Novel Coronavirus (COVID-19)

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.


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.

FirstCare Health Plans has teamed up with MDLIVE to provide access to board-certified doctors 24 hours a day, seven days a week.

To visit with a doctor:

  • Log into your member portal;
  • Download the MDLIVE mobile app; or
  • Call and speak to an MDLIVE representative at 1-800-718-5082

After your visit, prescriptions (if needed) will be sent immediately to your preferred pharmacy.

Option 2: Find a doctor, clinic or hospital near you.

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.


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