As the COVID-19 outbreak continues, TAC Health and Benefits Services (HBS) staff are closely monitoring the situation and are working to remain responsive to the needs of TAC Health and Employee Benefits Pool (TAC HEBP) members.
We offer the following information to assist our members. Please check back for updates.
Last updated: 1/23/2023
Currently, HBS is operating as normal with no changes to our standard business practices in services to TAC HEBP Members.
Our staff is available to receive phone calls and emails requesting assistance with questions and concerns. You can reach your Employee Benefits Specialist or other staff at the same telephone number or email you normally use. Visit the HBS Contacts page to find contact information for the staff who serve you.
Blue Cross Blue Shield of Texas Customer Care: 855-357-5228 between 7 a.m. and 7 p.m. CST.
Navitus (prescription drug benefits) Customer Care: 844-268-9789, 24 hours a day, 7 days a week.
COVID-19 Health Benefits Info for TAC HEBP Members
No member cost-sharing (copays, deductible or coinsurance) will be required for COVID-19 testing and testing-related services for as long as the Public Health Emergency Declaration is in effect (as determined by the federal Department of Health and Human Services). The declaration was renewed on Jan. 11, 2023 for an additional 90 days. Once the emergency Public Health Emergency Declaration expires, COVID-19 testing will be treated like any other medical condition, that is, subject to copay, deductible and coinsurance as applicable.
NOTE REGARDING AT-HOME COVID-19 TEST KITS:
Beginning Jan. 15, 2022, members covered by a group health plan will be able to purchase over-the-counter COVID-19 tests authorized by the U.S. Food and Drug Administration (FDA). The cost of each kit, up to $12 per kit, will be covered by the health plan. Kits can be purchased at pharmacies that are part of the Navitus network. See details in 'Testing' section below.
The COVID-19 vaccine, including charges for administering the vaccine, will continue to be covered at 100%.
Effective Jan. 1, 2021, treatment for illness due to COVID-19 is covered like any other medical condition under the health plan, i.e. subject to copays, deductibles and coinsurance.
Members can continue to receive COVID-19 services via telephone consultation with their physician.
The MDLive copay for telemedicine services will continue to be waived until further notice.
Here is how your benefits work for COVID-19 testing and treatment:
I: Testing for COVID-19
Members experiencing symptoms of the virus, or who believe they have been exposed to it, should be tested for COVID-19. Check with the testing facility prior to receiving services to be sure your health insurance will be accepted as payment.
Effective Jan. 1, 2021, telephone consultations and in-person office visits with an in-network physician are paid by the plan at the normal benefit level (i.e. subject to office visit copay or deductible and/or applicable coinsurance). Charges specifically for the COVID-19 test administered at an in-network testing facility or physician’s office will be paid at 100% until the end of the Public Health Emergency Declaration (extended on Jan. 11, 2023 for an additional 90 days), after which time the test will be treated the same as any other diagnostic testing under the health plan.
Services by an out-of-network physician will be paid by the plan at the normal benefit level for out-of-network services (if allowed).
Through the health plan, at-home testing kits can be obtained at a pharmacy in the Navitus network. We highly recommend that members get their at-home COVID-19 test kits at the pharmacy counter to ensure that the kits are processed properly and that members have no out-of-pocket costs at the point of sale (up to $12 per kit). Covered members are eligible for up to eight kits per month.
To view Navitus' list of network pharmacies, go to: www.navitus.com/Navitus.Web/media/pdf/Navitus-Pharmacy-Network-Listing-National-and-Chains.pdf.
If a testing kit is purchased elsewhere, a claim may be submitted for reimbursement* using the COVID-19 OTC Test Claim Form posted here: https://www.navitus.com/members
*Maximum reimbursement is $12 per kit, for up to eight kits per member per month
For more details regarding Navitus' procedures with respect to at-home COVID-19 tests, see Frequently Asked Questions here.
II: Treatment for COVID-19:
Effective Jan. 1, 2021, physician and facility charges (inpatient and outpatient) for COVID-19 treatment are covered like any other illness (subject to deductibles, copays and coinsurance).
Prescription drugs are covered under Pharmacy Benefits (subject to Rx/pharmacy deductibles, copays and coinsurance).
Please note that these changes to your health plan benefits are subject to revision based on government mandates as we continue responding to changing COVID-19 conditions.
You may access information about your county or district's health benefits here: mybenefits.county.org.
Contact your Employee Benefits Specialist at 1-800-456-5974 if you need more information.