With the May 11 end of the COVID-19 Public Health Emergency comes changes to coverage under the Federal Employee Health Benefit Program (FEHBP).
Here are some of the major changes included in the Office of Personnel Management’s public health emergency transition guidelines to FEHBP carriers:
FEHBP plans must continue to cover laboratory and over-the-counter COVID-19 diagnostic tests, but may impose cost-sharing (including deductibles, copayments, and coinsurance) and medical management (including prior authorization). In other words, carriers may charge out-of-pocket costs for lab and over-the-counter COVID-19 tests.
FEHBP carriers must continue to cover, without cost-sharing, COVID-19 vaccines on an in-network basis, but they can stop providing out-of-network coverage for vaccines. During the public health emergency, carriers were required to provide both in-network and out-of-network coverage of COVID-19 vaccines.
Carriers are encouraged to notify covered individuals of changes to key information about their COVID-19 benefits (e.g., date when the carrier would begin to impose cost-sharing requirements).
Federal employees and retirees enrolled in the FEHBP are encouraged to monitor plan communications and visit their carrier’s website for more information on how the changes will affect them.