Members pay $0 for pharmacist assessment and prescribing of Paxlovid at pharmacies, including CVS. Pharmacist Assessment and Prescribing of Paxlovid program Members pay $0 for these prescriptions while the government supply is available. Members will pay their copay, coinsurance or deductible for COVID-19 associated visits (INN and OON) when there’s an associated COVID-19 test done within 2 days before or 2 days after.ĬOVID-19 anti- viral medications or treatments, like Paxlovid* Members pay $0 for COVID-19 associated visits (INN and OON) when there’s an associated COVID-19 test done within 2 days before or 2 days after. It will be applied to their out-patient testing benefit, which is part of their medical plan.Įvaluation & Management Visit (E&M) - Telemedicine, Urgent Care, ER and Office Visits Associated with COVID-19 tests Members will pay their copay, coinsurance or deductible at in-network locations. Members pay $0 for lab tests, including rapid diagnostic and swab-and-send tests, at in-network locations. Members can also use funds from a health savings account or a flexible spending account toward test kits. Members will be able to get an at-home test kit for around $12 per test, or $24 for a box of two from CVS® and other retailers. Members will pay the retail cost of test kits. Plans cover eight OTC COVID-19 tests per month with a $0 member cost share, if obtained at a pharmacy, or with a post-service reimbursement claim. Members pay $0 for the vaccine at in-network locations.*ĬOVID-19 at- home test kits, also known as over-the-counter, or OTC test kits Members pay $0 for the vaccine at any location. It includes a summary of the changes to COVID-19 coverage that will take place once the federal emergencies end for fully insured or Small Group Aetna Funding Advantage SM plan sponsors. Starting May 12, 2023, health plans and group plan sponsors will no longer be subject to federal requirements for coverage of COVID-19 testing, vaccinations and treatments.Īetna will send a notice to plan sponsors in a few days. On January 30, 2023, the federal government announced that the two national emergencies addressing COVID-19, the Public Health Emergency (PHE) and the national emergency, will end on May 11, 2023.
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