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Your frequently asked questions about COVID-19 (coronavirus)

By September 1, 2021September 3rd, 2021Company News Featured

Have a question about COVID-19? We’re here to help.

What COVID-19 vaccines are available?

COVID-19 vaccines continue to be an important step in reducing risk of severe disease, hospitalization, and death, as well as in slowing the spread of the virus. Currently, three vaccines are authorized and recommended in the United States to prevent COVID-19:

Pfizer-BioNTech, which is FDA-approved for people 16 years and older and is recommended under an emergency use authorization (EUA) for adolescents 12 through 15 years old.

Moderna, which is recommended under EUA for people 18 years and older.

Johnson & Johnson’s Janssen, which is recommended under EUA for people 18 years and older.

Does Independence cover the COVID-19 vaccine?

Yes. Independence covers the cost of health professionals administering the vaccine with no cost sharing (co-pays, deductibles, coinsurance) for 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 Centers for Medicare and Medicaid Services (CMS) covers the full cost of the vaccine and its administration. Providers must submit all claims for the COVID-19 vaccine and any associated costs to Original Medicare.

Are COVID-19 boosters available?

Pfizer-BioNTech and Moderna boosters received EUA from the FDA for certain immunocompromised individuals (e.g., solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise). Formal authorization from the FDA is still needed before boosters can be given to the broader population.

People who received Johnson & Johnson’s Janssen COVID-19 vaccine will also likely need a booster. However, there isn’t enough data currently available to support those people getting a Pfizer-BioNTech or Moderna dose. More data is expected on this which we will share when available.

Does Independence cover COVID-19 boosters?

Yes. Independence covers the cost of administering the Pfizer-BioNTech and Moderna boosters for certain immunocompromised individuals (e.g., solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise). For Medicare Advantage members, CMS covers the full cost of boosters and their administration. Providers must submit all claims for the COVID-19 vaccine and any associated costs to Original Medicare.

Independence plans to cover the cost of administering boosters for the broader population once formal authorization from the FDA is received.

Can Independence help me obtain a vaccine and/or  booster?

Independence does not control the availability or distribution of any vaccines or boosters. Distribution of the vaccine and boosters is controlled by the federal government, in collaboration with local and state governments and Departments of Health. To find a location near you, visit Vaccines.gov.

Does Independence provide reimbursement to providers for administering the vaccine and/or boosters?

Yes. Independence takes responsibility as a health plan to bear the costs for the administration of COVID-19 vaccines and boosters for its 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. Independence Blue Cross has no control over the availability and prioritization of distributing the vaccine.

More information:

When can I get a COVID-19 booster?

The COVID-19 vaccines authorized in the United States continue to be highly effective in reducing risk of severe disease, hospitalization, and death, even against the widely circulating Delta variant. Experts are looking at all available data to understand how well the vaccines are working, including how new variants, like Delta, affect vaccine effectiveness.

If the FDA authorizes and the CDC’s Advisory Committee on Immunization Practices recommends it, the goal is for the broader population to start receiving Pfizer-BioNTech and Moderna COVID-19 booster shots this fall. The first people eligible for a booster will most likely be those who were the first to receive a COVID-19 vaccination (those who are most at risk). This includes health care providers, residents of long-term care facilities, and older adults.

Does Independence cover COVID-19 testing?

Yes. Independence covers the cost for medically appropriate diagnostic and antibody testing that is ordered by a physician or authorized by a health care professional at no cost to the member. This coverage is in accordance with federal mandates through the end of the public health emergency. Independence does not cover tests that are needed for return to work, a condition of employment, return to school, or travel.

These 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.2 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.

Members can find a list of testing locations in PA, NJ, and DE on the Independence COVID-19 website.

Does Independence cover the cost of COVID-19 treatment for its members?

Yes. Commercial member cost-sharing is waived 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, and 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 emergency1 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, and 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 associated with admissions for in-network, in-patient, acute care treatment of COVID-19 through October 31, 2021 for commercial members and through the end of the public health emergency for Medicare Advantage members. Self-insured customers can opt-out of coverage.

Does Independence cover telemedicine services for COVID-19?

Yes. Commercial member costs are being waived through October 31, 2021 for telemedicine visits with in-network primary care doctors, specialists, and behavioral health providers if there is a COVID-19 diagnosis.1 Normal member cost-sharing applies to telemedicine services that are not related to a COVID-19 diagnosis.

Some members may also have access to MDLIVE 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 member costs are also being waived through the duration of the public health emergency for telemedicine visits with in-and out-of-network primary care doctors, specialists, and behavioral health providers if there is a COVID-19 diagnosis.  Normal member cost-sharing applies to telemedicine services that are not related to a COVID-19 diagnosis. Medicare Advantage members also have the option of using MDLIVE, which is available all year as a filed benefit with zero-dollar cost-sharing.

To see all the telemedicine services covered by Independence, visit the medical policy page on ibx.com.

Does Independence cover telemedicine services for members that don’t have a COVID-19 diagnosis?

Yes. Independence updated its telemedicine policy for fully insured and self-funded commercial members. The updated policy covers many of the expanded telemedicine services made available during COVID-19 and includes substantially more telemedicine services than the policy we had in place prior to the pandemic. For example, prior to the pandemic, Independence only offered coverage for primary care telemedicine visits whereas the updated policy covers telemedicine for many specialty services, including:

  • Evaluation and management services for primary care and many specialty services (e.g., office/outpatient visits for most preventive medicine services, cardiology, pulmonary, etc.)
  • Medical nutrition therapy services
  • Transitional care management
  • Hospice care
  • Lactation counseling
  • Specific behavioral health
  • Medical genetics and genetic counseling

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 updated 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 the Centers for Medicare & Medicaid Services, through the duration of the public health emergency. The coverage is not limited to COVID-19 related care.

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 you have questions or need additional help related to premium payments, 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.

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 its 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.

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.

 

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.

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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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