COVID-19 Testing Coverage Update

Effective May 12, 2023

Canton, MA, April 13, 2023 – When the COVID-19 pandemic arrived in early 2020, Tufts Health Plan and Harvard Pilgrim Health Care, both Point32Health companies, quickly mobilized to do everything we could to help our members, providers, employers and communities navigate the myriad and unfamiliar challenges it brought forth. We responded with very real and meaningful actions in terms of expanded coverage, relaxing of policies, providing additional testing and vaccine access, keeping our members and customers up to date with relevant changes, and providing financial support to vulnerable populations in our communities.

Over-the-counter/home testing kits

On May 12, 2023, following the end of the federal public health emergency, we will no longer cover over-the-counter COVID-19 tests for our commercial members. Our Medicare members will also no longer have coverage through their Red, White and Blue Medicare card. Our Medicaid members will continue to have access, based on MassHealth and Rhode Island Medicaid requirements.

Provider ordered testing and treatment

COVID-19 tests, treatments and services ordered by a provider, including Paxlovid, will remain covered and we follow federal guidelines regarding approved treatments. We are following state guidance related to cost shares for these services.¹ COVID-19 vaccines will remain covered at no cost to our members.

¹ If an ASO account opted out of covering these this may not apply.