University of Utah Health Plans and COVID-19

During the federal COVID-19 Public Health Emergency (PHE), we temporarily expanded our benefit coverage to make it easier for you to access the care you needed during the pandemic. The PHE ends May 11, 2023, and these expanded benefits will return to being covered under your normal health plan benefits. That means any applicable cost shares, such as copays and coinsurance, will apply.

Here's a look at the changes and how we'll be covering COVID-19 care and treatment moving forward:

• COVID-19 vaccinations, including boosters, are covered under the Member's benefit plan similar to other covered vaccinations. Most benefit plans consider vaccinations preventive care which are covered at no cost if received from an in-network provider. Talk to your doctor or pharmacist about when you should get vaccinated.
• COVID-19 lab tests, if ordered by an in-network provider, are covered under the Member's benefit plan similar to other laboratory services.
• We'll continue to cover the cost of FDA-approved treatment prescribed by your provider for COVID-19 in the same way as other regular health plan benefits. Cost shares may apply.
• All pre-authorization requirements have been reinstated.
• All credentialing requirements have been reinstated.
• Over-the-counter COVID-19 tests will no longer be covered and will be an out-of-pocket expense.

We'll also continue to provide flexibility in accessing services virtually. During the PHE, the Centers for Medicare and Medicaid Services (CMS) approved several services that could be provided virtually rather than in-person. CMS will continue its policy through December 31, 2024. While we’re not required to do so, we’ve decided also to continue an expanded definition of allowed services under telehealth. We support the advantages of telehealth and its ability to make health care more easily accessible.