Member Updates & Information

Medicare will cover the diagnostic testing of the coronavirus (COVID-19). Members will have no out-of-pocket costs. Additionally, Medicare covers all medically necessary hospitalizations. This includes if you are diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. Medicare Supplement plans will pay their share of costs after Medicare pays its share of the Medicare-approved amount for covered health care costs. Medicare Supplement plans will pay Medicare Part A and Part B costs with the same cost sharing a member would normally have based on the Medicare Supplement plan they are enrolled in. For more information, visit Medicare.gov.

Members with a Medicare Supplement deductible will need to meet that deductible before their plan pays for any associated treatment.

Yes – if you are having an urgent dental issue, you may have the option to be seen by your dentist virtually – and you’ll pay the same as you would if you were seen in the dentist’s office. Coverage for these emergency virtual encounters is limited to problem-focused evaluations and follow ups only. This dental telemedicine benefit is available for the duration of the COVID-19 public health emergency. To learn more about your dental telemedicine options, please call your dentist.

Please note – CareFirst’s Video Visit does not include access to dental providers. Please call your dentist to learn more about your dental telemedicine options.

During the COVID-19 pandemic, most people have not been able to see their orthodontist except for emergency or urgent care. But some people may receive a bill even though their appointment was cancelled.

Treatments like braces require multiple visits over many months, even years. At the start of your treatment, many orthodontists work with you to create a payment plan, which may be automated. As a result, you may still be receiving a monthly bill, even though you have not been seen by your orthodontist due to the COVID-19 public health crisis. 

If you are experiencing difficulties making these payment plan payments or are concerned about owing a large payment once you can begin office visits again, CareFirst encourages you to contact your orthodontist and ask about payment options. The total amount you owe should not change, despite delays in check-in visits during the COVID-19 public health crisis.

CareFirst’s participating providers should not bill you for any costs associated with PPE. If your in-network doctor or dentist has added an additional charge, or sent you a separate bill, for PPE or other “enhanced infection control” measures,  please contact our customer service department by secure email through My Account, or call the number on the back of your member ID card. 

• Members can call our free 24-Hour Nurse Advice Line at 800-535-9700 anytime and speak with a registered nurse to discuss their symptoms and get recommendations for the most appropriate care.
• Members can also register for CareFirst Video Visit to securely connect with a doctor, day or night, through their smartphone, tablet or computer. Members can visit CareFirst Video Visit to get started – no appointment is necessary for urgent care services.

As of January 18, 2022, four free tests are available to all households through the federal government. Visit covidtests.gov, and click the blue “Order Free At-Home Tests” button. Then, complete and submit the online form. Everyone qualifies. You do not need health insurance to receive your free tests. People may also access free or affordably priced testing in the community. A list of community-based testing sites can be found here.

CareFirst covers, with no cost share to the member (including our members enrolled in high deductible health plans), the appropriate diagnostic testing for COVID-19. Beginning January 15, 2022, and for the duration of the Federal Public Health Emergency, over-the-counter tests used for diagnostic purposes that are purchased online or at a store or pharmacy will also be covered.

CareFirst does not provide benefits for COVID-19 testing for surveillance, work or social purposes, which includes but is not limited to testing conducted:

• at the direction of a member’s employer to obtain or maintain employment;
• for the return to school or to participate in school activities (e.g., sports); or
• to participate in recreational activities (e.g., concerts, public events, cruises).

This policy will apply to all CareFirst members except where testing for surveillance, work or social purposes is required by law.

Some large employers may have elected different benefits. To be sure you understand your benefits, and coverage for COVID-19 testing where you live and work, please call member services at the number on the back of your member ID card.

No. Under the new requirement from the Biden-Harris Administration, over-the-counter COVID-19 tests will be covered without a provider’s order or clinical assessment.

No. Unfortunately, CareFirst doesn’t have direct access to tests currently. We empower our members to purchase over-the-counter COVID-19 tests from a retailer of their choosing. After a claim is submitted and processed, CareFirst will provide reimbursement.

The following claims process pertains to CareFirst commercial members only. If you are a Medicare Advantage, Medigap, Medicaid or Dual Eligible Special Needs Plan member, please call the number on the back of your member ID card for benefit information. Commercial members can submit claims online by logging in to, or registering for My Account, clicking ‘My Documents’, then ‘Forms’ and selecting ‘Over-the-Counter COVID-19 Test Online Claim’ to get started. To print and mail your claim, download the claim form (PDF).

The submitted claim must also include:

• The purchase receipt documenting the date of purchase and price
• UPC from the packaging for the over-the-counter COVID-19 test
• Signed, completed attestation stating the test:
  • Was purchased on or after January 15, 2022
  • Is for a CareFirst member
  • is not for school or employment purposes
  • has not and will not be reimbursed by another source
  • is not for resale

The attestation included in our claims process ensures our members comply with the spirit of this policy: to ensure tests are accessible and affordable for those who need them.

No. CareFirst doesn’t cover the cost of tests used for these purposes. We will cover the cost of a test used for personal diagnostic use only. We will ask members to sign an attestation regarding use when submitting a claim.

No. CareFirst will reimburse members for tests purchased from a retailer of their choosing. This includes online vendors, pharmacies or stores.

Members may receive reimbursement for up to eight over-the-counter COVID-19 at-home tests per covered individual in the household per 30-day period without a healthcare provider order or clinical assessment. If multiple tests are sold in one package, i.e., if one package includes two tests, it counts as two tests and not one test package toward the quantity limit.

Medicare will cover the diagnostic testing of the coronavirus (COVID-19). Members will have no out-of-pocket costs. Additionally, Medicare covers all medically necessary hospitalizations. This includes if you are diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. Medicare Supplement plans will pay their share of costs after Medicare pays its share of the Medicare-approved amount for covered health care costs. Medicare Supplement plans will pay Medicare Part A and Part B costs with the same cost sharing a member would normally have based on the Medicare Supplement plan they are enrolled in. For more information, visit Medicare.gov.

Members with a Medicare Supplement deductible will need to meet that deductible before their plan pays for any associated treatment.