blue cross blue shield tn covid test reimbursement form

Health plans are offered by Blue Shield of California. Pregnant members can use this form to request a blood pressure monitor at no cost. Blue Cross Blue Shield COVID At-Home Test Reimbursement Form. OTC tests are covered with no out-of-pocket costs when purchased at the pharmacy counter for members with . this.go=function(){if(this.check()){var a=document.createElement("script");a.type="text/javascript";a.src=g;document.body&&document.body.appendChild(a)}}; If you purchased an OTC at-home test at the direction of your health care provider, please use this form: If you purchased an OTC at-home test for any other reason, please use this form: Send a copy of all your receipt(s) with the form. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. For members of all other BCBSRI heath plans You dont need to sign in to search for a pharmacy. endstream endobj 468 0 obj <>/ProcSet[/PDF]>>>>stream If you made two separate purchases and each purchase covered three members, you would need to submit six separate claim forms. hbbd```b``)n`"EV`U`*8*I2&?tq&e@$E&">I0DjE0!c`) $L*H-`l)`l3Oz's&30t%S! [& [CDATA[ Our participating pharmacy network for COVID-19 home test kits has approximately 65,000 pharmacies nationwide. The health and well-being of our members is our top priority, and we remain committed to ensuring our members and customers have access to the care and information they need. At a participating pharmacy, go to the pharmacy counter (not the store checkout) and. O=>WNW% With each claim form, you should include the same receipt. Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services, must be purchased on or after January 15, 2022, used to identify the potential COVID-19 infection, will be self-administered with results that can be self-read, will not be resold, given or supplied to persons other than family members covered under the same policy, The purchase receipt documenting the date of purchase and price, UPC** cut-out from the over-the-counter COVID-19 test packaging, Signed, completed attestation confirming and acknowledging that the purchased over-the-counter at-home COVID-19 test meets eligibility guidelines. At-home testing options and costs Updated April 15, 2022. This coverage applies to all BCBSRI health plans except Medicare. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Through May 31, all BCBS companiesincluding the BCBS Federal Employee Program (FEP)are: It is important that our members feel safe and secure during these unprecedented times, said Scott P. Serota, current president and CEO of the Blue Cross Blue Shield Association. Members should complete the OptumRx Over-the-Counter Test Reimbursement Form and include their receipts. For members of BCBSRI Medicare Advantage and Plan 65, For members of all other BCBSRI health plans. Taxes and shipping costs are eligible for reimbursement, but total reimbursement may not exceed $12 per test. c I had COVID-19 symptoms. Please note that this network may be different than your plans standard pharmacy network. The California Department of Health Care Service (DHCS) will reimburse the cost of your at-home tests purchased from March 11, 2021, to January 31, 2022. Overseas members should use the Overseas Medical Claim Form. This currently does not apply to Medicare Advantage members. Use the claims form for OTC at-home tests with a healthcare provider order. and independent licensees of the Blue Cross and Blue Shield Association. Thats why we are committed to ensuring our members who are dealing with a diagnosis of COVID-19 can easily access the care they need.. Chico, CA 95927-2540. For more information, view our privacy policy. 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