COVID-19 FAQs

Updated on 12 de maio, 2023

Over the last few years, your BCBSRI health plan has included temporary coverage to help you access care during the COVID-19 pandemic. The federal Public Health Emergency has now ended, so coverage generally reverts to the standard benefits in your plan. This means that coverage for COVID-related services generally is treated the same as other services in your plan.

These FAQs apply to plans in the individual, Medicare, small group, and large group fully insured markets except where noted. Some employers have opted out of some of these changes. If you have questions about your benefits, please check with your employer or call BCBSRI Customer Service at the number on the back of your member ID card. You can also find more information about your benefits by logging in to myBCBSRI.

Care and benefits

Sim. The vaccine itself will be made available to healthcare providers at no cost. Your BCBSRI health plan will cover the cost for the vaccine to be administered. You will not pay any costs when you receive the vaccine from a pharmacy or other provider approved by the government. 

The vaccine’s availability will be based on the phased distribution schedule being developed by each state. The plan enables everyone to be vaccinated but not all at once. When the vaccine is available to you, you’ll be able to receive it at a pharmacy or from a provider. You can find more information on COVID-19 vaccines through the Rhode Island Department of Health and the Centers for Disease Control and Prevention.

There should be no costs, as the government-approved pharmacy or provider should bill BCBSRI directly. If you do get a bill, please call us for assistance.
 

The type of vaccine available will depend on the geographic location and provider. However, your coverage will be the same for all approved COVID-19 vaccines.
 

Yes, we have made temporary changes to our policies to help you access the care you need—with no added worries about cost. You will not pay any copays, deductibles, or other cost-sharing for medically appropriate:

  • Doctors' visits, urgent care or emergency room visits that result in COVID-19 testing.
  • Treatment for COVID-19 including emergency services, inpatient services, and provider office visits when received in-network.1

You do not need preauthorization or a referral for these services.

1Not all employers have chosen to cover all of these services without cost share. Please check with your employer to see if these temporary benefits are available under your plan.

The Rhode Island Department of Health recommends testing for anyone with COVID-19 symptoms and close contacts of people with COVID-19. For other testing recommendations, including for people without symptoms, please see the Rhode Island Department of Health website.

You will not pay any copays, deductibles, or other cost-sharing for medically appropriate COVID-19 testing ordered by a provider, and you do not need preauthorization or a referral for testing. 

Please note that testing is generally not covered by your BCBSRI health plan if you have no symptoms and no suspected exposure to COVID-19.

However, all Rhode Islanders can get free COVID-19 testing through the Rhode Island Department of Health, even if they don’t have symptoms. Testing for people without symptoms or exposure may not be free in states other than Rhode Island. 

You can find information about testing sites on the Rhode Island Department of Health website. The Rhode Island Department of Health also has a COVID-19 Info Line at (401) 222-8022. After hours, you can call 211. 

Anyone experiencing symptoms of COVID-19 should not go to a doctor’s office, urgent care center, or emergency room without calling their doctor first (except in a medical emergency).

To be covered by your BCBSRI health plan, your COVID-19 test must be medically appropriate and ordered by a healthcare provider. This includes testing for people who have been exposed or may have been exposed to someone with COVID-19. It does not include testing for people without symptoms and no suspected exposure. Also, it does not include testing for people without symptoms who are traveling or returning to school/work.

However, all Rhode Islanders can get free COVID-19 testing through the Rhode Island Department of Health, even if they don’t have symptoms. Testing for people without symptoms or exposure may not be free in states other than Rhode Island.

You can find information about testing sites on the Rhode Island Department of Health website. The Rhode Island Department of Health also has a COVID-19 Info Line at (401) 222-8022. After hours, you can call 211.

Testing for people without symptoms and no suspected exposure to COVID-19 is not covered by your BCBSRI health plan. To be covered by your BCBSRI health plan, your COVID-19 test must be medically appropriate and ordered by a healthcare provider. This includes people with COVID-19 symptoms and people have been exposed or may have been exposed to someone with COVID-19.

However, all Rhode Islanders can get free COVID-19 testing through the Rhode Island Department of Health, even if they don’t have symptoms. Learn more about these tests on the Rhode Island Department of Health website. Please note that testing for people without symptoms or exposure may not be free in states other than Rhode Island. 

Whenever possible, in-network providers should be used for COVID-19 testing and treatment. For COVID-19 testing, BCBSRI covers out-of-network providers at no cost when testing is ordered by a healthcare provider. For COVID-19 treatment, your out-of-network benefit applies. In-network COVID-19 treatment is temporarily covered at 100% for emergency services, inpatient services, and provider office visits.* 

*Not all employers have chosen to cover all of these services without cost share. Please check to see if these temporary benefits are available under your plan.

Yes, FDA-approved at-home testing kits are covered if you have an order or prescription from a doctor or other provider.

Sim. If COVID-19 antibody testing is ordered for you by your healthcare provider and is consistent with the Centers for Disease Control and Prevention (CDC) guidelines, you will not pay any copays, deductibles, or other cost-sharing. You do not need preauthorization or a referral for testing. An antibody test can tell you if you had a previous infection of COVID-19. It may not be able to show if you have a current infection, because it can take one to three weeks to make antibodies after symptoms occur.

Yes, you have coverage for clinically appropriate video and phone visits from certain in-network providers. This telemedicine coverage is a standard part of your BCBSRI health plan and is in addition to the video visits available through BCBSRI Doctors Online if that service is available with your plan. Your cost share for COVID-19-related telemedicine treatment will continue to be covered without any copays, deductibles, or other cost sharing.* Please see below for details about your coverage.

For members with coverage through their employers or who buy a plan through HealthSource RI or directly from BCBSRI (except a Medicare plan)

  • For in-network providers 
    You’ll be able to access a comprehensive list of services via video or phone. This includes visits with primary care providers, specialists, and therapists. If your plan requires a referral to see a specialist, you’ll need to get that referral for telemedicine visits as well as in-person visits. Your share of the cost will follow your standard benefits as outlined in your benefit booklet or subscriber agreement.
     
  • For BCBSRI Doctors Online (if that service is available with your plan)
    You’ll pay the designated telemedicine provider cost share in your subscriber agreement or benefit booklet. Doctors Online provides access to top-rated, board-certified doctors via smartphone, tablet, or computer. You can receive 24/7 care for common, non-emergency health concerns as well as pre-schedule virtual behavioral healthcare appointments with licensed therapists and psychiatrists. Referrals for Doctors Online are not needed. Find out how to register for Doctors Online

For members with a Medicare Advantage plan 

  • For in-network providers 
    You have $0 coverage for clinically appropriate video and phone visits from certain primary care and behavioral health providers, including in-network primary care providers, clinical psychologists, registered dietitians, and clinical social workers. During the COVID-19 pandemic, you also temporarily have telemedicine benefits for select other providers at the same cost share you’d pay for an in-person visit. These providers include specialists, chiropractors, urgent care centers, retail-based clinics, and diabetes educators. If your plan requires a referral to see a specialist, you’ll need to get that referral for telemedicine visits as well as in-person visits.
     
  • For BCBSRI Doctors Online 
    You pay $0 for services received through BCBSRI Doctors Online, which provides access to top-rated, board-certified doctors via smartphone, tablet, or computer. You can receive 24/7 care for common, non-emergency health concerns as well as pre-schedule virtual behavioral healthcare appointments with licensed therapists and psychiatrists. Referrals for Doctors Online are not needed. Find out how to register for Doctors Online

For members with Plan 65

  • For providers 
    You’ll be able to access a comprehensive list of services via video or phone for $0. This includes visits with primary care providers, specialists, and therapists. 

*Not all employers have chosen to cover all this service without cost share. Please check with your employer to see if this temporary benefit is available under your plan.

In addition to the BCBSRI Doctors Online service, other platforms are available for your in-network provider to use. The federal government has approved several other apps for telemedicine visits:

  • Apple FaceTime
  • Facebook Messenger video chat
  • Google Hangouts video
  • Skype

Applications that are more public, such as Facebook Live, Twitch, and TikTok, should not be used.

These tips can help you keep your information confidential while you are using video to talk with your doctor:

  • Find a private location within your home or wherever you are using it so there is no one looking over your shoulder or listening to you.
  • Don’t use a public computer, and try not to use a public or unsecured internet connection.
  • Make sure you know who you’re talking to. If you’re not sure, verify the provider’s phone number and call their office to confirm.
  • Be on guard against unsolicited calls offering services, such as COVID-19 testing, or medications or supplements that offer protection from COVID-19.

If your BCBSRI plan includes coverage for Doctors Online, you can video chat with a board-certified doctor or licensed therapist on your smartphone, tablet, or computer. BCBSRI Doctors Online is available for common, non-emergency health issues 24/7 as well as for scheduled therapy sessions and psychiatry visits.  

You can download the BCBSRI Drs. Online1 app from the Apple App Store or Google Play2 or visit drs-online.com. Tenha as suas informações de identificação de membro BCBSRI à mão.

1BCBSRI Doctors Online is not available with all plans. Em caso de emergência, deve ligar sempre para o 911. O Doctors Online não se destina a substituir estes serviços e não deve ser usado nessas circunstâncias. O Doctors Online é um serviço de telemedicina fornecido pela American Well®, uma empresa independente que administra o Doctors Online em nome da BCBSRI.

2Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store é uma marca de serviço da Apple Inc. Google Play é uma marca comercial da Google Inc.

The CDC recommends the flu shot for everyone six months of age and older. Here’s why getting a flu shot is more important than ever this year:

  • The flu vaccine prevents tens of thousands of hospitalizations each year.
  • You can get the flu and COVID-19 at the same time.
  • Getting vaccinated may also protect those around you.

As a BCBSRI member, you can get a flu shot at no cost at participating pharmacies, in-network doctors' offices, and Rhode Island flu clinics.* In addition to the flu shot, a nasal spray flu vaccine is available for those ages 2 to 18. Please note that BCBSRI Medicare Advantage members can get their flu shot at any out-of-state pharmacy, even if it is not in the participating pharmacies list. Find out where to get a no-cost flu shot at bcbsri.com/flu

Due to the COVID-19 pandemic, there may be different procedures in place for getting your flu vaccine than in other years, so please check with the location.

*This benefit is not available to Plan 65 members or members who only have dental coverage from BCBSRI.

As a BCBSRI member, you can get a flu shot at no cost at participating pharmacies, in-network doctors' offices, and Rhode Island flu clinics.* In addition to the flu shot, a nasal spray flu vaccine is available for those ages 2 to 18. Please note that BCBSRI Medicare Advantage members can get their flu shot at any out-of-state pharmacy, even if it is not in the participating pharmacies list. Find out where to get a no-cost flu shot at bcbsri.com/flu.

*This benefit is not available to Plan 65 members or members who only have dental coverage from BCBSRI.

Because some symptoms of flu and COVID-19 are similar, it may be hard to tell the difference based on symptoms alone, and testing may be needed to help confirm a diagnosis. Learn about the similarities and differences between the flu and COVID-19 on the CDC website. It is possible to have COVID-19 and the flu at the same time. BCBSRI members can find out where to get a no-cost flu shot at bcbsri.com/flu.

*This benefit is not available to Plan 65 members or members who only have dental coverage from BCBSRI.

Under the guidance of The Centers for Medicare & Medicaid Services (CMS), BCBSRI has made a temporary change to our referral policy to help our Medicare Advantage members access the care they need during the public health emergency associated with COVID-19—with no added worries about cost. Effective 1 de março, 2020, we are waiving all referral requirements for our Medicare Advantage plans—regardless of plan. Any Medicare Advantage claims that were denied for not having a referral with a date of service of 1 de março, 2020, or after will be adjusted, and we will make the appropriate payments.

Under the guidance of The Centers for Medicare & Medicaid Services (CMS), BCBSRI has made a temporary change to our provider policy to help our Medicare Advantage members access the care they need during the public health emergency associated with COVID-19—with no added worries about cost. Effective 1 de março, 2020, we are providing the same cost-sharing for both in- and out-of-network services. Any Medicare Advantage claims that were charged an out-of-network claim rate with a date of service of 1 de março, 2020, or after will be adjusted, and we will make the appropriate payments.

We have reopened all Your Blue StoreSM locations with new protocols. We also are offering online exercise and mindfulness classes as well as educational workshops at Your Blue StoreSM Studio. Join us at Your Blue Store Studio LIVE on our Facebook page every weekday at 10h00 and 14h00 If you can’t make the live classes, you can view the videos anytime on the BCBSRI Facebook page. We offer 10 different classes each week, and all fitness levels are welcome.*

*If it's been a while since you've exercised or you have health issues or concerns, it's a good idea to talk to your doctor before starting to exercise.

We’ve extended our standard time frame for submitting claims during the public health emergency. We won’t count time after 1 de março, 2020 and before the end of the emergency toward the 365-day timeframe to submit claims.

We’ve extended our standard time frame for filing an appeal during the public health emergency. We won’t count time after 1 de março, 2020 and before the end of the emergency toward the 180-day time frame to file an appeal.  

Effective 1 de dezembro, 2020, your doctor does not need to get prior authorization for:

  • The following in-network services: inpatient facilities, long-term care facilities, inpatient rehabilitation, skilled nursing facilities, and telemedicine
  • Treatment for COVID-19, including emergency services, inpatient services, and professional services when received in-network
  • Inpatient services related to COVID-19 that are received out-of-network

Please note that this is a temporary change. Your doctor will need to request prior authorization for any other services as indicated in your subscriber agreement. 

The app provides Rhode Islanders access to resources that may be helpful during the public health crisis, including a location diary that helps users identify the people and places they are in contact with and a symptom diary. The State is encouraging all Rhode Islanders to use the CRUSH COVID RI app.

Download on the App Store
Get it on Google Play

About COVID-19

COVID-19 is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China.

Read about symptoms and find the Self-Checker tool on the CDC website.

There are now authorized vaccines to prevent COVID-19 in the United States. Find out more on the CDC website.

COVID-19 is thought to spread mainly through close contact from person to person, including between people who are physically near each other (within about 6 feet), mainly through respiratory droplets. People who are infected but do not show symptoms can also spread the virus to others. On the CDC website, see How COVID-19 Spreads.

Yes, the CDC has recommendations for people at high risk. You can find detailed information on the CDC website.

Under the Governor’s Executive Order, everyone in Rhode Island must wear face coverings when in a public place, both indoors and outdoors, with limited exceptions. For information about those exceptions and additional information about masks, please see this Reopening Rhode Island advisory sheet

Quarantine is for people who are not sick but may have been exposed to COVID-19. For information on who must quarantine, please visit the Rhode Island Department of Health.

On the CDC website, you’ll find detailed information on what to do if you are sick or if you are caring for someone who is, including how to keep others from getting sick, emergency warning signs, and tips for disinfecting your home.

Please see these tips for protecting yourself and others from COVID-19.

Testing and treatment

COVID-19 home tests are now covered at $0 only when you have an order or prescription from your provider. Some employers may not offer this benefit, so check with your HR or benefits administrator.

If you have a provider’s order or prescription for a home test, you can submit a claim for reimbursement electronically by logging in to myBCBSRI.com.

For members of all BCBSRI health plans except Medicare Advantage and Plan 65
If you purchased home test kits before 12 de maio, 2023, you have a year to submit a reimbursement form

Coverage has reverted to your standard benefits. Copays, deductibles, and other cost sharing may apply.

COVID-19 lab tests are covered for $0 only when you have an order or prescription from your provider.*

*Not all employers have chosen to cover this benefit without cost share. Please check with your employer. 

Testing for people without symptoms and no suspected exposure to COVID-19 is not covered by your BCBSRI health plan.

COVID-19 testing will continue to be covered with no copays, deductibles, or other cost sharing. Because the provider is not contracted with us, however, we cannot control how they communicate charges to you.

Yes, if you have a BCBSRI Medicare Advantage plan that includes a quarterly OTC allowance, you can use it to buy COVID-19 home test kits. To use your quarterly OTC benefit, you must buy the home test kits in store through the national retailers in your OTC network or through NationsBenefits.

Telemedicine

You continue to have coverage for clinically appropriate video and phone visits from primary care providers, specialists, and therapists. Your share of the cost is the same as for an in-person visit.  For those video and phone visits that had been covered with no copays, deductibles, or other cost sharing during the public health emergency, coverage has reverted to your standard benefits.

Vaccine FAQs

Sim. Vaccines for COVID-19 will continue to be covered at no cost. Find a COVID-19 vaccine location.

Coverage of COVID-19 vaccines for out-of-network providers will continue to be covered with no copays, deductibles or other cost sharing. Because the provider is not contracted with us, however, we cannot control how they communicate charges to you.

Rhode Islanders can get a copy of their COVID-19 vaccine record through portal.ri.gov/VaccineRecord. You can call the Rhode Island Department of Health at (401) 222-8022 for help. Please note that only people who have received their COVID-19 vaccination in Rhode Island will be able to look up their vaccination record online.

The above information is a summary of benefit and practice changes that apply at this time, and is subject to change. Não é um contrato. For details about coverage, including any limits and exclusions not noted here, please call us at (401) 459-5000 or 1-800-639-2227 (TTY/TDD: 711).

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