For updated information, visit the CDC website¹³.

Most patients with COVID-19 don’t require specific treatment other than rest and isolation to prevent the infection from spreading. Individuals at higher risk¹⁴, such as adults age 50 and older, or people who are unvaccinated or have certain medical conditions, are more likely to get very sick from COVID-19. These individuals may need treatments such as antiviral medications and/or monoclonal antibody products. Call your doctor if you think you may have COVID-19 and may be at higher risk for complications. The CDC website¹⁵ is also a good source of information on treatment and medications.

Yes. COVID-19 vaccines can lower your risk of getting and spreading the virus that causes COVID-19. Vaccines can also help prevent serious illness and death. The COVID-19 vaccine is currently available at no cost while government supplies last. Most members won’t have to pay the vaccine administration cost through May 11, 2023. Learn more about the COVID-19 vaccine.¹⁶

Starting Jan. 1, 2023, regular cost share and deductibles apply for treatment of COVID-19, including hospital and office visits, for fully insured commercial members and some self-insured plans, except as otherwise required by law.

Medicare Advantage members will continue to have no copayment for those treatments where the law so requires, which includes COVID-19 monoclonal antibodies treatment through Dec. 31, 2023, or COVID-19 oral antivirals until it becomes commercially available.

QUEST Integration members will continue to have no copayment for COVID-19 treatments that meet criteria for medical necessity.

To be sure we follow the law, HMSA will not change how we handle taxes. Whether or not you have to pay taxes will depend on your plan. If you have a Medicare Advantage plan, an HMO plan, or a Federal health plan, you will not have to pay taxes. Your plan covers it. If you have a PPO or CompMED plan and your provider chooses to collect tax, you will be responsible for paying tax.

No. HMSA does not cover COVID-19 testing for surveillance or employment purposes.

Yes, HMSA covers diagnostic lab tests for COVID-19 according to CDC guidelines with no copayment for members through May 11, 2023. Starting May 12, 2023, regular cost shares and deductibles will apply for diagnostic lab tests.

This covers diagnostic tests for COVID-19 only. HMSA doesn’t cover screening tests.

If you’re having oral surgery or another dental medical procedure that’s a benefit of your medical plan and performed in a dentist’s office by an HMSA participating dentist or oral surgeon, the preoperative COVID-19 test will be covered under your medical plan through May 11, 2023. COVID-19 testing isn’t covered for dental procedures such as cleanings, fillings, or X-rays that are paid under your dental plan and not your medical plan.

No. HMSA does not cover diagnostic testing for COVID-19 for travel purposes, such as to avoid quarantines associated with business or leisure travel.

Following guidance issued by the Centers for Disease Control and Prevention¹⁷, HMSA will cover antibody tests only if one of the following conditions is met to support the diagnosis of COVID-19 illness or complications of COVID-19 in the following situations:

• A positive antibody test at least seven days following acute illness onset in persons who had a previous negative antibody test (e.g., seroconversion) but did not receive a positive viral test might indicate SARS-CoV-2 infection between the dates of the negative and positive antibody tests.
• A positive antibody test can help support a diagnosis when patients develop complications of COVID-19, such as multisystem inflammatory syndrome or “long COVID.”

Starting May 12, 2023, regular cost shares and deductibles will apply.

HMSA will not cover antibody testing if the test is being used to indicate immunity to COVID-19. HMSA fully supports clinical advancements that improve the diagnosis, treatment, and prevention of COVID-19. However, while antibody testing may play an important public health role in the way we track COVID-19 cases and assess its impact on our population, the antibody testing is not currently recognized by the CDC as a valid diagnostic test for COVID-19 (except in the situations listed above) or a reliable test to demonstrate immunity.

Visit the CDC website¹⁷ for more information.

Yes. HMSA will pay for testing at no cost to you if you are having surgery and certain other procedures such as colonoscopies and the provider requires testing. Testing is covered with no cost-sharing through May 11, 2023 for commercial, Medicare Advantage, Fed 87, and FEP plans. Starting May 12, 2023, regular cost shares and deductibles will apply for preoperative COVID-19 diagnostic lab tests. For EUTF members, regular cost shares and deductibles will apply starting June 1, 2023.

QUEST Integration members will continue to have no copayment as part of their health plan benefits for COVID-19 services.

For dates of service from March 1, 2020, through May 11, 2023:

• HMSA will cover diagnostic lab tests for COVID-19 according to CDC guidelines with no copayment for members.
• COVID-19 diagnostic lab tests are also covered if they’re related to clearance for surgery or other medical procedures (i.e., colonoscopy), or when you have symptoms of COVID-19, or have been exposed to COVID-19.
• This applies to HMSA’s commercial, EUTF, Fed 87, and Medicare Advantage plans.

Starting May 12, 2023, regular cost shares and deductibles will apply for:

• Diagnostic lab tests and testing-related services that are consistent with CDC guidance related to COVID-19 for commercial, EUTF, Fed 87, and Medicare Advantage plans.
• Preoperative COVID-19 diagnostic testing for patients with no COVID-19 symptoms who will undergo surgery and other procedures for commercial, Medicare Advantage, and Fed 87 plans. For EUTF members, regular cost shares and deductibles will apply starting June 1, 2023.

QUEST Integration members will continue to have no copayment as part of their health plan benefits for COVID-19 services.

Testing required to bypass quarantine requirements is not covered. COVID-19 testing for surveillance or employment purposes are not covered.

Yes. HMSA will cover the cost of OTC at-home COVID-19 diagnostic tests for HMSA commercial plan members during the public health emergency, which ends May 11, 2023. This reimbursement applies from Jan. 15, 2022, through May 11, 2023.

HMSA will not reimburse for tests purchased on or after May 12, 2023. Eligible members may request reimbursement on My Account for tests purchased on or before May 11, 2023, within one year from the date of purchase. For example, if the test was purchased April 1, 2023, you must request reimbursement by April 1, 2024.

HMSA will reimburse Fed 87 members for the price of the tests, including shipping and sales tax, up to $12 per test for OTC at-home COVID-19 tests. Members can be reimbursed for up to eight tests per month. Tests must be authorized, cleared, or approved by the FDA. Not all tests are authorized, cleared, or approved by the FDA. Tests that will be covered should say “OTC” for over-the-counter at-home tests. To see if a test is covered, visit the FDA website for a list of authorized, cleared, or approved over-the-counter at-home COVID-19 diagnostic tests¹⁸. Fed 87 members can submit their reimbursement form to HMSA through My Account.

Starting May 12, 2023, HMSA’s preferred provider will no longer offer commercial plan members OTC at-home tests at no cost. This includes discontinuation of ordering through HMSA’s preferred provider, Hawaii Family Medical Center (dba Kuhio Medical Center, a subsidiary of HMSA.

Learn more about over-the-counter at-home COVID-19 tests¹⁹.