Here With You After the COVID-19 Public Health Emergency
Note: The following information applies to Health Insurance Marketplace plans.
The Department of Health and Human Services (HHS) has confirmed the federal Public Health Emergency for COVID-19 (PHE) declared by the Secretary of the Department of Health and Human Services (Secretary) under Section 319 of the Public Health Service (PHS) Act expires at the end of the day on May 11, 2023.
Effective May 12, 2023, FirstCare Health Plans coverage for COVID-19 vaccines, testing and treatment is as follows:
COVID-19 Testing and Treatment
COVID-19 Testing
COVID-19 Diagnostic Testing
Coverage of FDA-approved or authorized COVID-19 tests ordered by a physician or other healthcare provider, such as physician assistants and nurses, and performed by a CLIA certified laboratory will be in accordance with your standard medical plan benefit. Cost-sharing may apply.
COVID-19 Over-the-Counter (OTC) Tests
FirstCare Health Plans will not cover OTC COVID-19 tests effective May 12, 2023.
Surveillance Testing
FirstCare Health Plans will not cover in or out of network surveillance testing.
COVID-19 Treatment
There is no change in coverage of treatments if you are exposed to COVID-19 once the PHE ends. In cases where cost-sharing and deductibles applied during the Public Health Emergency, they will continue to apply after the Public Health Emergency.
Telehealth
Telehealth visits will be covered in accordance with your standard medical plan benefit. Cost-sharing may apply.
NOTE: If you receive routine home care via telehealth under the hospice benefit, this flexibility will end at the end of the PHE.
COVID-19 Vaccine Update
COVID-19 vaccine and booster serum and administration are part of your benefits. You will have zero out-of-pocket cost for a COVID-19 vaccination if you receive your vaccinations from an in-network provider.
Potential Schemes Related to COVID-19
Scammers are using telemarketing, text messages, door-to-door visits as well as social media to conduct their fraudulent activities. These individuals are offering COVID-19 tests, grants and prescription cards in exchange for personal information to benefit themselves and harm the public.
Ways to protect yourself from fraud, waste and abuse schemes:
- Never share information to unknown individuals. This should include date of birth, Social Security number, Medicaid or Medicare numbers, health care details, financial or other personal identifiable information. Sharing this type of information can lead to identity theft.
- Review your Explanation of Benefits (EOB) or MyBSWHealth for suspicious activity or claims.
- Ignore offers or advertisements for COVID-19 testing or treatments on social media.
- Never post photos of your COVID-19 vaccination cards on social media.
- Do not open links in text messages from unknown individuals.
- Do not trust any unexpected calls or visitors offering COVID-19 tests or supplies.
- Do not pay anyone to speed up your vaccine eligibility.
- Report suspected fraud to health plan helpline: 1-866-399-8161
What to Do if You're Sick
The COVID-19 virus and its variants are still circulating in the community. Even individuals who are fully vaccinated should remain watchful of their health.
If you feel sick with fever, cough, or have difficulty breathing and have traveled to high-risk locations or were in close contact with someone with COVID-19 in the 14 days before you began to feel sick, seek medical care.
Option 1: Stay home and visit a doctor virtually.
Option 2: Find a doctor, clinic or hospital near you.
Find a Provider
When you schedule your visit, share your concerns about your COVID-19 symptoms or exposure. Your doctor’s office, clinic or hospital will have instructions for your visit.
Option 3: If you are experiencing a medical emergency, call 911.
Notify the operator if you have COVID-19 or need to be seen for COVID-19 symptoms. If available, put on a face mask before the ambulance arrives.
Helpful Tips & Phone Numbers