April 29, 2020
Our focus has been to help our employer customers and members during the COVID-19 outbreak. We are monitoring this pandemic and are extending some of our coverage and eligibility dates. As always, members should call the number on their ID card for answers to their specific benefit questions.
| Benefit | Effective Date | Projected End Date | Link to Article on Original Dates |
| COVID-19 Testing | 3/7/20 | Cost share waiver ends with the end of Health and Human Services (HHS) public health emergency | COVID-19 Coverage Information for Employers and Members |
| COVID-19 Testing-related Visits | 3/18/20 | Cost share waiver ends with the end of HHS public health emergency | UPDATE: COVID-19 Coverage for ASO Groups Regarding FFCRA and Telehealth Expansion |
| Telehealth Expansion | 3/18/20 | 5/31/20* | UPDATE: COVID-19 Coverage for ASO Groups Regarding FFCRA and Telehealth Expansion |
| COVID-19 Treatment | 4/1/20 | 5/31/20 | Decision Needed: ASO Groups Can Waive Member Cost Sharing for COVID-19 Treatment |
| Interfacility Transfer | 4/1/20 | 5/15/20* | BCBSNM Waiving Prior Authorization for Transfers to Post-acute Facilities |
| Prior Authorization | Services scheduled between 1/1/20 and 6/30/20** | 12/31/20 | Extending Prior Authorization on Previously Approved Elective Surgeries, Procedures and Therapies |
| Chest CT Scan | 3/2/20 | End of HHS public health emergency * | Making It Easier to Access Chest CT Scans |
**Services that were originally approved or scheduled between Jan. 1 and June 30, 2020
New Mexico has a broader mandate than set forth federally and currently there is no projected end date for New Mexico coverage nor cost share waiver.
Extensions on Telehealth Expansion: Self-funded customer (ASO) decisions will be extended as Blue Cross and Blue Shield of New Mexico (BCBSNM) makes extensions for fully insured members. An ASO account’s prior decision will remain in place unless the group requests a change from its account executive. BCBSNM will accommodate changes on a monthly basis. Requests received between the first and 15th of every month will begin dates of service the first of the following month. Requests received after the 15th of the month will begin dates of service following the next effective period.
Action may be needed for ASO groups: If your ASO client would like to make a change from their original decision, please contact your account executive no later than Thursday, April 30. If you don’t communicate that change by April 30, your client’s decision will continue as currently coded. Change decisions made after April 30 cannot be accommodated for a May 1 effective date.
Reminder: COVID-19 testing and testing-related visits are covered at no cost share for fully insured and ASO members as required by the Families First Coronavirus Response Act until the end of the federal public health emergency.
Eligibility Requirements Extension for Employees: We previously relaxed the eligibility requirements for currently enrolled/covered group members.
- From now through June 30, employers can maintain employees who were enrolled on their plans as of March 20, regardless of the eligibility definition stated in their plan or the BPA. The previous date was through April 30.
- This extension is for both group medical coverage and ancillary products.
- This includes reduced work hours, furlough, leave of absence or layoffs.
- Groups do not need to do anything. No paperwork or email is needed, as we will accept current and accurate eligibility files.
- This flexibility does NOT apply to those who are newly electing coverage via the special enrollment period.
