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The Federal government announced the end of the COVID-19 Public Health Emergency and this will result in changes to our health care plans and benefits.
What do I need to do? No action is required on your behalf.
When do these changes take effect? May 12, 2023 or later.
What does this mean for me? What specific benefits are changing?
Vaccines: COVID-19 vaccinations are currently covered at 100% through a Federal government-paid supply. The government will transition payment to health plans (like our ASR, BCBSM and HAP plans) when this supply runs out, expected to be this summer or early fall.
COVID-19 vaccines have been added to the Affordable Care Act (ACA) list of preventive benefits. Once the vaccines move from the government supply to our County’s health plan coverage, this coverage will continue to be covered at 100% (for in-network only). Out-of-network coverage will be subject to our plan specific benefits and may require cost share or full payment for services.
For Testing: COVID-19 testing will no longer be covered at 100%. For tests administered by a health care provider, a testing facility or a lab, employees and retirees will now be subject to applicable copays, deductibles, and coinsurance for both in-network and out-of-network services. Testing administered by a non-participating health care provider or lab will no longer be covered. Testing for employment, travel, sports and/or school purposes is excluded from this coverage.
Over-the-counter COVID-19 tests will no longer be covered whether purchased at retail pharmacies or online. However, the IRS deems these as eligible healthcare expenses. So employees can use health Flexible Spending Account (FSA) dollars to pay for the OTC tests.
For Treatment: FDA-approved or authorized treatments will continue to be covered and subject to normal member cost share (e.g. copays, deductible/coinsurance).
Currently there are drugs used for treatment that are covered at 100% through a Federal government-paid supply, and similar to vaccines, these drugs will continue to be covered at 100% until the supply runs out. At that time, the costs of these drugs will transition to health plans (like our ASR, BCBSM and HAP plans) and be subject to normal member cost share.
Where can I get more information?
More information can be found with your healthcare provider on ASRHealthBenefits.com, BCBSM.com, HAP.org or Navitus.com.
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