COVID-19 and End of Public Health Emergency Update

 

The federal government confirmed May 11, 2023, as the end of the Public Health Emergency (PHE). UnitedHealthcare has been planning for this change and reviewing recent guidance from government agencies about how the end of the PHE affects COVID-19 vaccines, testing and treatment.

UnitedHealthcare’s approach for COVID-19 vaccines, testing, treatment and telehealth for Group Retiree (Group Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) plans) is as follows:

COVID-19 vaccines ─ COVID-19 vaccines, booster shots and administration that are covered by Original Medicare will continue to be covered under your Medicare Part B benefit in and out of network, with your part of the cost being $0.

Over-the-counter (OTC) tests ─ Effective May 12, 2023, eight OTC COVID-19 tests per 30 days are covered under your plan with a $25 copay through your pharmacy network.  If you purchase an OTC at-home COVID-19 test at any in-store or online retailer other than at the pharmacy counter at a network pharmacy, you may submit the purchase receipt(s) for reimbursement through the UnitedHealthcare member site for a maximum reimbursement of $12 per test. Many OTC at-home COVID-19 tests are sold as a two-pack which means that the reimbursement for the two- pack would be $24 ($12 for each test).

COVID-19 lab-based testing ─ COVID-19 PCR and antigen tests, when ordered by a physician or certain other health care providers such as physician assistants and certain registered nurses and performed by a laboratory, will continue to be covered in accordance with Medicare rules and your Medicare Part B plan benefits.

COVID-19 treatment ─ If you have a Part D plan, coverage for COVID-19 oral antivirals will continue while the government funded supply is available, with your part of the cost being $0. When the government-funded supply is depleted, any Part D coverage for COVID-19 oral antivirals will be provided in accordance with your Part D plan benefit.

All other FDA-approved or FDA-authorized COVID-19 treatments covered by Original Medicare will be covered in accordance with your standard Medicare Advantage plan benefits.

Telehealth/Virtual Visits ─ Coverage for telehealth visits will continue at the same level, with your part of the cost being $0 for the national vendors (i.e., AmWell, Doctors on Demand and TeleDoc) and coverage for local providers based on your plan’s benefits.

 

Disclaimer

The information is a summary and is subject to change, as of May 11, 2023. It describes benefits we offer to all members in all states. It also includes federal requirements. More benefits may be available in some states and under some plans.