COVID-19 expanded benefits update

There is a new COVID-19 update for members covered by Arkansas Blue Cross and Blue Shield and Health Advantage (fully insured health plans).

Arkansas Blue Cross and Health Advantage are committed to the safety and well-being of our members. Since the beginning of the COVID-19 public health emergency, we have been working closely with the state and federal government during the coronavirus outbreak to help our fully insured members get access to the care they need during the coronavirus outbreak.

Status of COVID-19 expanded benefits

At the outset of the COVID-19 public health emergency, Arkansas Blue Cross and Health Advantage temporarily extended a number of voluntary, expanded COVID-19-related benefits and suspended some of our normal practices.

Of course, those measures covered under federal mandates will remain in force until federal officials advise that they may be discontinued. Officials have announced the federal mandate will continue through July 15, 2022.

But now that COVID-19 infection rates have decreased markedly and the state health emergency is no longer in effect, some of the voluntary temporary measures put into place by Arkansas Blue Cross that are not specifically required by the federal mandate are being discontinued as of July 31, 2022.

Please note: Decisions about coverage changes for members of self-funded health plans served by BlueAdvantage Administrators of Arkansas or Health Advantage are made by the employers or plan sponsors who fund those self-funded programs.

Here is an update on the status of COVID-19-related benefits and measures:

1) Coverage (at no cost to our members) of COVID-19 diagnostic tests ordered by healthcare providers – and an initial medical exam that prompts a provider-ordered COVID-19 test.

This applies to diagnostic testing services that meet primary coverage criteria for COVID-19 as defined by the Centers for Disease Control & Prevention (CDC) and are ordered by a healthcare provider. It also includes an initial medical exam that results in a provider-ordered COVID-19 test. For COVID-19 tests and the initial exams that prompt them, providers should not collect cost-sharing amounts from the member while this voluntary temporary measure remains in force.

This measure will remain unchanged and in force until the public health emergency declaration is terminated by the federal government.

2) Waiver of cost-sharing for medical services (beyond the initial exam that prompts a provider-ordered COVID-19 test) for our fully insured members whose primary diagnosis is COVID-19.

This includes COVID-19-specific visits to an in-network medical clinic, urgent care center and/or emergency room and inpatient treatment for which COVID-19 is the primary diagnosis. This excludes, however, an initial medical exam that results in a provider-ordered COVID-19 test.

This measure will be discontinued as of July 31, 2022. As of August 1, 2022, healthcare providers should resume collecting member cost-sharing.

When the termination date is known of the federal public health emergency, we will give healthcare providers 90 days’ notice before discontinuing the current COVID-19-related measures that are remaining in force. The federal government is only giving providers a 60-day advance notice.

If you have questions about the status of COVID-19-related benefits and related member cost-sharing, please contact your Arkansas Blue Cross representative.

Thanks for your continued commitment to serve our members.