COVID-19 Information & Updates

COVID-19 Coverage and Billing - Public Health Emergency Set to End

As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.

Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:

  • COVID-19 Vaccination and Administration - Will continue to be covered as a preventative health benefit with no member cost share.
  • COVID-19 Lab Tests - Will be covered, but subject to member cost share.
  • OTC COVID-19 Tests - Will only be covered for our Federal Employee Health Benefits (FEHB) members.

If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:

Commercial: 866.895.5828

Medicare Advantage: 800.455.9776

Latest on COVID-19: Testing & Vaccines

IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.

COVID-19 Information & Updates

COVID-19 Coverage and Billing - Public Health Emergency Set to End

As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.

Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:

  • COVID-19 Vaccination and Administration - Will continue to be covered as a preventative health benefit with no member cost share.
  • COVID-19 Lab Tests - Will be covered, but subject to member cost share.
  • OTC COVID-19 Tests - Will only be covered for our Federal Employee Health Benefits (FEHB) members.

If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:

Commercial: 866.895.5828

Medicare Advantage: 800.455.9776

Latest on COVID-19: Testing & Vaccines

IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.

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Prescription Drug Transition Policy

For Non-Long-Term Care Residents

For any drug that you are currently taking that is not on our formulary, or that requires additional authorization, we will cover a temporary 30‐day supply (unless you have a prescription written for fewer days, in which case multiple fills will be allowed to provide up to a total of a month’s supply of medication) when you fill the prescription at a network pharmacy. If you are given this temporary supply, please speak to your doctor before you use the entire supply so you and your doctor can select a formulary alternative or request an exception. We will not pay for this drug beyond your first 30‐day supply unless you have been approved for a formulary exception.  

For Long-Term Care Residents

If you are a resident of a long‐term care facility, we will cover a temporary transition supply up to 31 days.  If you need a drug that is not on our formulary, or is subject to additional authorization, but you are past the first 90 days of membership in our plan, we will cover up to a 31‐day emergency supply of that drug (unless you have a prescription for fewer days, in which case multiple fills will be allowed to provide up to total of a month’s supply of medication) while you pursue a formulary exception or work with your physician to select a formulary alternative.  

For Members Moving from Home to a Long-Term Care Facility or From a Long-Term Care Facility to Home

If your level of care changes (e.g., entering a long term‐care facility or going home after a stay in a long‐term care facility), Indiana University Health Plans provides transitional supplies of non‐formulary or otherwise restricted medications. For the first month after being discharged from a long‐term care facility, you can get at least a 31‐day supply of your current medications to allow time for you and your physician to switch to a formulary alternative or request an exception. 

Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Enrollment in Indiana University Health Plans depends on contract renewal. Other pharmacies/physicians/providers are available in our network. Product types include HMO and HMO-POS. H7220_IUHMA19511 Accepted 11/17/2018