Cigna Healthcare

With COVID-19 Emergencies Ending, Cigna Healthcare Announces Standard Coverage Effective May 12

The federal government announced in January that both national emergencies addressing COVID-19 will end on May 11, 2023.

Effective May 12, 2023, when medical and pharmacy plans will no longer be subject to federal coverage requirements for COVID-19 testing, vaccinations, and treatment coverage, Cigna Healthcare standard coverage for insured plans* will be reinstated:

Pharmacy plan coverage (if applicable)

• COVID-19 vaccines will be covered on all formularies under the preventive benefit, at 100% in-network only.**
• FDA-approved antivirals and therapeutics will be covered with the cost share subject to plan design.

Medical plan coverage

Covered as Preventive:

• COVID-19 vaccines will be covered under the preventive benefit, same as the flu shot, at 100% in-network only.** Availability of out-of-network coverage with applicable cost share is based on plan design.

Covered as medically necessary/appropriate with applicable cost share based on plan design and place of service:

• PCR lab testing – coverage under your Lab benefit
• FDA-approved antivirals and therapeutics
• COVID treatment

No longer covered:

• Over-the-counter (OTC) COVID-19 tests. The Internal Revenue Service does consider these tests an eligible medical expense reimbursable under health savings accounts and flexible spending accounts. Customers may use funds to pay for OTC kits separate from the health plan.

Click here to download pharmacy and medical coverage grid for more detail.

Helping you prepare your employees for the upcoming changes, we created an optional customer letter you can download and share. As plan designs can vary, the letter invites customers to visit MyCigna.com, checkout the MyCigna app, or call the toll free number on their ID card starting May 12.

• For medical only plans, click here to download the Cigna Healthcare customer letter.
• For integrated pharmacy and medical plans, click here to download the Cigna Healthcare customer letter.

Thank you for your continued trust in Cigna Healthcare to help improve the health and vitality of your employees. If you have any questions, please contact your Cigna Healthcare representative.