Empire Reimburses COVID-19 Vaccines to Members

THE DETAILS OF EMPIRE’S VACCINE REIMBURSEMENT

To get reimbursed for receiving the COVID-19 vaccine, you will need to make sure you are taking an FDA-approved vaccine. These vaccines can either be the Pfizer, Moderna, or the most recently announced Johnson & Johnson vaccine.

All three of these vaccines have received the FDA’s green light and are for widespread use. To find a location that administers these vaccine shots, visit an established national center approved for Medicare and Medicaid Services.

The federal government will supply each approved administration facility with one of these vaccine variants. With the government footing the bill on the vaccine, Empire will only need to cover the cost of administering the shot.

Whether a member visits a center in or out of their network, Empire will still reimburse you for the vaccine’s costs. Included will be both vaccination shots of the vaccine free of cost to you.

Safety and convenience are the top priority during a national public health emergency like the COVID-19 pandemic. Included in the reimbursement program are both employer and self-funded members in a single person or family plan.



TEMPORARY CHANGES TO THE ADMINISTRATIVE POLICIES

Due to this national public health emergency’s nature, Empire will continue to make adjustments to its policies. The COVID-19 pandemic has caused many impacts on the healthcare system that haven’t been seen previously.

Each of the adjustments made by Empire Bluecross Blueshield is to ensure that its members can receive adequate treatment when they need it. An example of a change made to their administrative policy is the authorization of patient transfer to lower-level care.

Prior authorization (PA) requirements have been suspended for patients who transfer from a hospital to a nursing facility. These requirements are also suspended for any lower-level care facility.

Additionally, Empire has also stated that they will agree to clinical or other state administrative mandates. These mandates will support the local communities’ members, allowing them to access the medical care they need.



THE CARES ACT

At the start of the pandemic, the federal government passed the CARES Act in March of 2020. Under this government order, all COVID-19 testing and vaccines are covered during the current pandemic.

This coverage also extends to those who visit urgent care or doctors’ offices concerning coronavirus care. This funding will remain as long as the public health emergency order is in place.

This funding applies to all Empire members, regardless of the type of health insurance plan or doctor you visit. If you suspect that you have come in contact with someone positive for the virus, get tested as soon as possible.

The government extended the COVID-19 CARES Act in January, likely to remain in place until the end of 2021. As long as the pandemic is still affecting the United States, this assistance program will continue to help Americans.



CONCLUSION

In a commitment to keeping our communities safe, Empire Bluecross Blueshield has implemented a vaccine reimbursement program. As long as the vaccine is FDA-approved and administered at an established center, you can receive insurance reimbursement.

Along with this program, the insurance company has also implemented various administrative policy changes to support us during these trying times. Included is the suspension of prior authorization if a member needs to be transferred to a lower-level care facility.

With these changes in place, Empire has set each of its members up with an effective support network. If you have any questions regarding the vaccine reimbursement program, contact your account representative for more information.