The Department of Health and Human Services (HHS) has confirmed the federal Public Health Emergency for COVID-19 (PHE) declared by the Secretary of the Department of Health and Human Services (Secretary) under Section 319 of the Public Health Service (PHS) Act expires at the end of the day May 11, 2023.
Effective May 12, 2023, Baylor Scott & White Health Plan coverage for COVID-19 vaccines, testing and treatment is as follows:
COVID-19 vaccine and booster serum and administration are part of your benefits. You will have zero out-of-pocket cost for a COVID-19 vaccination if you receive your vaccinations from an in-network provider.
Medicare Advantage members will continue to receive COVID-19 PCR and antigen tests with no cost-sharing when the test is ordered by a physician or other health care providers, such as physician assistants and nurses, and performed by a CLIA certified laboratory.
For Individual, Fully Insured Employer plans, ASO, FEHB and Grandfathered plans, coverage of FDA-approved or authorized COVID-19 tests ordered by a physician or other health care providers, such as physician assistants and nurses, and performed by a CLIA certified laboratory will be in accordance with the member's standard medical plan benefit. Cost-sharing may apply.
Baylor Scott & White Health Plan will not cover OTC COVID-19 tests effective May 12, 2023.
HMO Covenant Health Advantage and HMO BSW SeniorCare members may obtain OTC COVID-19 tests with their OTC card benefit.
The cost of home testing for COVID-19 is an eligible medical expense that can be paid or reimbursed under health flexible spending arrangements (health FSAs), health savings accounts (HSAs), or health reimbursement arrangements (HRAs).
Baylor Scott & White Health Plan will not cover in- or out-of-network surveillance testing.
There is no change in coverage of treatments if you are exposed to COVID-19 once the PHE ends. In cases where cost-sharing and deductibles applied during the Public Health Emergency, they will continue to apply after the Public Health Emergency.
Telehealth visits will be covered in accordance with your standard medical plan benefit. Cost-sharing may apply.
NOTE: If you receive routine home care via telehealth under the hospice benefit, this flexibility will end at the end of the PHE.
The COVID-19 virus and its variants are still circulating in the community. Even those who are fully vaccinated should remain watchful of their health.
If you feel sick with fever, cough or difficulty breathing and have traveled to high-risk locations or were in close contact with someone with COVID-19 in the 14 days before you began to feel sick, seek medical care.
Baylor Scott & White Health Plan offers a free and convenient COVID-19 screening questionnaire through MyBSWHealth. You can access the screening questionnaire in MyBSWHealth on the web or in the mobile app.
To install the app on your mobile device, visit MyBSWHealth.com/download or text "BETTER" to 88408 to have it sent to your phone. If your screening indicates you may have COVID-19, you may be directed to an eVisit. More information about eVisits, including how to link your visit to your Baylor Scott & White Health Plan account, is included below.
When you schedule your visit, share your concerns about your COVID-19 symptoms or exposure. Staff from your doctor's office, clinic or hospital will have instructions for your visit.
If you are experiencing a medical emergency, call 911. Notify the operator if you have COVID-19 or need to be seen for COVID-19 symptoms. If available, put on a face mask before the ambulance arrives.
Virtual visits — also called eVisits — are available 24/7 through MyBSWHealth.com or in the mobile app. To install the app on your mobile device, simply visit My.BSWHealth.com/download or text "BETTER" to 88408 to have it sent to your phone.
Here's how it works:
Be sure to link your Baylor Scott & White Health Plan account to your MyBSWHealth account, so your visit will be properly processed according to your insurance plan.
Scammers are using telemarketing, text messages, door-to-door visits as well as social media to conduct their fraudulent activities. They offer COVID-19 tests, grants and prescription cards in exchange for personal information to benefit themselves and harm the public.
Ways to protect yourself from fraud, waste and abuse schemes:
To learn more about COVID-19, we recommend visiting:
Centers for Medicare & Medicaid Services
Health and Human Services (HHS)
Texas Governor's Proclamations
U.S. Department of Homeland Security's Federal Emergency Management Agency's (FEMA)
World Health Organization