Throughout the COVID-19 pandemic, Independence Blue Cross (Independence) has remained committed to helping members access the care they need. Now that the national Public Health Emergency (PHE) is set to end on May 11, 2023, Independence will be updating the following policies:
-
Timely filing of claims: Effective July 11, 2023, Independence will no longer waive the timely filing requirements. Claims incurred on or after July 11, 2023 must be submitted within 365 days.
-
COVID-19 testing: Effective May 12, 2023, standard cost-sharing will be applied, in accordance with a member's benefits, for FDA-authorized COVID-19 tests, including diagnostic tests (RT-PCR and Antigen tests). When medically necessary, testing will continue to be covered when prescribed by health care providers for individuals who have signs and symptoms of COVID-19 and/or who may have been exposed to the COVID-19 virus. For Keystone HMO Children's Health Insurance Program (CHIP), testing will continue to be covered through September 30, 2024, as it had been during the PHE.
-
Any COVID-19 testing done for screening or public health surveillance purposes, or tests without FDA authorization, will continue to be excluded from coverage. Independence will continue to cover nonprescription over-the-counter (OTC) tests for CHIP members per federal regulations. Other than for CHIP, Independence will no longer reimburse for nonprescription OTC COVID-19 tests. If a member has a Health Savings Account (HSA) or a Flexible Spending Account (FSA), they can submit for reimbursement through those programs. Testing will continue to be covered when medically necessary.
-
COVID-19 vaccination: The administration of the COVID-19 vaccine will continue to be covered at no cost to the member when obtained from an in-network provider. If the vaccine is administered by an out-of-network provider, standard cost-sharing will apply. Members should check their benefits to confirm whether they have out-of-network coverage. For CHIP, vaccination administration will continue to be covered through September 30, 2024. At the present time, the COVID-19 vaccine product will continue to be provided by the Federal government. Once the Federal government supply ends, Independence will cover the cost of the COVID-19 vaccine product as it is considered preventative.
-
COVID-19 treatments: Effective May 12, 2023, Independence will no longer waive cost-sharing for drugs/biologics for the treatment of COVID-19. For CHIP members, however, we are required by federal law to cover drugs/biologics without cost-sharing for COVID-19 treatments through September 30, 2024. Further, for Medicare Advantage members, the Consolidated Appropriations Act of 2023 permitted Part D plans to cover drugs that remain authorized under an EUA until December 31, 2024, and cost-sharing may apply to Part D enrollees.
-
Telemedicine visits: Effective May 12, 2023, standard telemedicine cost-sharing will apply for all telemedicine visits with a member's primary care provider (PCP) and specialists regardless of a COVID-19 diagnosis. Standard telemedicine cost-sharing will also apply for all virtual visits with a behavioral health provider. Independence will no longer waive cost-sharing for a COVID-19 diagnosis. For CHIP, telemedicine visits for the purpose of COVID-19 testing/treatment will be covered with zero cost-share through September 30, 2024.
Providers should communicate these COVID-19 coverage updates to their office staff and patients. We will follow up this article with additional communications that include links to these updated policies.
For more information on COVID-19 updates, visit the Provider Hub.