Apr 21, 2023
While many of the extra health care services and processes put in place by the government and Florida Blue when the COVID-19 public health emergency (PHE) have already returned to normal, others will change for members when the PHE expires at the end of the day on May 11, 2023.
Florida Blue has now released an outline of the changes that its commercial members can expect due to the expiration of the PHE:
- COVID-19 vaccines and boosters will remain at no cost for most members when using in-network providers, because they are a part of the member's wellness benefits. Florida Blue encourages members to stay up to date on all vaccines, including COVID-19 vaccines and boosters.
- COVID-19 tests and treatments are covered as a part of health plan benefits. However, they will now be subject to medical coverage guidelines and the member's normal contracted benefits and cost shares, that is, treated like any other health plan benefit. This applies to tests ordered by a health care provider and treatments provided by a health care provider or pharmacy.
- Telehealth or virtual health coverage is a standard benefit. Virtual care visits are a standard benefit for most of our members. This includes primary care providers, mental health counseling, and visits through their doctor's office or telehealth provider, including Teladoc if available through their plan. Coverage for virtual visits will be applied as outlined in the member's plan benefits.
- Over-the-Counter (OTC) COVID-19 tests available at retail stores and pharmacies will no longer be reimbursed by Florida Blue or Truli health plans. Members will still be able to purchase these, but like other at-home tests or pharmacy OTC items, they will not be covered under the health plan.
- HMO members (BlueCare, Simply Blue, Truli for Health, myBlue, myBlue Connected Care) will need to see providers in their networks to receive covered care. Coverage received from out-of-network providers will no longer be covered.
- PPO members (BlueOptions, BlueSelect) may have a higher cost share if they receive care from out-of-network providers. Care received from out-of-network providers will be subject to higher cost-sharing amounts as outlined in their plan benefits.
Members are reminded that they can find lists of local in-network providers by visiting FloridaBlue.com, by calling the number on their ID card or (877) 352-5830, or by visiting their local Florida Blue Center.
For more information, please contact your Amwins Connect Regional Sales Representative.
