- Members can receive COVID-19 services via telephone consultation with their physician. An in-person office visit is not required to get an order for the test.
- No member cost-sharing (copays, deductible or coinsurance) will be required for COVID-19 testing and testing-related services. The plan will pay 100%.
- The MDLive copay for telemedicine services will be waived through the end of the current benefit plan year.
Here is how your benefits work for COVID-19 testing and treatment:
I: Determining whether a test for COVID-19 is needed:
Members experiencing symptoms of the virus, or who believe they have been exposed to it, will need a doctor's order to be tested for COVID-19. Members have a choice between an on-site doctor visit or a consultation with their physician via telephone conference to determine whether testing is needed.
- A telephone consultation with an in-network physician will be paid by the plan at 100% (no member cost-share).
- For an in-person office visit, the member will not be required to pay an office visit copay or deductible and/or applicable coinsurance*.
- A telephone consultation with an out-of-network physician will require payment of an office visit copay or deductible and/or applicable coinsurance.
* While we do not anticipate a member being required by the doctor's office to pay a copay or deductible for services related to COVID-19 testing, if this happens the member will be able to request a refund through BCBSTX.
II: If the doctor provides an order for COVID-19 testing:
No member out-of-pocket (copay or deductible/coinsurance) will be required for the test kit or the laboratory service to process the test.
III: Treatment for COVID-19*:
- Physician and facility charges (inpatient and outpatient) will be covered at 100%*:
*Exceptions: for the following counties and districts, COVID treatment will be covered like any other illness (subject to deductibles, copays, and co-insurance):
- Comal County
- Guadalupe County
- Harris County Appraisal District
- Matagorda County
- Prescription Drugs will be 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. TAC HEBP will be reviewing our plan benefits once the pandemic/disaster declarations have been lifted to determine whether other actions are needed.
You may access information about your county or district's health benefits here: www.mybenefits.county.org.
Please contact your Employee Benefits Specialist at 1-800-456-5974 if you need more information.