procedural Terminology (CPT®) codes for Pfizer’s and Moderna’s vaccines and their administration, effective Sept. 11, 2023. Learn more here.
COVID-19 treatment with FDA-authorized oral anti-viral prescription medicines may be covered under our members’ pharmacy benefits. Members’ cost share will vary according to their benefit plan.
Medicare members: All services are covered according to the member’s current plan rules. See our Medicare Alerts and Announcements for more information.
Telemedicine coverage is available, according to the member’s regular benefit level. Check our telemedicine page for more details.
Check Member Eligibility and Benefits
Benefits for members of self-funded plans may vary. Use Availity® Essentials or your preferred vendor for eligibility and benefit verifications.