Back to Insights and Updates for ProvidersMay 2023

COVID-19 coverage updates

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President Joe Biden has signed a bill that will officially end the federal COVID-19 Public Health Emergency (PHE) at the end of the day on May 11, 2023. As a result, Point32Health is returning to many pre-pandemic operations and policies and will be updating the Coronavirus (COVID-19) Updates for Providers page.

Point32Health will continue to comply with federal and state guidelines for COVID-19 vaccines, boosters, testing and treatment. Some updates include:

  • COVID-19 vaccines: In-network COVID-19 vaccines will remain covered at no cost to our members. We are following federal and state guidance related to out-of-network member cost shares for these services.
  • Over-the-counter/home testing kits: On May 12, 2023, following the end of the PHE, we will no longer cover over-the-counter COVID-19 tests for Commercial members. Medicare members will also no longer have coverage through their Red, White and Blue Medicare card. Medicaid members will continue to have access, based on MassHealth and Rhode Island Medicaid requirements.
  • Provider ordered testing and treatment: COVID-19 tests, treatments and services ordered by a provider, including Paxlovid, will remain covered and we follow federal guidelines regarding approved treatments. We are following state guidance related to cost shares for these services.

Self-insured plans may apply different member cost-sharing for these services. Please contact your employer.

For information on COVID policies as of May 12 or later, please refer to the Coronavirus (COVID-19) Updates for Providers page.


Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

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Writers

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Production Coordinator

Kristina Cicelova,
Graphic Designer