COVID-19 Member Resources

Everything you need to know about your coverage and COVID-19

Here's what we're doing for our members

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is taking steps to help our members stay healthy and get the care they need. We will continue to respond to this crisis to best serve our members and support doctors, nurses and hospitals.

COVID-19 (Coronavirus) - Ways We're Supporting Our Members

No cost-sharing for COVID-19 testing

Coverage for Telehealth, phone, or virtual visits with primary care and specialty doctors

The vaccine is available at no cost to all members

Don't delay. Get the care you need now.

It’s important to keep your total health top-of-mind during this time. If you have a chronic illness, an emergency or need health care for something else, don’t delay your care. Call your doctor to learn of any protocols they are following and schedule visits that you feel comfortable with. Ask about virtual visits or contactless waiting to make sure you get the care you need in a way that you feel safe. Doctor’s offices are following strict health and safety guidelines to make sure you can feel comfortable getting routine care.

Care that should not be delayed:

  • Flu Shots
  • Routine Physicals
  • Cancer Screenings
  • Childhood Vaccinations
  • Mental Health Screenings and Treatment
  • Preventive Care

We are committed to carrying out actions to assist our members and community in the face of COVID-19. We will continue to reevaluate and take recommendations from the CDC into consideration.1

How will these coverage changes affect you?

COVID-19 Vaccine Coverage

The COVID-19 vaccine will be available at no cost to all Blue Cross NC members. This means you’ll pay nothing out of pocket for the vaccine.

Even after the COVID-19 crisis has ended, the vaccine will still be covered for you at no-cost sharing as part of our preventive care benefits. This is similar to a yearly flu shot or other vaccinations.

Note: We have identified an issue with COVID-19 vaccine administration claims pulling member liability in error. The impacted claims will be adjusted, please allow at least 30 days for adjustments to be made.


All adults, ages 12 and older, are now eligible to get the COVID-19 vaccine. Visit the North Carolina Department of Health and Human Services website for more information.

Members who live outside North Carolina will need to follow their local and state guidelines to figure out when and how they can receive the vaccine.

Covering virtual doctor's visits and care (Telehealth)

We've extended Telehealth coverage through December 31, 2021. Increasing your ability to use virtual (video or over-the-phone) appointments with your in-network doctor.2

Blue Cross NC will cover all telehealth visits at the same cost as face-to-face visits. This means, what you normally pay when you visit a doctor in-office is what you’ll pay for a telehealth visit.

Virtual (or telehealth) visits can be used with your primary care doctors, specialists, and behavioral health providers. Or any licensed NC provider who can provide telehealth services.

To use your telehealth benefits you should:

  • Call your doctor before going into the office to see if telehealth is available. This will help prevent the spread of illness.
  • Make sure the doctor you are using is in-network. These benefits are only for in-network doctors.

No prior approval on COVID-19 testing

COVID-19 tests do not need prior approval. That means, your doctor doesn’t need to ask us for approval before you’re tested for COVID-19. 

For tests performed at home or at an in-network lab, we will cover, at no cost-share to you, COVID-19 testing methods that meet all three criteria:

  • It’s ordered by a doctor or health care provider
  • Your doctor has deemed it medically necessary; in order for them to provide you with the right care and treatment 
  • Has been cleared, approved, or given emergency authorization (EUA) by the U.S. Food and Drug Administration (FDA).

If you think you have COVID-19, please call your doctor. Be ready to answer questions about your symptoms and if you could have been exposed to the virus. 

Coverage and no cost-sharing for COVID-19 testing

Blue Cross NC will provide coverage and will not apply cost-sharing for COVID-19 tests. See the full details below. 

COVID-19 Doctor Visits and Testing3

COVID-19 Testing:

For visits to an in-network provider, we will provide coverage and waive your costs (like deductibles, copays, and coinsurance) for services you have to determine if you have COVID-19.

For tests performed at an in-network lab or at home, we will cover, at no cost-share to you, COVID-19 testing methods that are consistent with CDC guidance and meet all three criteria:

  • It’s ordered by a doctor or health care provider
  • Your doctor has deemed it medically necessary; in order for them to provide you with the right care and treatment 
  • Has been cleared, approved, or given emergency authorization (EUA) by the U.S. Food and Drug Administration (FDA).

Most testing prescribed by your doctor will automatically meet these requirements with no additional work from you.  

For an out-of-network visit to a doctor for a COVID-19 screening, or lab testing as a result of the screening appointment, keep in mind: 

  • Blue Cross NC does not have a contract with the out-of-network provider to limit their ability to charge you for amounts beyond what Blue Cross NC pays the provider.
  • The provider may bill you to collect the difference. This practice is known as balance billing.
  • You should refer to our Find a Doctor tool, Blue Connect, or other resources to avoid this financial risk. 
  • For Medicare Advantage members, Blue Cross NC will pay the out-of-network providers directly. In the case that you make a payment to the provider upfront, Blue Cross NC will reimburse you. 

Updates for members on employer plans

The Department of Labor and the IRS have issued guidance that provides extended claim and appeal filing deadlines for individuals on employer-sponsored group health plans. You may now be able to submit claims or appeals for services that otherwise would have passed their timely filing date. Blue Cross NC will review your request based on your current plan benefits. Please reach out to your employer if you have additional questions or visit EBSA Disaster Relief Notice 2021- 01. This extension does not apply to State Health Plan, FEP, Medicare or Individual plans - including Dental and Vision.

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