During the COVID-19 outbreak, Sanford Health Plan is committed to providing you and your family with health care access.
COVID-19 testing is fully covered.
Sanford Health Plan will cover 100 percent of the cost of specimen collection and testing for COVID-19. Testing is covered when indicated as medically necessary by a qualified practitioner.
At-Home COVID Testing Reimbursement
Office and ER visits for COVID-19 are covered.
Sanford Health Plan will cover office visits and ER visits at 100 percent when related to COVID-19 testing. If you have symptoms of COVID-19, call your provider for guidance.
What will Sanford Health Plan cover with regard to COVID-19 testing and treatment?
1. Testing: Members will not pay copays, deductibles or coinsurance for medically necessary tests to diagnose COVID-19. This includes the COVID-19 tests, anti-body tests, specimen collection, and any related rule out tests to make the COVID-19 diagnosis (Note: Testing must be medically necessary, consistent with CDC guidance and at the direction of a doctor). There is no prior authorization requirement to review for testing, meaning your doctor does not have to ask us for the OK to test for COVID-19. Cost-share is waived for both in and out of network facilities. All services for or relating to COVID-19 testing and diagnosis will be covered at zero cost share until the end of the Public Health Emergency (PHE).
2. Testing-Related Visits: Members will not pay copays, deductibles or coinsurance with in-network providers for visits related to COVID-19, whether at a provider's office, urgent care clinic, emergency room or by telehealth. Cost-share is waived for both in and out of network facilities. This policy will remain in effect until the end of the Public Health Emergency (PHE). Treatment for COVID-19, including medications and inpatient admissions, are covered at the cost share according to the member’s plan. This includes anti-viral and anti-body treatment.
3. Vaccines: The vaccine itself will be provided by the government, so there will not be a charge for the vaccine. Sanford Health Plan will waive costs for administering the vaccine, meaning we will cover 100 percent of the allowed amount. This includes the amount for the office visit to administer the vaccine.