BlueCross expands benefits for virtual visits

BlueCross expands benefits for virtual visits

BlueCross BlueShield of South Carolina (BlueCross) is the third-party administrator for the State Health Plan. Below is information from BlueCross about Blue CareOnDemand and other telehealth services. If you have questions, please contact BlueCross at 800.868.2520.

Telehealth visits provide convenience for people to access care at home. This will also help slow the spread of COVID-19 by limiting exposure, mitigating the surge of demand on our health care system and helping protect health professionals on the front lines.

 What we are doing

Blue CareOnDemandSM:  Any visit type through Blue CareOnDemand is now available with no member cost share, effective until further notice, when code COVID19 is used. For more information on the member experience follow this link to details.

Telehealth: Our provider telehealth policy has been expanded effective March 17, 2020, and for 30 days thereafter. After that, the policy will be reevaluated for extension or modification.

  • Telephone visits: Services delivered over the phone to existing patients will be covered. Providers offering these services must already be credentialed in the BlueCross system.
  • Telehealth services: HIPAA-compliant telehealth services (process and technology using both audio and video) will be covered at the same benefit level as office visits. This includes visits with new patients and current patients for providers already credentialed by BlueCross to offer telehealth services. Other providers will need to apply to BlueCross to use these telehealth services in their practices.
  • Members are encouraged to call their doctor and ask for a virtual visit. These virtual visits must be medically necessary and meet qualifying criteria. Please note that the member’s copay and coinsurance will still apply.

 In addition to expanding virtual access to health care providers, BlueCross has taken the following steps to help our members as it monitors COVID-19. These steps include:

  • Waive prior authorizations. BlueCross will waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance for members if diagnosed with COVID-19. We will make dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19.
  • 100 percent coverage on testing. BlueCross will cover medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19 at no cost share to the member where such testing is not covered as part of the Public Health Service response. We will ensure patient testing and any subsequently needed care are done in close coordination with federal, state and public health authorities. There are not limitations on the number of times a member can get the test.

It is important to understand that the waiver or all cost sharing is solely for the COVID-19 test and not the associated physician office visit and other services. These services will still be subject to office copay, deductible and coinsurance.

Where to find more information

For the latest information, visit bcbs.sc/covid-19.

 

You can view current insurance coverage, update contact and beneficiary information, and make special eligibility changes through PEBA Insurance's MyBenefits portal 

MyBenefits

 

You can view PEBA Retirement plan information (estimate retirement benefits, years of service credit, and beneficiary designation) through PEBA Retirement's MemberAccess portal

MemberAccess