What you need to know
The Department of Health and Human Services is planning for the federal public health emergency (PHE) for COVID-19 to expire on Thursday, May 11, 2023. Geisinger Health Plan (GHP) is committed to continuing to provide care to members that they need and deserve as the PHE unwinds.
How will this impact the cost of COVID-19 vaccines through May 11?
- All Geisinger Health Plan members will continue to have no cost-sharing for the COVID-19 vaccine when administered in network. If a member goes out of network, their standard coverage and cost sharing rules will apply.
- Vaccine cost-share waiver will remain in place through Sept. 30, 2024, for GHP Family (Medicaid) and GHP Kids (CHIP) members.
Will members have to pay for COVID-19 tests?
- Diagnostic tests: Members currently do not pay for a diagnostic COVID-19 test. Members also do not pay a visit fee to a PCP, urgent care center or ER if they are tested for COVID-19. These cost waivers will remain in effect until May 11, when the member PHE ends, and cost-sharing goes into effect.
- Surveillance testing: GHP does not cover population surveillance testing or other screening testing performed for non-diagnostic purposes or without suspicion of infection and individual clinical assessment.
- At-home tests: At-home tests are covered through the end of PHE.
- Effective Friday, May 12, Geisinger Health Plan will no longer cover at-home COVID-19 tests.
- Geisinger Health Plan will continue to cover at-home tests with no cost-share for GHP Family and GHP Kids through Sept. 30, 2024.
- Will antibody tests be covered?
- Cost-sharing for antibody tests is also waived through May 11 for non-Medicaid/CHIP members. The waiver remains in place through Sept. 30, 2024, for GHP Family and GHP Kids members. Cost-sharing will go into effect when PHE ends.
Inpatient treatment
- Will members pay for inpatient treatment related to COVID-19?
- During the pandemic, Geisinger Health Plan waived COVID-19-member cost-sharing for in-network inpatient treatment of COVID-19. These waivers were benefit enhancements not mandated by the CARES Act or other guidance. On Sept. 1, 2022, these enhancements ended. Cost-sharing was reinstated for all in-network inpatient treatment for COVID-19 beginning on or after Sept. 1, 2022, except monoclonal antibody treatment.
Telehealth
- How will this impact telehealth?
- Telehealth services played a key role throughout the pandemic, and they continue to serve as a way for patients and healthcare providers to meet. Geisinger Health Plan members can continue using telehealth services through their in-network provider or through our vendor, Teladoc. Cost-sharing is waived for telehealth services through May 11.
Prescriptions
- Will this impact early prescription refills?
- The early refill allowance for 30- or 90-day prescriptions at retail and mail-order pharmacies will also end May 11. Members are encouraged to ask about and use home delivery, when available, for their prescriptions. Early refills are available for controlled substances but will not apply for prescriptions containing opioids outside of certain conditions.
For employer groups
We’ve kept you up to date through this journey and have prepared FAQs to provide you with the needed answers as PHE ends.
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