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Stacey Shoff

Benefits Coordinator
805.306.4500 Ext. 4015

Stacey.Shoff@
simivalleyusd.org

BENEFITS

Benefits

yOUR HEALTH PLANS  Covid testings requirements 

Any member who needs a diagnostic test for COVID-19 will not have to pay anything out of pocket provided the test is FDA-approved or authorized to diagnose COVID-19 and ordered by a healthcare professional. This applies to members of both our Health Maintenance Organization and Preferred Provider Organization plans.

Blue Shield Members

Your co-payments will be waived only if you have symptoms of COVID-19 or have known or suspected exposure. Coverage is available both in and out of network, but there may be additional costs if used an out of network provider without authorization prior to the testing. 

If tested without having a qualified health care provider evaluation and order, the test will not be covered by my plan, and you will be responsible for the costs of testing.

Kaiser Permanente Members

There is currently no charge for COVID-19 testing. Members must receive authorization for testing from an authorized Kaiser Permanente professional prior to receiving the test. 

United Healthcare Members

Cost-share will be waived for testing and testing-related services during the national public health emergency. COVID-19 testing must be ordered by a physician or licensed healthcare professional and processed at approved locations in accordance with the U.S. Centers for Disease Control and Prevention (CDC) guidelines, including FDA-approved testing at designated labs around the country. Members cannot self-refer for the test. Members should call their physicians right away if they believe they have been exposed to COVID-19. The provider will have special procedures to follow. If the provider feels a COVID-19 diagnostic test is indicated, the provider will collect a respiratory specimen. In certain situations, the provider may refer a member to an approved testing location and United Healthcare will cover the testing without cost-sharing.

UnitedHealthcare Members will be able to get the vaccine at no charge.  

UHC Members will be able to get the vaccine at $0 cost-share (copayments, deductibles and co-insurance) as noted below, no matter where they get the vaccine and including when 2 doses are required. In fact, members shouldn’t receive a bill for the COVID-19 vaccine. 

  • Employer and Individual* health plans: Members will have $0 cost-share for both in- and out-of-network providers through the national public health emergency period.
  • Medicare health plans: Members will have $0 cost-share on vaccines at both in- and out-of-network providers through December 31, 2021.
  • Members should not receive any bills for COVID-19 vaccines from their vaccination provider or UnitedHealthcare during the public health emergency period. If a member receives a bill, they should call the number on their UnitedHealthcare card and we can help them determine what to do.  
  • Be aware of fraud. If someone calls, tests, or emails a member promising access to the vaccine for a fee, the member should not share their personal or financial information. No one should ask a member to pay to put their name on a list to get the vaccine. No one should ask a member to pay to get early access to a vaccine.
  • Be sure to follow the vaccination instructions, which you will receive when you get the vaccine. Most FDA-authorized COVID-19 vaccines will require a second dose. You will need to get both doses in the required time frame to have protection from COVID-19. To help slow the spread of the disease, it’s important you continue to wear a face mask, physically distancing and wash your hands regularly.
  • Members who have questions about the COVID-19 vaccine should speak with their primary care provider or a health care professional regarding vaccine recommendations given their specific health conditions.
  • Members should plan on bringing specific documents with them to get their COVID-19 vaccine, including their insurance card or Medicare insurance card as well as their health status information.
  • Once a member gets the COVID-19 vaccine, members should keep their COVID-19 vaccination documentation with them. Members should also keep their primary care provider informed of the COVID-19 vaccines they get.
  • Members should not receive any bills for COVID-19 vaccines from their vaccination provider or UnitedHealthcare during the national public health emergency period. If a member receives a bill, they should call the number on their UnitedHealthcare card and we can help them determine what to do.

Anthem Blue Cross

All cost-sharing (co-insurance or co-pay) will be waived for the contracted rate for in-network and allowable amounts for out-of-network for screening and testing, including hospital/emergency room, urgent care, and provider office visits for the purpose of screening and/or testing for COVID-19. Members also have zero-cost online doctor visits using LiveHealth Online.

Ventura County Health Agency Testing Locations

www.vchca.org/health-information/covid19

Los Angeles County Health Agency Testing Locations

covid19.lacounty.gov/testing/

California Covid Vaccines Sign Up Information

covid19.ca.gov/vaccines/

Healthy LIfestyle

healthcare online resources

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