COVID-19 vaccines are an important tool in reducing the risk of severe disease, hospitalization, and death. Vaccines also slow the spread of the virus. Booster shots are an additional dose of the vaccine that offers better protection over time.
Vaccine and booster coverage. Independence Blue Cross (Independence) covers the cost of administering vaccines and boosters with no cost-share (such as copays, deductibles, or coinsurance) for members regardless of where the vaccine is given. For a vaccine distribution site near you, visit vaccines.gov. If you are a Medicare Advantage member, please see information below.
Eligibility. The Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccines for everyone six months and older, and boosters for everyone five years and older. Children six months and up receive age-appropriate doses.
Timing for boosters. The CDC recommends anyone ages five and up receives a COVID-19 booster if it has been at least two months since their last dose. Children ages six months to four years, who received Moderna shots as their primary series, are also eligible to receive a booster two months after their last shot. There is no booster recommendation for children ages six months–four years who got the Pfizer-BioNTech COVID-19 vaccine primary series.
Safety and efficacy. The COVID-19 vaccines are proven safe and effective in protecting against the virus. If you’re uncertain, read more about the myths and facts surrounding the COVID-19 vaccines on the CDC’s website.
COVID testing. Independence covers the cost for medically appropriate diagnostic and antibody testing of COVID-19 ordered by an authorized health care professional. In addition, Independence covers up to eight over-the-counter (OTC), FDA-approved tests per calendar month as required by the Biden Administration.1
How to get OTC tests if you have Independence prescription drug coverage:
If you have pharmacy coverage through another company, please contact the phone number on your prescription drug card for information on how OTC COVID-19 test coverage applies.
Additional details can be found in these FAQs. These coverages are in accordance with federal mandates through the end of the public health emergency.1 Independence does not cover tests needed for return to work, a condition of employment, return to school, or travel.
If you are a Medicare Advantage member, please see information below.
Check your symptoms. Call your doctor if you think you’ve been exposed to COVID-19 and developed symptoms. Visit the Centers for Disease Control and Prevention (CDC) for more details on symptoms, including those for people who already received a COVID-19 vaccination.
Treatment. New outpatient treatments for COVID-19 are available and can be taken orally (by mouth) at home. These antiviral drug options can help patients at high risk for severe COVID-19. Speak with your doctor as soon as symptoms appear to learn more about treatment options and determine if you are eligible.
If you are a Medicare Advantage member, please see information below.
Visit a doctor from anywhere.² Telemedicine services for a COVID-19 diagnosis with primary care doctors and specialists are covered at no cost through the end of the public health emergency.¹ Telemedicine services from your doctor for a non-COVID diagnosis are also available — cost-sharing applies based on your health plan.
MDLIVE®.² You can schedule a telemedicine appointment with a doctor 24/7 with MDLIVE at no cost, depending on your plan. MDLIVE doctors can assess your symptoms and help with next steps. Register or login at mdlive.ibx.com.
If you are a Medicare Advantage member, please see information below.
Feeling stressed? Members can find their way On To Better Health with our interactive cognitive behavioral therapy program for conditions like anxiety, depression, and insomnia. Plus, stay physically active and emotionally balanced with programs to conquer physical distancing in our Achieve Well-being tool. Login to your account at ibx.com.
Virtual visits for mental health.² If you have mental health benefits through Independence, you can talk to an in-network mental health counselor online or on the phone, and standard cost-sharing will apply. If the visit is to diagnose COVID-19, cost-sharing will be waived until the end of the public health emergency. Visit ibx.com to find a provider.
General resources. Independence also offers general resources and information about mental health through its Know Your Mind campaign and the #mindPHL campaign, a collaboration with the City of Philadelphia. If you or a loved one is seriously struggling, call or text 9-8-8 anytime for free support.
Wear a mask. COVID-19 and its variants mainly spread from droplets released into the air when we cough, sneeze, or talk. Public officials and health experts still recommend wearing masks indoors when community COVID-19 levels are high.
Increase space and distance. The closer you are to a greater number of people, the more likely you are to be exposed to the virus that causes COVID-19. There are a few steps you can take, in addition to checking local COVID-19 community levels, to help you avoid possible exposure to the virus. Consider how well-ventilated an area will be, keep distance between yourself and others, or avoid crowded areas. Whenever possible, avoid contact with people who have COVID-19, whether or not they feel sick.
Wash your hands regularly. Viruses can spread from touching recently contaminated surfaces and then touching your face. Washing your hands is one of the most important defenses against the spread of COVID-19 and other illnesses. Keep hand sanitizer on you when you don’t have access to soap and water.
Vaccine coverage. As of January 1, 2022, Independence covers the cost of administering vaccines and booster shots with no cost-share (such as copays, deductibles, coinsurance) for Medicare Advantage members. The health care provider administering the vaccine does not need to be part of the Independence network, but must participate in the Medicare program.
Diagnostic and antibody COVID-19 testing. Independence covers the cost for medically appropriate diagnostic and antibody testing ordered by an authorized health care professional. Members are encouraged to contact a medical professional for COVID-19 testing if they suspect illness or exposure.
Over-the-counter (OTC) COVID-19 tests. Original Medicare covers the cost of up to eight OTC, also called at-home, FDA-approved COVID-19 tests each calendar month for individuals with Medicare Part B (Medical Insurance), including those enrolled in a Medicare Advantage plan. This policy went into effect April 4, 2022, and runs through the duration of the public health emergency.
For our Medicare Advantage members, this benefit is covered outside of their Independence Medicare Advantage plan and will be processed through their Medicare Part B coverage. To pay $0, visit any participating eligible pharmacy or health care provider and show your red, white, and blue Medicare card. Visit medicare.gov/medicare-coronavirus for a list of participating pharmacies and health care providers.
Medicare Advantage members can choose to purchase OTC COVID-19 test kits with the IBX Care Card under the OTC benefit at participating retailers.
Note: OTC test kits are those which require no medical professional or laboratory involvement for the supply of the test, completion of the testing, or assessment of results.
Treatment. Medicare Advantage members will have a $0 cost-share for in-network acute inpatient treatment of COVID-19 covered through their plan benefits. Independence will waive the cost for out-of-network acute inpatient treatment of COVID-19 through the end of the public health emergency¹.
Visit a doctor from anywhere². COVID-19 related telemedicine visits with in- and out-of-network primary care doctors, specialists, and behavioral health providers are covered at no cost through the end of the public health emergency¹. Telemedicine services from your doctor for a non-COVID diagnosis are also available & cost-sharing applies based on your health plan.
Talk to a doctor 24/7². Schedule a same-day appointment with a board-certified doctor through MDLIVE® at no cost, depending on your plan. MDLIVE doctors can assess your symptoms and help with next steps. Register or log in at ibxmedicare.com/mdlive.
Sign up for Independence updates and information. If you have coverage through your employer or purchased an Individual or Family plan, get connected today.
Medicare members can sign up at ibxmedicare.com/getconnected.
¹ The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act mandate that member cost-sharing (deductible, co-pays, and coinsurance) is waived both in and out-of-network for the testing and diagnosis of COVID-19 through the public health emergency. When the public health emergency referenced by the FFCRA and CARES Act ends, the waiver of cost sharing for out-of-network COVID-19 testing and diagnosis will end. The Biden Administration recently announced that the federal public health emergency will end on May 11, 2023. We are working to ensure a smooth transition, so Independence members continue to have access to the care they need.
² If you have coverage through your employer, benefits and coverages may vary. Please check with them about how these programs apply.
MDLIVE is an independent company.
OptumRx is an Optum® company — an independent company that provides home delivery, specialty, and infusion pharmacy services.
Y0041_HM_112009_2023 Website last updated: 2/21/2023
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.
