BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina, Inc. Group Eligibility Guidelines Related to COVID-19 Pandemic
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan Cover COVID-19 Tests Approved as Necessary and Reliable
Employers are keenly interested in ways to bring people back to the workplace safely — a goal we share at BlueCross BlueShield of South Carolina and BlueChoice HealthPlan. We want to remind you that when it comes to COVID-19 tests, none are currently approved as a guarantee that people are safe to return to a workplace setting. That includes home tests that claim to detect COVID-19 antibodies.
We rely on input from the Centers for Disease Control and Prevention, along with other agencies, as we update our policies to best serve our customers and members. As we mentioned to you in early July, the CDC says antibody testing should not be regarded as proof of immunity — despite what you might be hearing from vendors selling these tests. Therefore, we are not currently covering these tests unless ordered by your physician.
Please review our policies below, which are based on guidance from the CDC, Department of Labor (DOL), Department of Health and Human Services (DHHS) and Department of the Treasury.
The following updates address COVID-19 polymerase chain reaction (PCR) testing (including home test kits for the coronavirus) and serology testing coverage (for antibodies).
Also included is guidance on employer decision-making based on the antibody test results — again, our policy reflects the most up-to-date input from federal agencies.
Coverage Details: COVID-19 polymerase chain reaction testing (includes home test kits) and serology testing
PCR diagnostic testing for COVID-19 is covered at no cost to members when ordered by an attending health care provider. The test must be provided at the point of care for individuals who are symptomatic and are concerned about infection. The test must also be ordered for the purpose of identifying and treating active disease.
Serology (antibody) testing and home test kits will be covered at no cost when all of the following conditions are met:
A health care provider deems them medically necessary in accordance with accepted standards of current medical practice for a patient with COVID-19 symptoms, or asymptomatic individuals with known or suspected recent exposure.
Serology (antibody) testing is not used as a sole means of diagnosis of COVID-19 infection.
According to the CDC, antibody test results should not be used to assume immunity. Therefore, antibody tests should not be used to make decisions about the use of personal protective equipment, returning to the workplace and forming groups of individuals.
Based on additional guidance jointly released by DOL, DHSS and the Department of the Treasury, public health and employment return-to-work testing are not medically necessary and will not be covered.
Members and employers can find the revised notice and updated information regarding COVID-19 on our website at www.BlueChoiceSC.com/COVID-19.
If you have questions, please contact your account representative.