The federal COVID-19 public health emergency will end on May 11, 2023.
How this effects COVID-19 coverage for Kaiser Permanente members:
Beginning May 12, 2023, unless required by state or local mandates, in Colorado, Georgia, Hawaii, Washington, D.C., Georgia, Maryland, Oregon, Virginia, and Washington, COVID-19 vaccines, testing, and treatment will be covered like any other condition:
- COVID-19 vaccines will be covered under preventive benefits at applicable plan cost-sharing, typically $0
- COVID-19 PCR testing will be covered under the outpatient diagnostic lab benefit at applicable plan cost-sharing
- COVID-19 over-the-counter (OTC) antigen tests will not be covered consistent with current plan coverage that does not cover OTC tests
- COVID-19 treatment will be covered under the drug benefit with applicable plan cost-sharing
- Out-of-Network (OON) Services for COVID-19 (e.g., OTC antigen tests, treatment, and vaccines) on HMO and EPO plans will only be covered for urgent care and emergency services, when legally required, or when OON coverage is included in a Kaiser Permanente member’s plan.
Self-funded customers will follow all the changes outlined above unless the plan sponsor requests different coverage for COVID-19 related services.
For additional details about the end of the federal COVID-19 public health emergency, visit account.kp.org.
