UPDATED May 5, 2022

Puede ver una traducción al español de este artículo en nuestra sala de prensa.

At Blue Cross and Blue Shield of Nebraska (BCBSNE), our top priorities are to ensure the health and safety of our customers and employees and provide quality service. We continue to follow the guidance of local and federal health officials regarding the impact of COVID-19.

Please see below for important updated information about benefits for COVID-19 vaccinations, testing and treatment, as well as benefits for telehealth services.

Coverage for COVID-19 vaccinations

Approved vaccines

COVID-19 vaccines authorized by the U.S. Food and Drug Administration are a safe, effective way to reduce your risk of severe illness. Vaccines are widely available, and BCBSNE encourages members to receive their shot(s).
To view the latest vaccine information, including:

    • Approved vaccines
    • Age groups that are eligible
    • Booster shot eligibility
    • Dose requirements
    • And more

Visit the CDC’s website.

Available at no cost to most members

Most BCBSNE members will receive these approved vaccinations at no cost. Through the Coronavirus Aid, Relief and Economic Security (CARES) Act, the government is paying for the cost of the vaccine (drug) and most health plans will cover the cost of the administration and related office visit if applicable. To determine if additional administration costs may apply, please talk to your employer or call the number on the back of your BCBSNE member ID card.

Vaccine distribution

The Centers for Disease Control and Prevention (CDC) and state health departments are coordinating vaccine distribution.

To find a vaccination site and book an appointment near you, visit Vaccines.gov/Search/. For more information on the U.S. COVID-19 vaccination program, visit the CDC’s website. 

Coverage for COVID-19 testing

BCBSNE is continuing to waive member cost-sharing for medically appropriate in-network COVID-19 testing and related services through July 14, 2022*. This means members will pay nothing for medically appropriate in-network testing and related services in a telehealth session, doctor’s office, urgent care facility or emergency room.

This waiver of cost shares applies to all fully insured and self-funded groups and individual health plan members, along with those who receive their insurance through our Medicare Supplement and Medicare Advantage plans.

Medically appropriate COVID-19 tests must be ordered by a doctor or health care provider for the purpose of diagnosing COVID-19. This includes COVID-19 drive-through test sites or home test kits purchased with an order from a doctor.

Typically, the most appropriate test is the single component rapid (antigen) or PCR test, which tests only for COVID-19. Avoid having multiple or unnecessary tests, including large panel tests. Many conditions are tested for in large panel tests, only one of which is COVID-19. These may not be covered under your health plan, and you could be responsible for the entire fee (approximately $1,000).

Over-the-counter COVID-19 testing

Test kits that do not require a doctor’s order or a lab to read the results are considered over-the-counter (OTC). Beginning Jan. 15, 2022, there will be a $0 cost share for up to eight individual OTC COVID-19 tests per member per 30 days. This applies to all fully insured and self-funded groups that use BCBSNE’s pharmacy benefits manager, Prime Therapeutics, as well as individual health plan members. Federal Employee Program (FEP) members: Please visit FEPBlue.org for purchase instructions. People with Medicare should reference the Centers for Medicare and Medicaid Services (CMS) for information on obtaining OTC COVID-19 tests.

All FDA-approved OTC COVID-19 tests are eligible for reimbursement. View the list of eligible tests here. Tests purchased prior to Jan. 15, 2022, are not eligible for reimbursement.

Our pharmacy benefits manager, Prime Therapeutics, has established a preferred network of pharmacies to support members in obtaining at-home tests without member cost share. This network includes approximately 65,000 pharmacies nationwide. These preferred pharmacies can bill OTC COVID-19 tests directly to your insurance, resulting in no cost to you.*

View the list of participating Nebraska pharmacies. View the list of all participating pharmacies.

Tests purchased from a non-preferred pharmacy, online retailer or retail store can be submitted for reimbursement through the pharmacy paper claims process for OTC COVID-19 tests. These claims will be reimbursed up to $12 per individual OTC COVID-19 test. Reimbursement includes tax and shipping, if any, as long as the tax and shipping can be readily identified on the receipt. For example, a box that includes two tests would be reimbursed at a maximum of $24 (including tax and shipping). If a large pack of tests is purchased for multiple members, a claim form is required for each member, and they may use the same receipt.

Free tests are also available to order at CovidTests.gov.

COVID-19 testing for public surveillance or employment purposes is not covered. This includes testing for work, school, travel and other public surveillance reasons, unless reimbursement becomes required by law.

*Some pharmacies may not yet be able to bill your insurance directly for OTC COVID-19 tests. Members should check with their pharmacy on its policies regarding OTC COVID-19 tests. If pharmacies are not able to support direct billing, please keep your receipt and use the pharmacy paper claims process for OTC COVID-19 tests to request reimbursement.

Coverage for coronavirus treatment

As of Jan. 1, 2021, BCBSNE began applying member cost shares to treatment of COVID-19. Self-funded groups that were covering treatment of COVID-19 without member cost shares could extend that coverage past Dec. 31, 2020. Employees of self-funded groups should check with their employer to find out about their cost shares.

Coverage for telehealth

Member cost shares will continue to be waived through July 14, 2022,* for all in-network telehealth visits directly related to diagnosing COVID-19. Normal plan cost shares apply for all other covered telehealth services. 

We encourage you to reach out to your primary care provider to learn about their telehealth capabilities. You can also register to use services provided by BCBSNE’s preferred telehealth provider, Amwell. To do so, please follow the instructions found on NebraskaBlue.com/Telehealth.

Prevention tips

The CDC recommends the following preventive actions:

  • Maintain proper hygiene:
    Wash your hands frequently with soap and water for at least 20 seconds. Cover your cough or sneeze with a tissue, then throw it away. Disinfect surfaces that are touched often.
  • Limit exposure:
    Stay home if you are sick and avoid close contact with people who are ill.
  • Protect yourself and others:
    Wear a mask and practice social distancing when you are in public spaces.

Resources and information from our local provider partners

Bryan Memorial Hospital: BryanHealth.com/Coronavirus
CHI Health: CHIHealth.com/Coronavirus
Children’s Hospital and Medical Center: ChildrensOmaha.org/COVID
Methodist Hospital: BestCare.org/COVID-19
Nebraska Medicine: NebraskaMed.com/COVID

Frequently asked questions

What is COVID-19?
COVID-19 is a coronavirus first identified during an investigation into an outbreak in Wuhan, China. While other coronavirus strains have sickened people before, this is the first time this strain has been seen in humans.

How does the virus spread?
The first infections of COVID-19 were linked to a live animal market, according to the CDC. The virus now spreads from person-to-person through droplets when an infected person coughs or sneezes. If the droplets are inhaled or land in the mouth or nose of another person, they may become infected.

What are the symptoms?
COVID-19 symptoms include fever, cough and shortness of breath, according to the CDC.

What should I do if I think I have the virus?
Don’t panic. Call your doctor or use telehealth services if you have symptoms and have been in close contact with a person known to have COVID-19 or if you live or have recently traveled to an area with COVID-19 cases.

If you need to go to your doctor’s office, urgent care or the emergency room, it’s important to call ahead, so health care staff can prepare for your arrival and prevent you from accidentally exposing other patients to the virus should you have the disease.

In the event of an emergency, call 911 and tell emergency services that you might have COVID-19.

What should I do to prepare?
You should prepare for a COVID-19 infection in your household just like you would for any other emergency. Make a backup plan for work and childcare and keep extra staples, including food and medical supplies, on hand.

What COVID-19 vaccines are approved?

To view the latest vaccine information, including:

  • Approved vaccines
  • Age groups that are eligible
  • Booster shot eligibility
  • Dose requirements
  • And more

Visit the CDC’s website.

Can I get the vaccine if I’ve already been infected?

Yes, the vaccine is available to everyone, regardless of if you have a history of symptomatic or asymptomatic COVID-19 infection, according to the CDC.

How do I know if I should get the vaccine?

Your primary care doctor can best help you answer this question because they know your medical history and can guide you accordingly. Schedule time to talk with them.

Can I choose which vaccine I get?

You should talk with your doctor to determine which vaccine is best for you. This would be based on several factors, including health conditions, demographics, etc. Also, not all vaccines will be available in all geographic areas.

What will I pay for the vaccine?

At this time, the vaccine is available at no cost to you because it is currently funded through the government. However, there may be additional costs for administration. There is no cost for administration for most members. To determine if additional administration costs may apply, please talk to your employer or call the number on the back of your member ID card.

Where can I find the most up-to-date information?
For the most up-to-date information about COVID-19, visit CDC.gov/Coronavirus.

The Nebraska Department of Health and Human Services is keeping track of COVID-19’s impact on Nebraska. Visit DHHS.NE.gov for state-specific vaccine information and additional resources.

*The Department of Health and Human Services will provide a 60-day notice before lifting the public health emergency (PHE).