Updated January 14, 2022
These are unprecedented times. As the news of COVID-19, also known as the novel coronavirus, continues to evolve, you may have questions about your coverage or what to do if you feel sick. We've pulled together some information and resources that can help.
For information and updates on COVID-19 vaccines, please review this helpful flyer. Please also visit the South Carolina Department of Health and Environmental Control (DHEC) website at www.scdhec.gov or Centers for Disease Control and Prevention (CDC) website at www.cdc.gov.
- Over-the-Counter Diagnostic Tests
January 14, 2022
Beginning January 15, 2022, BlueChoice® HealthPlan of South Carolina will reimburse members for the purchase of over-the-counter COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration. You can purchase tests at local retailers or online. Please review the FAQs below for more information on which purchases are eligible and how to get reimbursed.
If you would like to file for reimbursement for the purchase of over-the-counter COVID-19 tests, download the member reimbursement form.
Where can I purchase eligible over-the-counter COVID-19 tests?
You can purchase tests at local retailers or online.
Do I need to buy a certain type of test?
Tests must be authorized, cleared or approved by the U.S. Food and Drug Administration. See the list of qualifying tests.
Will there be any out-of-pocket costs?
Members will pay for their tests out of pocket and file for reimbursement. With proper documentation, we will reimburse you in full.
How can I file a claim for reimbursement?
Here's the reimbursement process:
- Save the purchase receipt(s) and cut out the UPC code(s) on the test box(es).
- Download and print the reimbursement form(s). You will need one form for each plan-covered individual who will be using the test.
- Mail the form(s), along with the UPC code(s) and receipt(s), to the address on the form.
If you don’t send in complete documentation, we will return the form with a request for additional information. To process the claim, the physical copy of the product barcode is required. You must mail in the required documentation.
When should I expect to receive payment? Is there a way to check on the status of a claim?
The processing standard for claims is 30 days. You can log into My Health Toolkit® to see the status of your claims. We will send out reimbursements in the form of checks.
Will BlueChoice® reimburse me for sales tax and shipping costs?
Yes. Be sure to include these expenses with your documentation.
Will BlueChoice reimburse me for over-the-counter COVID-19 tests I bought before January 15, 2022?
No. We will reimburse you for over-the-counter COVID-19 tests you purchased on or after January 15, 2022, only.
What if I can’t afford the upfront cost of purchasing an over-the-counter COVID-19 test?
Many communities offer free COVID-19 testing. Here is a list of sites.
Do I need to see a doctor to qualify for a covered over-the-counter test?
No. BlueChoice will provide reimbursement for eight over-the-counter, self-administered tests per 30-day period for each covered individual on the plan. COVID-19 tests ordered or given by health care providers do not count against the monthly maximum of eight tests per member.
Is there a limit to how many over-the-counter tests the member’s insurance will cover?
We will provide reimbursement for eight over-the-counter tests per 30-day period for each covered individual on the plan.
How will BlueChoice count multiple tests sold together in one package?
BlueChoice will count each test separately, even if tests are sold together in one package. For example, a package containing eight tests would count as eight tests, not one.
Will BlueChoice cover tests for members whose employers require them to be tested?
BlueChoice will not cover tests purchased for this reason. Members who need tests to comply with workplace requirements can take advantage of free COVID-19 testing in their communities. Here is a list of sites.
- Kids and COVID-19: What to Know
There is no doubt the pandemic has been stressful for everyone. This is especially true for parents. The U.S. Food and Drug Administration has approved the first COVID-19 vaccine for children ages 5 – 11. This gives about 430,000 South Carolinians access to the vaccines.
There are a lot of unknowns with this novel coronavirus, but Dr. Matt Bartels, our vice president and chief medical officer, provides some answers to common questions parents may have about the pandemic’s effect on children.
What is going on now with the pandemic?
The pandemic continues to march on. The declining case counts we are seeing currently are encouraging, but that doesn't mean COVID-19 is completely subsiding. In several areas of the world, case counts continue to rise, some at levels even higher than those at the beginning of the pandemic. There’s not enough population immunity. Variants continue to develop or reemerge. Those factors pose the greatest unknowns, making it a challenge to predict when there will be another surge in our country.
What do we know about children and COVID-19?
We are continually learning with this new virus. It does appear that healthy children are less seriously affected by it. There are exceptions for children with underlying medical conditions.
You can find more information on children and COVID-19 from the Centers for Disease Control and Prevention* (CDC).
What do experts think is most likely to happen next with the pandemic?
Most experts agree the pandemic is not over. They expect outbreaks with continued surges around the world. We need to be aware of significant health disparities around the globe especially affecting access to vaccines. Health care is not the same everywhere. Because of that, the ongoing spread of COVID-19 is certainly going to continue even within the United States. The virus will continue to spread especially through unvaccinated people and those who are not immune.
How does it look in South Carolina?
Current data is positive in terms of declining case counts and hospitalizations. This doesn’t mean we are out of the woods. We don’t know what the next variant is going to look like. With continued spread, new mutations are likely to develop. Population immunity is critical to ending the pandemic.
Why is it important for children ages 5 – 11 to have access to the COVID-19 vaccine?
Children are part of our communities. They can become infected or carry the COVID-19 virus, contributing to ongoing spread and the likelihood of variants developing. It’s fortunate that children are not as severely affected by acute infection. But there are many instances of admissions to hospitals — including intensive care units — of children and adolescents. The risk to children from COVID-19 can be severe in certain instances. The overall risk to children is much less than it is to the elderly and people with chronic conditions in terms of disease severity, but the risk is not zero.
Children can easily become virus spreaders and cause illness in more people who are more vulnerable. It can be easy to focus only on the individual. With this virus, we also should consider the risk to our families and others in the community.
Overall, why are childhood vaccines important?
In the last 100 years, there have been two advances that have affected the health of the population more than any other medical developments: clean water and vaccinations. Despite the numerous things happening in health care, those two improvements have saved more lives than all other interventions. Vaccines have saved millions of lives and prevented numerous outbreaks of disease. Vaccines are critical for protecting both the individual and the population.
What should parents consider when deciding to vaccinate their children against COVID-19?
If faced with the choice to vaccinate or take the chance of your child becoming infected, I would always encourage parents to choose vaccination. Vaccines are currently safer than ever.
One challenge is significant misinformation in the public realm. People should always look at the facts. Find information from a reputable source, such as the Centers for Disease Control and Prevention. You can also check out the South Carolina Department of Health and Environmental Control website. Talk with a trusted medical adviser, such as your child’s pediatrician.
If more than half of the population in South Carolina is vaccinated, why do children need to be vaccinated?
More than half is not enough to declare population immunity. Until children are vaccinated, they are potentially at risk of becoming ill or passing along the virus to others. While vaccines are not a guarantee, they are a remarkably effective way to add layers to our defense. To contain ongoing spread and prevent new variants, it is critical that children get immunity. The safest, quickest way for children to become immune is through vaccination.
What can parents do to keep themselves and their children safe?
Get themselves and their children vaccinated. There are breakthrough cases, but data shows these cases are almost always less severe. The vaccines are a safe and effective tool in the toolbox for preventing severe illness. Take other precautions, such as wearing a mask indoors and maintaining a safe distance from others.
What about the multisystem inflammatory syndrome?
We are still evolving in our understanding about this. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.
The syndrome can be serious, even deadly, but most children who were diagnosed with this condition thus far have gotten better with medical care.
While concerning, there is no reason to panic, as it is a small number of children (300 worldwide) who have been affected by multisystem inflammatory syndrome. What we do know is that you should seek medical attention immediately if your child presents with unusual symptoms. Find more on what to look for on the CDC’s website.
Should children still be going to the doctor, even for non-emergency reasons?
You should always consult with your health care provider if you have concerns. You may not need to bring them in to the office, however. During the pandemic, there have been many improvements including the way patients are triaged. Many doctors’ offices have embraced new technology, such as telehealth visits. However, if your child is sick, you should absolutely always consult your doctor.
Should children go in for well checkups and vaccines?
You should check with your doctor’s office. Some well checkups, especially for older children, may be able to be done virtually. The prioritization is on children under 2 years old, who should always be seen in person. We are observing that some patients are delaying getting necessary vaccines and screening tests, but with the right protocols these can all be completed safely. I would urge everyone to do their best to stay up to date on these visits.
As far as activities go for children, what should parents consider?
Use common sense and follow recommendations from the CDC.
Don’t travel too far from home and avoid large group play. It’s mentally and physically beneficial for kids to go out and play to get exercise, but it is important for them to maintain social distancing. Older children should wear masks. Stay outside and keep at least 6 feet from others.
Is there anyone who shouldn’t wear a mask?
Children under 2 or anyone with trouble breathing shouldn’t wear a mask. Over the age of 2, children should wear masks with adult supervision. Children over the age of 2 should wear a mask when they are in public settings especially indoor areas, when around people who are not in their household or when they are unable to maintain social distance.
This is important because COVID-19 is spread person to person through respiratory droplets. We know that wearing a face covering is important in slowing the spread of the disease.
What should parents of infants know about COVID-19?
Thankfully, what we have seen with this pandemic is that it really does appear to be affecting children in much less severe ways than older people and people with chronic health conditions. That doesn’t mean children are completely immune. It simply means they tend to be very mildly affected, and in many cases, asymptomatic, including infants. That doesn’t mean they can’t get sick. It just means that their risk appears to be much less as an age group.
At the beginning of the pandemic, there was worry that it would affect the younger infants more severely like the influenza virus often does. The good news is that unlike influenza, COVID-19 does not appear to be severely affecting infants in large numbers.
Certainly, everyone is susceptible to getting this disease, and it appears that many can be carriers of the virus. However, infants shouldn’t be considered at higher risk than other children, and with the right precautions, families with infants can safely venture out of their homes.
The same precautionary rules apply to parents of infants. Don’t overexpose your infants. Keep your distance. Non-household contacts should stay at least 6 feet apart. Wash your hands. Wear a mask if over age 2 years.
What should you do if a parent gets COVID-19?
Consult with your doctor and your pediatrician. Make sure you follow CDC guidance, and isolate from family if possible. Make sure that children and any other caregivers wear masks and minimize close contact to limit exposure.
The CDC recommends having a sick room in your house if possible. Use it to keep anyone infected with the disease separate from others. If you can’t do that, wearing a mask in the house has been shown to limit the spread of the disease.
How should parents be talking with kids about the coronavirus?
The CDC website has very good advice on this. Keep the discussion factual. Minimize the fear. Let kids express themselves. And most importantly, keep the conversation going.
Parents should watch for signs of withdrawal and depression in their children. Don’t let them worry in silence. Kids are intelligent and they are susceptible to the same fears and concerns as adults. Talk to them and provide ways for them to stay active and to do so safely. Communication is very important during these unprecedented times.
Other ideas for practicing good mental health for your kids:
- Take a break from the news and social media
- Get outside
- Maintain a healthy routine
- Find fun activities to do together so that kids have something to look forward to
- Focus on healthy eating and exercise
It’s been undoubtedly stressful for everyone. This has forced everyone to slow down, and that’s not a bad thing. Hopefully this can be a healthy reset on all of our priorities.
*The Centers for Disease Control and Prevention is an independent organization that provides health information you may find helpful.
This article contains links to third party sites. Those organizations are solely responsible for the contents and privacy policies of those sites.
Scams During COVID-19
As COVID-19 evolves, scammers have looked to capitalize on the COVID-19 pandemic. Fraudsters are targeting people in a number of ways, including door-to-door visits, social media platforms (i.e., Facebook Twitter, etc.).
If you think you may be getting sick, use a symptom checker and get more information to help guide your health care decisions. Learn more.
See a doctor without leaving home. If you are experiencing COVID-19 symptoms, you can consult with a health care professional by phone or video chat. Check out your options.
Prevent the spread of germs. Frequent handwashing and limiting contact with others can help limit the spread of COVID-19 and other illnesses. Learn more about how to avoid germs.
Keep Up to Date on the Latest Information
The news on COVID-19 is changing rapidly. And there is a lot of misinformation out there. For the latest information on COVID-19, we recommend that you turn to trusted public health organizations such as:
Watch Now: Our chief medical officer, Dr. Matthew Bartels, shares answers to the most common questions and clinical guidance related to COVID-19.
Frequently Asked Questions
Members can call the customer service number on the back of their ID cards for benefit-related questions.
- What is coronavirus disease 2019 (COVID-19)?
COVID-19 is a respiratory disease caused by a new coronavirus. Coronaviruses are a large family of viruses that may cause illness in people. The name of this new respiratory disease is coronavirus disease 2019, abbreviated as COVID-19.
- What are the symptoms?
Symptoms of COVID-19 include fever, cough and shortness of breath. Symptoms may also include chills, repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or sense of smell. These symptoms may appear two to 14 days after exposure to the virus. This list is not all-inclusive. Please consult your medical provider about any other symptoms that are severe or concerning to you.
- How dangerous is this virus?
According to the U.S. Centers for Disease Control and Prevention* (CDC), COVID-19 can affect anyone and can cause symptoms ranging from mild to very severe. People with risk factors and underlying health conditions, such as heart disease, lung disease and diabetes, may be more likely to need hospitalization if they have COVID-19.
*The U.S. Centers for Disease Control and Prevention is an independent organization that provides health information you may find helpful.
- How is the virus passed from one person to another?
Someone who is actively infected with COVID-19 can spread the illness to others, even if he or she has no symptoms.
The virus spreads from one person to another through respiratory droplets. These droplets are produced when someone with the illness coughs, sneezes or talks. The droplets can be inhaled, land in the mouths or noses of people nearby, and persist for up to a couple of days on some surfaces. It generally takes close contact (less than 6 feet away) to become infected.
- How can I prevent the spread of the coronavirus or other respiratory viruses?
The best way to prevent illness is to avoid being exposed to the virus. To limit virus exposure, the CDC* recommends that you:
- Maintain good social distance (at least 6 feet) from others and avoid close contact with people who are sick.
- Cover your mouth and nose with a cloth face covering when around others.
- Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place; after going to the bathroom; before eating or preparing food; and after blowing your nose, coughing or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60 percent alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
- Always wash hands with soap and water if hands are visibly dirty.
- Avoid touching your eyes, nose and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
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*The U.S. Centers for Disease Control and Prevention is an independent organization that provides health information you may find helpful.
- What should I do if I may have been exposed to or think I am sick with COVID-19?
If you develop a fever and symptoms of respiratory illness, such as a cough or difficulty breathing, or if you have been in close contact with a person sick with COVID-19, contact your doctor before you attempt to see anyone in person. You can tell your health care provider your symptoms, and he or she can give you instructions on how to get your medical needs addressed while minimizing the risk of exposure to yourself and others.
People who are mildly ill with COVID-19 can isolate at home during their illness. When under home isolation, you should:
- Stay at home, except for getting medical care.
- Do not go to work, school or public areas.
- Avoid using public transportation, ride-sharing services or taxis.
- Separate yourself from other people and animals in your home, and avoid sharing personal household items.
- Monitor your symptoms and seek medical care if your illness gets worse.
Should you have life-threatening symptoms, such as trouble breathing, call 911 or go to your nearest emergency room. If possible, put on a face mask before seeking emergency medical care.
- What kind of support does BlueChoice® HealthPlan of South Carolina offer?
If you have questions about getting care during the pandemic, using your benefits or managing your health, we are here to help you. You may be contacted by BlueChoice to introduce programs that are right for you. To reach us, simply call the customer service number on the back of your member ID card.
- What about vaccines?
Is the COVID-19 vaccine safe and effective?
According to the U.S. Centers for Disease Control and Prevention (CDC)*, COVID-19 vaccines are safe and effective. The CDC recommends you get a COVID-19 vaccination as soon as possible.
- Who should get vaccinated?
Everyone 5 years of age and older is eligible to get free COVID-19 vaccinations.
- Where can I get the vaccine?
To find vaccine locations near you, go to https://vaxlocator.dhec.sc.gov/ or http://www.vaccines.gov, text your ZIP code to 438829 or call
. You can also check your local pharmacy’s website to see if vaccination appointments are available. 800-232-0233
- What should I expect when getting the vaccine?
The process will depend on the location you choose. See if the location requires an appointment or accepts walk-ins. Parental consent is required for those ages 5 – 15.
- Is there a cost to get the vaccine?
COVID-19 vaccines are free for everyone ages 5 and up. Vaccines are available to all people living in the United States regardless of health insurance or immigration status.
- Should I get a booster shot?
Booster shots are available and free for anyone who has received the COVID-19 vaccine.
- When can I get a booster shot?
You can get a booster six months after completing your primary COVID-19 vaccination series.
Testing and Treatment
- Are the coronavirus test and treatment covered under my insurance?
If you have COVID-19 symptoms or if you have been exposed to someone who has tested positive for the virus, your doctor can order a medically necessary test at no cost to you.
Beginning January 15, 2022, your plan will reimburse members for the purchase of over-the-counter, self-administered COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration. Members can purchase tests at local retailers or online.
Public health and employment return-to-work testing are not considered medically necessary and will not be covered.
COVID-19 treatment will be covered according to your plan benefits. Please contact Member Services to confirm coverage for your plan.
- Are at-home diagnostic tests covered?
We will reimburse members for the purchase of self-administered and self-read, over-the-counter COVID-19 diagnostic tests that have been authorized, cleared or approved by the U.S. Food and Drug Administration. Over-the-counter COVID-19 tests that must be sent to a lab for analysis will not be reimbursed. See the list of qualifying tests here.
- Are there any other ways to access free over-the-counter COVID-19 tests?
Yes. Every household in the United States is eligible to order four free at-home COVID-19 tests online through www.COVIDtests.gov. You can also place your order through the United States Postal Service at www.USPS.com/COVIDtest.
- Are there any prior authorizations required for COVID-19 treatment?
Prior authorization is required for any related services for the treatment of COVID-19 if those related services would normally require a prior authorization. For example, inpatient admission to treat COVID-19 requires prior authorization.
Health Care During the Pandemic
- Is it safe to go to a doctor's office right now?
Generally speaking, yes. Most providers’ offices have implemented additional safety measures such as mask requirements, temperature checks, pre-appointment screening questionnaires and social distancing in waiting rooms.
Many providers are also offering virtual visits via video or telephone to accommodate non-urgent medical needs and behavioral health consultations. You would pay the same amount for a virtual visit as you would for an in-person visit.
- If I have an upcoming preventive care visit or screening, should I go?
Yes. It is still important to attend annual wellness checkups, immunization appointments and well-child visits. If there is not a pressing need, you can talk to your doctor about rescheduling. However, delaying preventive care such as mammograms or colonoscopies is not recommended, as it may also delay a potentially serious diagnosis.
- Is there a chance the hospital or provider will cancel my procedure? If so, what are my options?
If your procedure is canceled, it is likely for good reason. Elective surgeries or procedures may be postponed or rescheduled to free up space or ensure adequate staff. Your doctor can help you determine whether it is safe to delay a procedure and may present other options.
- Could my prescription be impacted? Can I buy more than my usual refill limit to get them filled early?
BlueChoice® is closely monitoring any potential medication access issues to make sure our members get the medications they need in a timely manner.
BlueChoice members who have mail-order pharmacy benefits are encouraged to use them. For members who have concerns about running out of medications, we recommend they first contact their doctor or pharmacist. Members can call the customer service number on the back of their member ID cards for benefit-related questions.
*The U.S. Centers for Disease Control and Prevention and the South Carolina Department of Health and Environment Control are independent organizations that provide health information you may find helpful.
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