The COVID-19 Public Health Emergency and National Emergency Have Ended
During the COVID-19 federal Public Health Emergency (PHE), CareFirst BlueCross BlueShield (CareFirst) enhanced our benefits to ensure our members could get the care they needed.
The federal PHE expired on May 11, 2023. As a result, effective May 12, 2023 testing for COVID-19 and in-office or virtual visit testing related services will be processed in accordance with member benefits. This includes any applicable member cost-sharing (including copay, coinsurance and deductible) and network limitations.
Additionally, CareFirst will no longer reimburse commercial members* for over-the-counter at-home COVID-19 tests if purchased after May 11, 2023. For tests purchased on or before May 11, 2023, commercial members have one year from the date of purchase to submit a claim for reimbursement.
Other benefits that are impacted include:
- Monoclonal antibody treatment for COVID-19—we will revert to imposing member cost-sharing for monoclonal antibody treatment pursuant to the member’s contract effective May 12, 2023
The following changes will revert back to their pre-National Emergency limits effective July 10, 2023.
- Timely filings—extensions and changes:
- Filing limitations for appeals, COBRA, claims filing and disability timelines; time periods for filing appeals for adverse benefit determinations, filing a request for an external review or to provide information to perfect a request for external review
- Timeframe to elect COBRA and the grace period for COBRA premium payments
- The period to request special enrollment in certain circumstances
Please note, the current telemedicine and audio-visit policies that were implemented during the PHE will remain in place and unchanged until further notice.
If your health plan covers preventive services at zero cost-share, the COVID-19 vaccine will be included as a preventive service (with the end of the PHE, out-of-network benefits may apply).
*This process applies to members with individual, employer-sponsored or student health plan coverage, as well as Federal Employee Program (FEP) and Federal Employee Health Benefits Program (FEHBP) plan members.