Have a question about COVID-19? We’re here to help.
Does Independence cover the COVID-19 vaccine?
COVID-19 vaccines are an important step in slowing the spread of the virus. However, it will take time for the U.S. to reach COVID-19 herd immunity. During that time, we urge members to continue following the advice of health professionals to minimize the chances of catching or spreading the disease. We also encourage members to continue to wear a mask, practice social distancing, and wash their hands regularly.
The U.S. Food & Drug Administration (FDA) has granted Emergency Use Authorizations for three COVID-19 vaccines. As more vaccines are authorized and manufactured, more people will be able to receive the vaccine.
The Federal government is currently covering the cost of the COVID‑19 vaccine itself. Independence covers the cost of health professionals administering the vaccine with no cost sharing (co-pays, deductibles, coinsurance) for commercial members – regardless of where the vaccine is given or if the health professional administering the vaccine is in the Independence network.
- Cost-sharing for COVID-19 vaccines being administered to high-deductible health plan members by health care providers in and out of the Independence network is being waived before deductible.
- Cost-sharing for COVID-19 vaccines administered by a home health agency is being waived, even if the home health agency is not in the Independence network. The requirement that a member needs to be home-bound to receive the vaccine from a home health agency is being waived for COVID-19.
- Cost-sharing for members who get the COVID-19 vaccine from a health care provider in or out of the Independence network during a preventive office visit is being waived. If a member gets the COVID-19 vaccine from a health care provider but the office visit is not considered preventive, cost-sharing for the office visit will still apply.
For Medicare Advantage members, the cost of the COVID-19 vaccine and its administration is being covered by Original Medicare as long as the health care provider administering the vaccine participates in the Medicare program (the health care provider does not need to be in the Independence network). This is in accordance with CMS guidance and will be paid by Original Medicare.
- Providers must submit all claims for the COVID-19 vaccine and any associated costs to Original Medicare.
Can Independence help me obtain a vaccine?
Independence does not control the availability or distribution of any vaccines. This includes the COVID-19 vaccine. Distribution of the vaccine is being controlled by the federal government, in collaboration with local and state governments and Departments of Health.
Does Independence provide additional reimbursement to providers for the vaccine?
Independence does not provide additional reimbursement for the COVID-19 vaccine itself until government sponsorship ends. We do, however, take responsibility as a health plan to bear the costs for the administration of the vaccine for our commercial members.
When and where can I get the COVID-19 vaccine?
All Pennsylvanians, including Philadelphia residents, 12 and older are currently eligible to be vaccinated. You can check Vaccines.gov to locate potential vaccine distribution sites in your area.
As with all vaccines, Independence Blue Cross has no control over the availability and prioritization of distributing the vaccine. Distribution of the COVID-19 vaccines is being controlled by the federal government, in collaboration with state and local governments. But whenever you’re able to get vaccinated, your vaccination will be covered.
- How the CDC Is Making COVID-19 Vaccine Recommendations
- CDC: COVID-19 Vaccination Recommendations for Philadelphia
- The Commonwealth of Pennsylvania’s Vaccination Page
- The City of Philadelphia’s Vaccination Page
Does Independence cover testing for COVID-19?
Independence Blue Cross (Independence) is committed to ensuring that our members have access to the care they need, at the right time, and in the right setting. As COVID-19 continues, we are working hard to make sure our members can receive appropriate testing and treatment for the virus if needed.
At the start of the pandemic, we quickly announced that we would cover testing for active COVID-19 (RT-PCR) at no cost to our members. We continue to cover and reimburse member cost-sharing (such as co-pays, deductibles, and coinsurance) for medically appropriate COVID-19 diagnostic and antibody tests and the administration of the tests when performed at an in-network physician’s office, urgent care center, drive-thru testing site, pharmacy, by a home health agency, or an emergency room. This coverage is available in accordance with federal and state mandates and company medical policies through the public health emergency. Independence does not cover tests that are needed to return to work, return to school, for travel, or for visiting with relatives.
These temporary changes to our testing policies include out-of-network coverage and are effective for the duration of the public health emergency for Medicare Advantage members. The cost-sharing waiver will not apply to testing done by providers unless the member has Medicare coverage.
The requirement that commercial and Medicare Advantage members must be homebound (as defined in the medical policy) to receive COVID-19 testing at home by a visiting nurse is being waived for the duration of the public health emergency*. Please note the following:
- The homebound requirement is only waived when the nurse visit for specimen collection is medically necessary for the individual’s condition and has been ordered by an eligible professional provider.
- The specimen collected must be delivered to an in-network laboratory to perform the test and the results must be sent to the prescribing professional provider. For Medicare Advantage members, this includes out-of-network laboratories as well.
Members should report any concerns about claim payment to our customer service staff at the number on their member card. If you have any questions about whether you should be tested, please contact a health care professional.
How can members find a testing location?
If you suspect that you may have COVID-19, your first step should be to contact your primary care doctor. Your primary care doctor will screen you for testing based on CDC guidelines. If you meet the testing criteria, your doctor will discuss testing options with you.
If you don’t have a primary care doctor but have telemedicine benefits, you may be able to contact an MDLIVE physician without cost-sharing.* MDLIVE physicians can perform COVID-19 screening and help you determine next steps. You can register for MDLIVE at ibx.com.
You can also contact your state health department for information on testing. Pennsylvania residents can call 1-877-PA-HEALTH. New Jersey residents can contact the NJ Department of Health for more information at 1-800-962-1253 or 1-800-222-1222.
What about treatment?
Independence is waiving members’ cost-sharing (co-pays, deductibles, co-insurance) for in-network, acute in-patient treatment of COVID-19 through October 31, 2021.
Cost-sharing will be applied to:
- Post-acute care (e.g. skilled nursing, rehabilitation and long-term acute care facilities)
- Outpatient treatment
- Prescription drugs
- Ambulance transportation to a post-acute setting
- Out-of-network care
For Medicare Advantage members, these temporary changes to our treatment policy will be offered for the duration of the public health emergency* and include coverage for out-of-network providers. After the public health emergency ends, in-network services will continue to be covered by both Keystone 65 HMO and Personal Choice PPO in accordance with our filed benefit. Cost-sharing will remain $0. However, Keystone 65 HMO members will no longer have coverage for out-of-network services. Out-of-network services will be covered for Personal Choice PPO members at a higher cost-share.
Independence will also waive cost-sharing for Emergency Department visits when members are admitted to the hospital under these same conditions. These changes are effective through October 31, 2021 for fully-insured business and through the end of the public health emergency* for Medicare Advantage members. Self-insured customers can opt-out of coverage.
Should members be using telemedicine?
Members are encouraged to utilize telemedicine services if they are available as part of their health plan. We have expanded members’ access to primary care and specialists through telemedicine for COVID-19 related diagnoses by waiving copays for these visits through October 31, 2021. This expansion includes:
- Specialist visits (via video)
- Specialists visits for Clinical Genetics and Medical Genetics (via video or telephone)
- Nutritionist visits (via video)
- Behavioral health visits
Telemedicine services from your doctor for a non COVID-19 diagnosis are available for the same cost as an office visit, based on your health plan.
Some members may have access to MDLIVE telemedicine visits. Cost-sharing for those visits vary based on members’ benefits. If you have questions about your access to MDLIVE telemedicine services, please check your member benefits at ibx.com. To access telemedicine options, log in to the member website at ibx.com.
For Medicare Advantage members, telemedicine services are available from primary care doctors and specialists for the duration of the public health emergency. Cost-sharing does apply but will be waived for COVID-19 diagnoses. Medicare Advantage members also have the option of using MDLIVE, which is available all year as a filed benefit with zero-dollar cost-sharing.
Can members do wellness visits through telemedicine?
Independence decided during the height of the pandemic to cover preventative well visits for commercial members via telemedicine. Now that more people are vaccinated and COVID-19 case rates have significantly declined, preventative well visits for commercial members via telemedicine will not be covered because there are components to the visits that require face-to-face interaction.
Annual wellness visits are always covered for members enrolled in Medicare Advantage, and can be done via telemedicine.
Are telemedicine visits with non-participating providers covered for members with out-of-network coverage?
Given Independence’s broad network, it is unlikely that a member would need to seek care from an out-of-network provider. Telemedicine visits with out-of-network providers are covered for commercial members with out-of-network coverage and are subject to the out-of-network cost-sharing under the member’s benefit plan. This applies to specialists, including behavioral health providers.
Medicare Advantage members have out-of-network telemedicine coverage, per the Centers for Medicare & Medicaid Services, through the duration of the PHE. The coverage is not limited to COVID-19 related care.
Is Independence waiving prescription drug refill limits?
We are not waiving prescription drug refill limits. However, we continue to carefully monitor COVID-19 developments and will adjust policies as appropriate. We recommend that members call the Pharmacy Services number on their ID cards as needed if they require additional medication refills.
How is Independence helping members who may be affected financially by COVID-19?
Independence encourages all members who can pay their health plan bill on time to continue to do so. However, we understand the toll this pandemic continues to take on everyone and therefore are allowing individual members (both on and off exchange) to pay their premium via credit card until October 31, 2021.
Credit card payments may be used to satisfy past due premiums as well as any current amounts that are due. Independence will accept American Express, Discover, Visa, and MasterCard. To further help consumer members, Independence will waive the fees associated with credit card payments. Members can make credit card payments by:
- Calling 1-888-879-4891 (TTY: 711)
- Using eBill: Log in at ibx.com and click Manage Account
If members have questions or need additional help related to premium payments, they can call Independence at 1-800-503-1253 (TTY: 711).
How is Independence communicating with its employees about COVID-19 and keeping them safe?
Independence remains steadfast in the aim to reduce the impact of COVID-19 on our workforce, our members, our customers, and our business. We communicate regularly with our employees and have taken many steps to safeguard their health.
In March 2020, Independence closed all of its office in Philadelphia and all affiliates’ offices in New Jersey and Minnesota. All employees have been required to work remotely since that time to help reduce the risk of illness through person-to-person contact. Additional safety measures and protocols were put in place for those that had to enter and work in our buildings. Access to company buildings remains extremely limited to those individuals whose work requires them to be onsite.
Our company’s leadership is developing a re-entry strategy based on guiding principles that focus on the health and safety of our employees. We remain committed to maintaining high-performing operations to ensure the stability of our business and service to our members and customers.
How is Independence addressing the needs of the health care community on the frontlines of fighting COVID-19?
Independence is fortunate to have strong relationships with the health care community that provides care for our members.
We launched a range of clinical and business initiatives since the start of the pandemic to address the key needs of the health care community on the frontlines of fighting the virus. These initiatives were put in place to help ensure that providers had the support they needed to continue delivering high-quality care to their patients.
Our COVID-19 Provider Hub website, which outlines many of these initiatives, is accessible to doctors, hospitals, health systems, and other health care professionals. We have also been communicating the latest news and information about COVID-19 to providers through our existing communication channels.
If someone wants more information about COVID-19, where should they go?
If you are looking for more information about specific symptoms you are experiencing or have questions about your personal health, we recommend you contact your doctor. For reliable information about COVID-19, we suggest visiting the Centers for Disease Control and Prevention (CDC) website at cdc.gov/coronavirus. The City of Philadelphia and Commonwealth of Pennsylvania have also established websites with information about COVID-19.
Our comprehensive website dedicated to COVID-19 also has information and resources available. We also continue to update our Newsroom and social media channels with the latest information about COVID-19.
Additional resources include:
- City of Philadelphia Information and Recommendations
- How to prepare: Managing anxiety and stress (provided by the CDC)
- COVID-19 helpline for Greater Philadelphia residents: 1-800-722-7112
- Mental Health COVID-19 resources (provided by Magellan Health)
- Living with threats of violence (provided by Magellan Health)
- What to do if you are sick with COVID-19 or caring for someone with COVID-19 (provided by the CDC)
How can members protect themselves against fraud?
Unfortunately, fraud exists everywhere. Independence, like many other organizations, have received some reports of potential frauds and scams related to COVID-19.
Members should be aware of individuals attempting to profit from this emergency and should remain diligent in protecting personal and health insurance information. Some of the reports we have received include:
- Individuals and businesses selling fake tests, treatments, and cures for COVID-19 online
- Phishing emails from entities posing as trusted organizations like the World Health Organization or the Centers for Disease Control and Prevention
- Online sellers falsely claiming to have in-demand products like cleaning, household, and health and medical supplies
- Unsolicited calls, e-mails or home visits from individuals offering free services or supplies in exchange for member numbers
Members can help to avoid fraud by following these tips:
- Reviewing medical claims submitted at ibx.com for accuracy
- Protecting their insurance card
- Protecting their identity and not providing their Social Security Number
- Declining to provide insurance information to anyone that is not directly providing care to a member
- Being cautious of unsolicited telemarketers and recruiters
If members suspect that something potentially fraudulent has occurred with respect to their Independence Blue Cross health insurance, they should contact us. All reports can be submitted anonymously. Here are three options for submitting a report:
- Submit through the Online Fraud & Abuse Tip Referral Form at com/antifraud.
- Call the confidential anti-fraud and corporate compliance toll free hotline at 1-866-282-2707 / TTY# 888-789-0429.
- Mail the report. Write a description of your complaint, enclose copies of any supporting documentation, and mail it to Independence Blue Cross, Corporate & Financial Investigations Department at 1901 Market Street, 42nd Floor, Philadelphia, PA 19103.
*Please note: The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act mandate that member cost-sharing (co-pays, deductibles, and coinsurance) is waived both in and out-of-network for the testing and diagnosis of COVID-19 through the public health emergency. The waiver of member cost sharing for both in and out of network will continue through the public emergency.
2If a member has coverage through an employer, benefits and coverages may vary.
MDLIVE is an independent company.
Website last updated: 1/3/21
Independence Blue Cross offers Medicare Advantage plans with a Medicare contract. Enrollment in Independence Medicare Advantage plans depends on contract renewal.
Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company — independent licensees of the Blue Cross and Blue Shield Association.
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