COVID-19 Information

Updated: January 31, 2024.

The COVID-19 public health emergency (PHE) officially ended on May 11, 2023. What does that mean to you? We want to assure you that, while some temporary measures have ended, all of the benefits listed in your Evidence of Coverage (EOC) are still fully in place.

This page includes information and resources that will help you continue to protect yourself from COVID-19.

COVID-19 Testing

Q: Are COVID-19 tests a Medicare Advantage covered benefit?

Yes, COVID-19 tests are covered if they’re administered or ordered by your doctor or other healthcare provider. As long as a healthcare provider orders the test, you don’t need to have symptoms or have been exposed to COVID-19 in order for the test to be covered.

You can also get free at-home COVID-19 tests delivered directly to your home. The limit is four per household, and the tests can be ordered here: https://www.covid.gov/tests.

Q: I have tests that have passed their expiration date. Can I still use them?

Actually, they may still be effective. The FDA has extended the expiration dates on many brands of at-home tests. You can find out if your “expired” tests should still be good to use by clicking here.

Q: Am I covered for the cost of a COVID-19 test requested by my employer or for other reasons?

No. COVID-19 tests requested by someone other than a doctor or healthcare provider, are not generally covered. That includes tests requested by your employer, so you can start or return to work; or needed for other reasons, such as travel or entertainment.

Q: Where can I get a COVID-19 test near me?

If your doctor or other healthcare professional recommends you get tested for COVID-19, you can go to any healthcare facility near you offering the test. This can be your doctor’s office, an urgent care center or local pharmacy. You may also get a COVID-19 test from a state or community health site, such as a “drive-through” site.
Find a location here
Please avoid going to an emergency room (ER) for testing; the ER is for severe illness and injury.
 

Oral Treatments for COVID-19

Q: How do I know if I should use one of these treatments?

Your doctor will decide if you’re at risk for having a severe case of COVID-19 and should use one of these treatments. 

Tell your doctor if you’re taking any drugs or have other illnesses (such as liver or kidney disease or other serious illnesses) to make sure there are no concerns that would keep you from using these medications. Also tell your doctor about your allergies and any vitamins, herbal supplements, and over-the-counter drugs you are taking.

Q: Where can I get one of these medications?

These drugs are only available with a prescription from your doctor. Not all pharmacies carry these drugs; your doctor or other healthcare provider will help you find a pharmacy that will have them.

We encourage you to have a caregiver pick up your prescription at the pharmacy to reduce the risk of spreading COVID-19.
 

Q: Is the U.S. government still covering oral anti-viral treatments such as Paxlovid and Lagevrio?

Government-purchased Paxlovid and Lagevrio distribution ended in December 2023. Going forward, health plans will be responsible for covering these oral anti-viral treatments and copays may apply.

Q: What is my cost for Paxlovid?

Paxlovid is a preferred medication on Tier 3 of SCAN’s formulary. Through the Pfizer Patient Assistance Program, SCAN is able to offer members Paxlovid for $0 at any pharmacy during all Part D benefit coverage stages.

If you would like to obtain Paxlovid through a patient assistance program instead of using SCAN, the PAXCESS program through the drug manufacturer is an alternative option members can use. For more information and to apply for the PAXCESS program, please visit https://paxlovid.iassist.com/.

Q: What is my cost for Lagevrio?

Lagevrio is a non-preferred medication on Tier 4 of SCAN’s formulary. This means you will be responsible for a Tier 4 copay, and your copay amount will be affected by the pharmacy you choose and your Part D benefit coverage stage.

If you would like to use Lagevrio, there is a patient assistance program available through the drug’s manufacturer, Merck. Not everyone may be eligible for this program. For more information and eligibility requirements, please visit https://www.merckhelps.com/LAGEVRIO.

More COVID-19 Information

Q: Where can I get the vaccine?

You can get the COVID-19 vaccine at the location most convenient for you. This may be your pharmacy, doctor’s office or a location sponsored by your local public health department.

Check the website of the pharmacy you use to see if they have appointments available.

If you are a veteran, your local Veterans Administration may also be offering the COVID vaccine. Spouses and caregivers can also get the vaccine through the VA.

Q: Will COVID-19 vaccines still be covered by SCAN?

Yes. COVID-19 vaccines (including approved booster doses) will continue to be covered when received by your doctor or at a pharmacy in the SCAN network. Find a pharmacy near you here.

Q: Does the COVID-19 vaccine have side effects?

While some people feel nothing, others may experience some side effects after receiving the vaccine. This can range from discomfort at the shot site to mild flu symptoms that can last up to three or four days.

If you’ve gotten the Shingrix vaccine for shingles, the process will be familiar to you. As with Shingrix, your COVID-19 vaccine might also require two doses and may cause some discomfort for a few days after the first and/or second dose.

You may have similar side effects after receiving a booster.

Prescription Drug Coverage

Q: Can I still get three-month supplies of my prescription drugs?

When the PHE ended on May 11, 2023, we returned to offering Tier 5, transition, and Long-Term-Care (LTC) pharmacy fills for up to one month's supply, unless they're in unbreakable packaging. 

Q: Will I still be able to get my prescriptions delivered at no cost?

Not all of them. The temporary allowances for major drug store chains like CVS, Walgreens, and Rite-Aid to provide home delivery services to you at no additional costs ended on May 11, 2023. You can still get prescription home delivery through Express Scripts Pharmacy or an in-network pharmacy that offers home delivery at no charge. 
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