April 20, 2023
The federal government has ended many of the requirements put in place during the COVID-19 public health emergency (PHE).
The end of the public health emergency (PHE) means that most of the mandates under the current PHE for COVID-19 end on May 11, 2023.
Therefore, the following changes will be effective May 12, 2023:
- At-home test kits: At-home test kits, or over-the-counter (OTC) tests, will no longer be covered as a medical expense and no longer available at no cost through pharmacies.
- COVID lab tests: Molecular and antigen lab tests for COVID and related office visits will continue per standard plan benefits but members may be responsible for cost sharing. Testing for other purposes, including return to work, is not covered.
- COVID treatment: Treatment for COVID-related illness will continue per standard plan benefits. Members may be responsible for cost sharing.
- COVID prescription treatment: Prescription drugs for treatment of COVID will be covered under standard plan benefits, with members responsible for cost sharing. We will follow the U.S. Food and Drug Administration (FDA) approval process as treatments move from emergency use authorization (EUA) to full approval.
- COVID vaccines: COVID vaccines are covered under the Affordable Care Act as preventive benefits. Members with preventive benefits coverage will continue to receive vaccinations with no cost shares; member cost shares may apply under some plans after May 11, 2023.
Additional changes:
- Extension of timely filing: Some requirements for filing of appeals, claims, and COBRA will revert back to standard timelines beginning July 11, 2023.
Resources:
Employer – COVID FAQ: https://www.premera.com/wa/employer/coronavirus-faq/
Member – COVID information page: https://www.premera.com/visitor/outbreaks
For additional information about the end of the public health emergency for COVID-19, the U.S. Department of Health & Human Services published a fact sheet (Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap | HHS.gov).
For questions about your benefit plans and what is covered, contact your Premera representative or producer.