Please note: Federal guidance effective Jan. 15, 2022 regarding coverage for at home COVID-19 tests pertains to coverage under prescription plans only. Please contact your prescription plan carrier for additional information.
Lifetime Benefit Solutions provides coverage in full for diagnostic/viral testing as well as antibody testing that is determined to be medically appropriate for the diagnosis and treatment of an individual by an attending provider as evidenced by an order from the attending provider.
No. Testing that is ordered or performed solely for purposes of pandemic control or re-opening the economy, and not based on a determination by an attending provider that the test is medically appropriate for the diagnosis and treatment of an individual is not covered under the member’s health benefit. This includes tests performed on someone with no symptoms to assess health status as required by parties such as a government/public health agency, employer, school, or camp.
Please note that free COVID-19 testing is available at locations across the state operated by the New York State Department of Health. Individuals do not need to be symptomatic or essential workers to obtain a test from these state sites. For more information, call the health department’s 24-hour hotline at (888) 364-3065.
COVID-19 Vaccine Information
The first quantity of doses for the vaccine have been paid for in advance by the federal government. There will be no cost share for non-grandfathered group members who receive COVID-19 vaccines that are authorized through an emergency use authorization (EUA) and recommended by the Advisory Committee on Immunization Practices (ACIP).
Coverage for the vaccine administration is covered for participating and non-participating providers through the end of the Federal Public Health Emergency.
We are following the federal, state and county distribution plans for the vaccine. The CDC has said the goal is for everyone to be able to easily get a COVID-19 vaccine as soon as large quantities are available; however, not everyone will be able to get vaccinated right away.
The first people to receive the vaccine will be nursing home residents and staff and high-risk hospital workers followed by:
While specific distribution plans are still in development, we encourage you to prepare for a COVID-19 vaccine by consulting with your primary care provider.
Please refer to the Department of Health’s website to determine where vaccines are available. Please note that based on the distribution plan, not everyone is able to get vaccinated at this time.
We will follow the state vaccine distribution plan and update providers and locations as the Department of Health updates their guidance. Not all providers will be able to receive the vaccine at this time.
COVID-19 Health Information
Given that the COVID-19 situation is rapidly evolving, the best resources for up-to-date health information are:
If you are showing symptoms of coronavirus COVID-19, please call your primary care doctor before going to any doctor’s office, emergency room or urgent care center. They will need to follow special protocols to meet you upon your arrival.
A telehealth visit with your doctor is also an option to do initial screenings, and telehealth services are covered for most members. Due to high call volumes, wait times may be longer than usual.
The U.S. Centers for Disease Control and Prevention recommends taking everyday preventive precautions to help prevent exposure to this virus and others like it by:
Practicing good health habits every day helps to keep our community healthy.