Below you will find the most recent information pertaining to COVID-19 and your State Health Plan benefits.
For the latest information on COVID-19, please visit the South Carolina Department of Health and Environmental Control (DHEC) website at www.scdhec.govexternal link, opens in a new tab and the Centers for Disease Control and Prevention (CDC) website at www.cdc.govexternal link, opens in a new tab.
The State Health Plan covers the COVID-19 vaccination as recommended by the CDC at no member cost. For vaccines that require more than one dose, the Plan will cover each required dose at no member cost. Coverage includes the cost of the vaccine and administration fee if the member receives the shot in a network doctor’s office. Any associated office visit charges will follow regular Plan coverage rules. Members can also take advantage of this benefit at a network pharmacy.
Medicare covers the cost of the COVID-19 vaccine under Medicare Part B. Express Scripts Medicare members need to present their Medicare card a network pharmacy for COVID vaccine coverage. Additional information is available at www.express-scripts.com/home/covid19.
More information about the distribution of the vaccine is available on DHEC’sexternal link, opens in a new tab website. Members who have questions about the safety and effectiveness of the vaccines or other clinical aspects, such as potential side effects, should visit the CDCexternal link, opens in a new tab and DHECexternal link, opens in a new tab websites.
The federal COVID-19 public health emergency ended on May 11, 2023. As such, beginning May 12, 2023, the State Health Plan covers testing for COVID-19 as follows:
- Diagnostic tests. Commonly known as COVID-19 PCR test or simply PCR, the State Health Plan covers this test under normal Plan provisions, and tests are subject to member cost share.
- At-home tests. The State Health Plan does not cover at-home, over-the-counter tests.
- Return to work/school tests. The State Health Plan does not cover testing for this purpose.