COVID-19 Vaccine Information
- In fall 2023, Pfizer, Moderna, and Novavax released updated vaccines that more closely target the Omicron subvariants and can restore protection against severe COVID-19 that may have decreased over time.
- There is no preferential recommendation for the use of any one COVID-19 vaccine over another when more than one licensed or authorized, recommended, and age-appropriate vaccine is available. Visit here more information about vaccine and booster guidelines.
According to the Centers for Disease Control and Prevention (CDC):
- Everyone aged 5 years and older should get one dose of an updated vaccine to protect against serious illness from COVID-19. In some cases, two doses may be recommended to stay up to date. Learn more here.
- Children aged 6 months to 4 years need multiple doses of COVID-19 vaccines to be up to date, including at least one dose of updated COVID-19 vaccine.
- People who are moderately or severely immunocompromised may get additional doses of an updated COVID-19 vaccine.
Yes. Independence covers COVID-19 vaccines, including the latest ones released in September and October 2023, as a preventive service.
- For individual, group commercial members, there is no cost sharing (co-pays, deductibles, coinsurance) when the booster is administered by an in-network health professional. However, if the COVID-19 booster is administered by an out-of-network provider, standard cost sharing will be applied based on a member’s health plan benefits.
- For Medicare Advantage members, there is no cost-sharing (such as copays, deductibles, and coinsurance) for the booster and the health care professional administering it does not need to be part of the Independence network. However, the health care professional must participate in the Medicare program.
Yes. However, starting May 12, 2023, cost-sharing (such as copays, deductibles, and coinsurance) will be applied for medically appropriate, FDA-approved COVID-19 diagnostic and antibody tests ordered by an in-network physician or authorized by a health care professional (unless the member has benefits that include out of network coverage). Co-pays, deductibles, and coinsurance are based on the member’s health plan benefits.
Independence does not cover tests that are needed for return to work, a condition of employment, return to school, or travel.
If you have any questions about whether you should be tested, please contact a health care professional.
Yes. However, starting May 12, 2023, Independence will no longer reimburse for over-the-counter/at-home COVID-19 tests. Until May 12, 2023, Independence will continue its coverage of up to eight FDA-approved over-the-counter COVID-19 tests per calendar month as directed by the Biden. Tests that are covered, include at-home COVID-19 test kits authorized by the Food and Drug Administration (FDA). The most common tests are BinaxNOW™, Flowflex™, InteliSwab™, On/Go™ and QuickVue®. Covered members can get up to 8 individual tests per month without a prescription (e.g., a family of 4 would be eligible for 32 tests a month). You can get an FDA-authorized COVID-19 test kits at Walmart, Sam’s Club, Rite Aid, and Walgreens for no out-of-pocket cost. Simply go to the pharmacy counter, present your member ID card, and ask to have the test submitted to OptumRx. You can also purchase an FDA-authorized over the counter COVID-19 test kit at other stores or online retailers. Keep your purchase receipt(s) to submit for reimbursement. You will be reimbursed up to $12 per test by submitting a claim.
To receive reimbursement for over-the-counter/at-home tests with a receipt dated May 11, 2023 or prior, members with Independence Blue Cross prescription drug coverage should submit documentation through ibx.com.
For members with a Health Savings Account or Flexible Spending Account offered through Independence Blue Cross, receipts can be submitted for reimbursement through those programs at ibx.com.
Yes. However, starting May 12, 2023, Independence will no longer reimburse for over-the-counter/at-home COVID-19 tests. Until May 12, 2023, Original Medicare will continue to cover the cost of up to eight over-the-counter/at-home, FDA-approved COVID-19 tests each calendar month for individuals with Medicare Part B (Medical Insurance), including those enrolled in a Medicare Advantage plan. For our Medicare Advantage members, this benefit is covered outside of their Independence Medicare Advantage plan and will be processed through their Medicare Part B coverage. To pay $0, visit any participating eligible pharmacy or health care provider and show your red, white, and blue Medicare card.
Yes. Independence will continue to cover in-network, inpatient treatment of COVID-19 for commercial members. Standard cost-sharing will apply. (Note: Self-funded groups will have the option of asking for a benefit exception to continue waiving cost-share). Independence Medicare Advantage members also have a $0 cost-share for in-network acute inpatient treatment of COVID-19 covered through their plan benefits. Independence is waiving the cost for out-of-network acute inpatient treatment of COVID-19 until May 11, 2023, at 11:59 p.m.
For Children’s Health Insurance Program (CHIP) members, standard coverage includes no member cost sharing for in-network, inpatient acute care treatment and emergency department visits associated with those admissions with or without a COVID-19 diagnosis.
Starting May 12, 2023, Independence will no longer waive cost-sharing for antivirals for the treatment of COVID-19. Co-pays, deductibles, and coinsurance are based on the member’s health plan benefits.
Yes. However, starting May 12, 2023, standard cost-sharing and co-pays will be applied for all telemedicine visits that individual and group commercial members have with primary care physicians and specialists, including behavioral health providers, regardless of their COVID-19 status. Cost-sharing and co-pays are based on the member’s health plan benefits.
For Medicare Advantage members, standard cost-sharing and co-pays will be applied starting May 12, 2023, for all telemedicine visits with primary care physicians and specialists, including behavioral health providers, regardless of the member’s COVID-19 status.
Until May 11, 2023, Independence will cover telemedicine for COVID-19 related services. Please see below for more specific information on how the coverage may apply to you.
Telemedicine services with in-network primary care doctors, specialists, and behavioral health providers are covered until May 11, 2023, for COVID-19 related services. Services must be for testing or to diagnose COVID-19.1 Normal member cost-sharing applies to telemedicine services that are not related to COVID-19.
Some members can also access MDLIVE for telemedicine visits.2 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.
Medicare Advantage Members
Telemedicine services with in-and out-of-network primary care doctors, specialists, and behavioral health providers are covered at no cost until May 11. Services must be for testing or to diagnose COVID-19. Normal member cost-sharing applies to telemedicine services that are not related to COVID-19. Members can also access MDLIVE for non-emergency and behavioral health virtual visits. Cost-sharing for MDLIVE visits vary based on members’ benefits.
Medicare Supplement Members
Telemedicine services are payable as a Medicare covered service for Medicare-eligible providers until May 31, 2023.
Telemedicine services with primary care physicians and specialists are covered at no cost through the until May 11, 2023, for COVID-19 related services. For non-COVID-19 visits, normal cost sharing (as applicable) applies for specialist telemedicine visits.
Independence will give members and providers 60 days’ notice before any changes to its telemedicine policy go into effect. To see all the telemedicine services covered by Independence, visit the medical policy page on ibx.com.
Yes. Independence has a permanent telemedicine policy for fully insured and self-funded commercial members. The policy covers many of the expanded telemedicine services made available during COVID-19 and includes substantially more telemedicine services than the policy that was in place before the pandemic.
Please note that there are some services better performed face-to-face that we covered through telemedicine at the height of the pandemic to keep everyone safe and healthy that are no longer covered through telemedicine under the permanent policy. To see all the telemedicine services covered by Independence, visit the medical policy page on ibx.com.
Does Independence cover telemedicine services from non-participating providers 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 from 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 CMS, until May 31, 2023.
Yes. 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 you have questions or need additional help related to premium payments, call Independence at 1-800-503-1253 (TTY: 711).
Yes. Starting May 12, 2023, Independence will resume refill restrictions for Medicare Advantage members based on their health plan benefits.
Is Independence going to resume processing out of network services for Medicare Advantage members at out of network rates?
Yes. Starting May 12, 2023, Independence will resume processing all out of network services for Medicare Advantage members at Out of Network rates, when applicable. Co-pays, deductibles, and coinsurance are based on the member’s health plan benefits.
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.
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 comfor 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 ibx.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.
1The 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: 5/19/22
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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