Care and Services Available for COVID-19 (Coronavirus)

COVID-19 vaccinations and boosters

Who’s eligible. Everyone ages 5 and older is encouraged to receive a COVID-19 vaccine. The FDA has authorized, and the CDC has recommended, vaccines and booster shots from Pfizer-BioNTech, Moderna, and Johnson & Johnson Janssen anyone ages 16 and older. Children ages 5 and older get an age-appropriate dose of the Pfizer-BioNTech COVID-19 vaccine.

Vaccine coverage. COVID-19 vaccines reduce the risk of severe disease, hospitalization, and death, and slow spread of the virus. AmeriHealth covers the cost of administering them with no cost share (such as co-pays, deductibles, coinsurance) for members regardless of where the vaccine is given. For a vaccine distribution site near you, visit vacccines.gov.

Booster coverage. A COVID-19 booster shot is an additional dose of the vaccine that is given after the protection provided by the original shot(s) has begun to decrease over time. AmeriHealth covers the cost of administering booster shots with no cost share. If you received a Pfizer or Moderna vaccine, you are eligible for a booster shot six months or more after the initial shots. If you received the Johnson & Johnson COVID-19 vaccine, a booster shot is recommended two months or more after initial shot.

Testing

COVID testing. AmeriHealth covers the cost for medically appropriate diagnostic and antibody testing of COVID ordered by an authorized health care professional at no cost to the member. In addition, AmeriHealth covers up to eight over-the-counter (OTC), FDA-approved tests per calendar month as required by the Biden Administration².

If you have FutureScripts (OptumRx) coverage:

  • To pay $0: Visit any Walmart, Sam's Club, Rite Aid, or Walgreens location, get your OTC COVID test kit off the shelf and check out at the pharmacy counter. Be sure to present your member ID card and ask to have the OTC test submitted to OptumRx.
  • Order online for $0: Log in at amerihealth.com. Select Pharmacy in the My Benefits box, then Pharmacy Mail Order/Home Delivery, then Order Now. If you have not accessed the Pharmacy Mail Order/Home Delivery function previously, you may be required to register your account. There is a minimum order amount required to get free shipping.
  • Get reimbursed if you pay out of pocket. If you purchased an OTC COVID test after January 15, 2022, you can submit for a reimbursement of up to $12 per test. Complete the OptumRx Over-the-Counter Test Reimbursement Form and include your receipts. You will need to submit a separate claim form for each family member.

If you have pharmacy coverage through another company, please contact the phone number on your prescription drug card for information on how OTC COVID test coverage applies.

Additional details can be found in these FAQs. These coverages are in accordance with federal mandates through the end of the public health emergency¹. AmeriHealth does not cover tests that are needed for return to work, a condition of employment, return to school, or travel.

Find a test location

Getting care

Treatment. Member cost share applies for in-network, inpatient treatment of COVID-19.

Telemedicine

Visit a doctor from anywhere¹. Telemedicine services for a COVID-19 related diagnosis from your primary care doctor are covered at no cost through the end of the public health emergency¹. Telemedicine services from your doctor for a non-COVID diagnosis are also available — cost sharing applies based on your health plan.

MDLIVE. You can schedule a telemedicine appointment with a doctor 24/7 with MDLIVE¹ at no cost, depending on your plan. MDLIVE doctors can assess your symptoms and help with next steps. Register or login at mdlive.amerihealth.com.

Your emotional health

Virtual visits for mental health¹. If you have mental health benefits through AmeriHealth, you can talk to an in-network mental health counselor online or on the phone and standard cost sharing will apply. If the visit is to diagnose COVID-19, cost-sharing will be waived. Visit amerihealth.com to find a provider.

Staying healthy

Wear a mask. Public officials and health experts are urging us to wear masks indoors or in large crowds, regardless of vaccination status. COVID-19 and its variants mainly spread from droplets released into the air when we cough, sneeze, or talk.

Practice social distancing. Limit close contact with anyone outside of your household. Even if you’re wearing a mask, it’s still recommended you stay at least six feet from others when in public, or at least two arms’ length apart.

Wash your hands regularly. Viruses can spread from touching recently contaminated surfaces and then touching your face. Washing your hands is one of the most importance defenses against the spread of COVID-19 and other illnesses. Keep hand sanitizer on you for when you don’t have access to soap and water.

Resources and links



¹ If you have coverage through your employer, benefits and coverages may vary. Please check with them about how these programs apply.

² The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act mandate that member cost sharing (deductible, co-pays and coinsurance) is waived both in and out-of-network for the testing and diagnosis of COVID-19 through the public health emergency.