Blue Cross to Cover Cost of Vaccine in EHA Plan

Testing, Treatment also covered

With two COVID-19 vaccines now approved by the U.S. Food and Drug Administration, members of the Educators Health Alliance (EHA) health insurance plan through Blue Cross and Blue Shield of Nebraska will be able to get a vaccine at no cost.

Blue Cross and Blue Shield of Nebraska has waived member cost-sharing for in-network testing and treatment of COVID-19 through March 31 for plan members who present with symptoms or have been exposed to others who have tested positive for COVID-19. The company encourages members to use in-network providers, as they will not ask for up-front payment.

“Most Nebraska school districts are part of the EHA network, and use our Blue Cross and Blue Shield of Nebraska plan. This is a wonderful move by Blue Cross,” NSEA President Jenni Benson said.

Members will pay nothing for medically appropriate in-network COVID-19 testing and treatment in a doctor’s office, urgent care facility or emergency room. It includes inpatient hospital stays related to the virus.

This waiver also applies to those who receive coverage through the Blue Cross and Blue Shield of Nebraska Medicare Supplement and Medicare Advantage plans.

‘Surveillance’ Testing Not Covered

COVID-19 testing done for non-diagnostic purposes, such as public surveillance or employment, will not be covered because it is not considered medically appropriate. Surveillance testing is when an individual has no COVID-19 symptoms (is asymptomatic) and has no known exposure to COVID-19.

Cost shares for COVID-19-related telehealth visits returned to normal on Jan. 1. However, recent federal legislation allows high deductible health plans linked to an HSA to waive member cost shares for the following reasons, without tax penalty:

  • COVID-19 testing, including the office/urgent care/emergency room visit;
  • Telehealth (for both COVID-19 and non-COVID-19-related services).

In addition, the legislation allows individuals to use HSA/FSA funds for the purchase of over-the-counter medical products without requiring a doctor’s prescription.

The EHA is a non-profit corporation created to procure quality, affordable health insurance for Nebraska educational employees. The rates set by the EHA Board are for the Blue Cross and Blue Shield of Nebraska health care plan used by more than 325 public school districts and affiliate groups in Nebraska.

The EHA plan evolved from a statewide health care plan NSEA founded in the 1960s. Today’s 12-member board has six NSEA representatives and three each from the Nebraska Association of School Boards and the Nebraska Council of School Administrators. NSEA Associate Executive Director and Comptroller Sheri Jablonski chairs the EHA board.

More than 80,000 Nebraskans are covered by the plan, making it the largest health plan in the state. Learn more at: ehaplan.org