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COVID-19 Coverage for Members

Vaccine | Testing and Treatment | Prescription Coverage | Mental Health Services | Telemedicine

Your health is always our priority. Your Blue Cross and Blue Shield of New Mexico (BCBSNM) health plan gives you access to the care you need during the COVID-19 pandemic.

With a BCBSNM health plan, you have access to care for COVID-19 related health issues. Use the doctors, labs and facilities in your BCBSNM health plan’s provider network for:

  • Lab tests to diagnose COVID-19
  • COVID-19 testing-related doctor’s visits
  • COVID-19 treatment

Most changes will end with the end of the public health emergency. Some may end sooner, depending on your plan.View effective coverage dates.

COVID-19 Vaccine

With a BCBSNM health plan, you have access to the COVID-19 vaccine at no cost to you. Talk with your doctor about when you should take the vaccine once available and discuss any questions you have about the vaccine.

While most plans cover the COVID-19 vaccine at no cost, some self-funded groups do not cover preventive services, including the COVID-19 vaccine. If you are unsure what your plan covers, contact your company’s benefits administrator or call BCBSNM Customer Service at the number listed on your member ID card.

Testing and Treatment

Getting Tested

If you think you may have the virus or have been exposed to someone who has it:

  • Call your doctor right away. Your doctor can order a COVID-19 diagnostic test and coordinate your testing at an in-network lab. If you don’t have a primary care doctor, we can help you find one. Call us at the Customer Service number listed on your BCBSNM member ID card.
  • You can also find an in-network doctor by logging in to Blue Access for MembersSM or downloading the BCBSNM app1 to use our Provider Finder®.

Some things to know about testing:

  • Your health plan covers FDA-authorized diagnostic testing for the COVID-19 virus.
  • Some testing locations may not be in your health plan’s network.
  • Some labs may not provide testing without a doctor’s order.

A note about antibody tests: Serology tests detect the presence of antibodies produced after exposure to the virus. While the tests are available, it remains uncertain whether antibodies will protect you against reinfection with COVID-19. The Centers for Disease Control and Prevention (CDC) does not recommend serology tests to determine when it is safe for a person to return to work or school.

Office Visits and Treatment

Your doctor will help guide your care. If you test positive for COVID-19, follow up with your doctor’s office so they can plan next steps. If you start to feel worse, let your doctor know. Telemedicine is the most convenient and safest way to get medical care without leaving home.

Your health plan also covers emergency and inpatient hospital care for COVID-19 at your regular benefit level. Seek emergency medical care immediately if you have:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability or difficulty waking or staying awake
  • Bluish lips or face

For those times when you can’t get in to see your doctor and it’s not an emergency, you can visit an in-network urgent care center. They offer primary care services and the wait time can be much shorter than an ER visit. And they can let you know if you need emergency care.

COVID-19 Costs

BCBSNM is waiving your share of the costs for COVID-19 testing and testing-related visits.

This means:

  • Lab tests to diagnose COVID-19 are covered at no cost.
  • Testing-related visits are covered at no cost to you when you see a primary care provider in your health plan’s network, either in person or using telemedicine.
  • Cost-sharing is also waived for COVID-19 treatment if you are a member in a fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, or Medicaid plan. The cost-sharing waiver ends with the end of the Health and Human Services (HHS) public health emergency for individual plans.
  • For BCBSNM fully insured group and Interagency Benefits Advisory Council (IBAC) members, there is no projected end date for the cost-sharing waivers for COVID-19 related testing and treatment.
  • For Medicare (excluding Part D) and Medicare Supplement members, cost-sharing was waived for COVID-related treatment from April 1 through Dec. 31, 2020. As of January 1, 2021, members will be responsible for the out-of-pocket costs associated with claims for treatment.

Many self-funded groups are also waiving cost-sharing for COVID-19 treatment. Their dates of cost-sharing waivers may differ.

If you are unsure what your plan covers, contact your company’s benefits administrator or call Customer Service at the number listed on your member ID card.

Remember to use your BCBSNM member ID card for your doctor’s visit and testing to help with the reimbursement process.

Prescription Coverage

It’s important that you have your medicine on hand at all times. Make sure you keep your refills current and reach out to your doctor before the last refill runs out. Your plan also may include the option to get up to a 3-month supply of certain drugs.

Many drug stores may offer delivery options. If part of your plan, you can also sign up online or call the number on your BCBSNM member ID card for mail-order delivery of 90-day supplies with AllianceRx Walgreens Prime2.

Talk with your doctor or pharmacist about your options. Remember, your care is always between you and your doctor.

Mental Health Services

Coping with the stress and anxiety of COVID-19 can be overwhelming. Remember to take care of your mental health. Your health plan covers mental health services, including counseling.

  • If you need help, call your primary care doctor. They may be able to see you without you having to leave home, using telemedicine. Or they may refer you to someone who specializes in mental health counseling and treatment.
  • Many BCBSNM health plans include 24/7 phone access to licensed mental health care specialists as part of the mental health coverage. The number may be listed on your member ID card, or you can call Customer Service to find out if you have this benefit.
  • Find free COVID-19 mental wellness support from Livongo’s myStrength3.

Telemedicine

Depending on your health plan, you may be able to see a provider in your health plan’s network virtually.

Your telehealth benefits give you access to care while reducing the risk of exposure to COVID-19.

Telemedicine benefits may differ based on your plan. Call the Customer Service number listed on your member ID card if you have questions about your coverage.

Call your doctor’s office to learn more about its telemedicine offerings.

Our Bilingual 24/7 Nurseline4 is also here to discuss any health concerns and can guide you if you think you’ve been exposed to COVID-19 or have symptoms. Nurses are available 24 hours a day, 7 days a week at 800-581-0368.

1To download the app, text BCBSNMAPP to 33633 or search for BCBSNM in the Apple App Store or Google Play. Message and data rates may apply.

2Blue Cross and Blue Shield of New Mexico (BCBSNM) contracts with Prime Therapeutics® to provide pharmacy benefit management and related other services. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is an online resource offered by Prime Therapeutics.

3myStrength is an independent website for Behavioral Health sponsored by Livongo. You acknowledge that you are voluntarily accessing and using the resources found on the site and consent that Livongo may provide Blue Cross and Blue Shield of New Mexico with an aggregate number of individuals who accessed the website link.

4The 24/7 Bilingual Nurseline may not be available with all plans. Check your benefits booklet for details.