Coronavirus & Your Healthcare

  • How COVID-19 tests and treatment are covered

    The Food & Drug Administration (FDA) authorized COVID-19 Home Test Kits are covered when ordered by a licensed physician or pharmacist, or when purchased by a member for use of COVID symptoms or due to direct exposure. Home Test Kits will not be covered if used for non-diagnostic purposes like travel or return to school.

    Ways to get no cost at-home test kits

    • At an in-network pharmacy: Find an in-network pharmacy near you by signing into your account and searching for Find a Doctor. You must present your insurance ID card at the pharmacy counter to obtain tests at no cost.
    • Online access: Go to ExpressScripts. Set up an account and get a kit shipped to your home.
    • Order online: Go to covidtests.gov.  Every household may now order 2 sets of 4 COVID at-home test kits. Additionally, Nomi Health is offering FDA-certified, at-home COVID tests for all Premera members. Order your test today.
    • COVID-19 treatment: For treatment of COVID-19, copays, deductibles and coinsurance will apply.
    • COVID at-home test kit coverage and reimbursement:
      • Free at-home COVID tests from US federal government now available: 4 tests per household, no cost, and supply is limited—first come, first served.
      • Free at-home COVID tests from Washington state government now available: 5 tests per household, no cost, and supply is limited currently to ZIP code.
      • Members may submit claims for reimbursement for in-home tests using the OTC claim reimbursement form and a separate claim reimbursement form is required if reimbursement is needed on more than one covered family member. Use this at-home test reimbursement form. The test you purchase must have been granted full or Emergency Use Authorization (EUA) by the Food & Drug Administration (FDA) and labeled for home use and have been purchased January 15, 2022 or later. Check the EUA list for approved home tests.
    • More on COVID testing: LifeWise will waive all costs (copays, deductibles, and coinsurance) for any member requiring FDA-approved or state-approved COVID-19 tests for diagnostic purposes. Cost waived for the related office visit (for in or out-of-network providers) as well as other respiratory, viral tests, and other blood work to determine the need for COVID-19 diagnostic testing. LifeWise also covers and waives costs for antibody tests that support diagnosis or that support people with COVID-related complications.

    Vaccine for COVID-19

    Who can get the vaccine?

    All Washington residents age 5 and older are vaccine eligible. When making an appointment for kids under age 18, check that the provider or site offers the correct Pfizer vaccine—it is the only vaccine approved for children. The Pfizer pediatric vaccine is a smaller dose for children 5-11. People over the age of 12 should receive the full dose Pfizer COVID-19 vaccine. More CDC info about kids COVID-19 vaccines.

    Find a vaccine location and schedule your appointment

    How much will it cost?

    No cost to you. The government has mandated that everyone in the United States will get the vaccine without out-of-pocket cost. Either your health insurance will cover it or the cost will be waived.

    Need a ride or vaccine at home?

    • Get a ride:Lyft, Uber, Sound Transit, and other organizations now offer free or discounted rides.
    • Home vaccinations: Not able to leave home? Get connected with state or county mobile vaccine teams. Fill out a secure form for home vaccines.
    • WA state hotline: Call 800-525-0127, then press #. Language help is available. Request home vaccine service if needed.

    Watch vaccine videos from CDC and WA Department of Health:

    COVID-19 fact vs. fiction
    What to expect after getting the COVID vaccine

    Virtual care options

    If you have COVID-19 symptoms or need care for medical or mental health, please use your virtual care options first to avoid possible exposure. Virtual care services may be able to assist with a review of symptoms and recommendations on next steps, but only in-person clinics or provider visits can diagnose and test for COVID-19.

    • Call your in-network primary care doctor's office.
    • Call the 24-Hour NurseLine at no charge. Just call the number on the back of your member ID card to reach medical professionals.
    • Use 98point6 for text-based primary care via mobile app.
    • Use Doctor On Demand for a video chat with a doctor for medical care and mental health therapy.
    • Talkspace offers virtual access to licensed therapists.
    • Teladoc Health provides high-quality healthcare by phone, or mobile app.
    • Boulder Care is video-based treatment for opioid use disorder
    • Workit Health is video-based treatment for alcohol use disorder
    • Many in-network providers, including local counselors, therapists, psychologists, psychiatrists, and facilities, are offering care virtually during this time.

    98point6, Doctor on Demand, Teladoc, Talkspace, Boulder Care, and WorkIt Health are independent companies that provide virtual medical care services on behalf of LifeWise.

    Additional resources

    How to stay safe at the workplace, schools, and home.
    How to know if you're high-risk and what to do.

    Frequently asked questions

    Key dates: Are there ones to know regarding COVID-19 benefits and coverage?

    Yes. 

    • Applied behavioral analysis (ABA) available through telehealth (Premera initiative) – Ends June 30, 2022
    • Cost share waivers for FDA-approved COVID-19 diagnostic testing other virus/respiratory testing tied to a COVID-19 diagnosis (federal Families First Act through the Public Health Emergency) – Ends July 15, 2022
    • Antibody tests covered when done in an inpatient setting, late illness onset, or outpatient inflammatory syndrome in children. Cost shares waived if criteria met. (CDC and EEOC guidelines) – Policy effective July 1, 2020; cost share criteria through July 15, 2022

    Vaccine: How do I show proof of vaccination?

    There are many options for showing proof of your COVID-19 vaccination, including carrying your card (or a photocopy of your vaccination card), taking a picture of your card with your phone, or using your state's record. For Washington state residents: Learn how to access your vaccine records through MyIRMobile. For WA state help getting your records, or if you don't have access to the internet or need language assistance, call 1–800–525–0127, then press #.


    Vaccine: Am I eligible for a booster dose?

    The Centers for Disease Control and Prevention (CDC) officially recommended the administration of a second booster vaccine dose from Pfizer/BioNTech or Moderna for people age 50 and up at least 4-6 months after the 2nd dose. Johnson & Johnson booster vaccines are recommended for those 18 and over at least 2 months after receiving the first dose. No out-of-pocket cost for members who meet these criteria.


    Vaccine: Why are boosters needed?

    People who are fully vaccinated are still strongly protected against hospitalization and death from COVID-19. But immunity against infection can wane over time, and the extra-contagious delta variant is spreading widely. U.S. health authorities want to shore up protection in at-risk people who were vaccinated months ago, though the priority remains getting the unvaccinated their first shots.


    Vaccine: What if I don't want to wait 6 months?

    Experts agree that getting a booster too soon can reduce the benefit. Timing matters because the immune system gradually builds layers of defenses over months, and letting that response mature improves the chances another, later dose will provide even stronger protection.


    Vaccine: Do I need a booster to still be considered fully vaccinated?

    No, the CDC says people still are considered fully vaccinated starting two weeks after the second dose of the Moderna or Pfizer vaccines, or the single-dose J&J shot.


    Vaccine: Will this be my last booster?

    Nobody knows. Some scientists think eventually people may get regular COVID-19 shots like annual flu vaccinations. But researchers will need to study how long protection from the current boosters lasts.


    Should I get a flu shot?

    The CDC, and many medical practitioners, are strongly recommending everyone get a flu shot this year. With the flu almost non-existent last year due to the stay-at-home orders, masking and handwashing, many are expecting this flu season to come back strongly. According to the CDC, it is safe to get both your COVID-19 vaccine and the flu vaccine at the same time.


    What's the difference between the flu and COVID?

    Both are contagious respiratory illnesses, but there are differences. Read CDC details on flu and COVID signs and symptoms differences. An easy-to-read flu vs. COVID graph is also available.


    Is personal protective equipment covered as a deductible medical expense?

    Yes. The IRS just issued guidance that personal protective equipment to prevent the spread of COVID-19 (such as face masks, hand sanitizer and sanitizing wipes) are deductible medical expenses. You can now get reimbursed for these items under any of these personal funding accounts:

    • Health flexible spending accounts (health FSAs)
    • Archer medical savings accounts (Archer MSAs)
    • Health reimbursement arrangements (HRAs)
    • Health savings accounts (HSAs)

    Is drive-through or home testing covered?

    Yes, your test is covered the same whether you're in the car, at home, or in a lab, as long as it is ordered by a physician or pharmacist.


    Is other help available?

    The Washington State Coronavirus Response website includes a list of programs and services for Washingtonians impacted by COVID-19. The site includes information on financial, food, housing, and well-being services, among others.

    Your county may offer additional support in your community. Check your county's website for resources.