Do you have questions about COVID-19?
Members and families are our top priority. We're here to help.
ASK YOUR QUESTION
Frequently asked questions
At-home over-the-counter COVID-19 test coverage
Every home in the United States is once again eligible to receive four free COVID-19 at-home test from the federal government. You can request your free tests at covidtests.gov. (updated December 2022)
Yes. As of January 15, 2022, GEHA covers COVID-19 OTC test kits through its pharmacy benefit. Members may visit a participating retail network pharmacy (subject to availability and participation) to obtain certain OTC COVID-19 test kits at $0.00 cost using their prescription benefit card. A prescription is not required for the COVID-19 test kit, but the kit must be processed through the pharmacy. Find a pharmacy
Members may purchase a test online and pick it up at a participating CVS Pharmacy. Click to see detailed instructions.
Members may also purchase a COVID-19 test online, have it shipped to their home and submit for reimbursement through the GEHA prescription benefit. For reimbursement through the prescription benefit, the member will sign in to the portal at Caremark.com with their Username and Password, and submit a claim form. Tests purchased online will be reimbursed up to $12 per test (or the actual price of the test, if less).
Members may purchase a COVID-19 test from a retailer outside of GEHA’s preferred pharmacy network. Members should save their receipts and submit for reimbursement through the GEHA prescription benefit. For reimbursement through the prescription benefit, the member will sign in to the portal at Caremark.com with their Username and Password, and submit a claim form.
Tests purchased outside GEHA’s preferred pharmacy network will be reimbursed up to $12 per test (or the actual price of the test, if less).
GEHA will cover at-home over-the-counter COVID-19 tests purchased on or after January 15, 2022. GEHA has provided coverage for at-home over-the-counter COVID-19 tests purchased before January 15 with an order from an authorized health care provider.
Members who purchased a test prior to January 15, 2022, can request reimbursement by submitting a claim form with the receipt and copy of health care provider order using the GEHA Medical Claim Form.
Members may only be reimbursed once for the purchase of an at-home OTC COVID-19 test.
GEHA is required to provide reimbursement for 8 tests per rolling 30-day period per covered member, meaning 8 tests per GEHA subscriber plus 8 tests per spouse, child or other dependent who’s covered on the subscriber's plan. That means, for example, a family of four can be reimbursed for 32 tests per rolling 30-day period, regardless of whether the tests are bought all at once or at separate times throughout the rolling 30-day period. GEHA recognizes that some OTC COVID-19 tests are sold in packages containing more than one test. In applying the quantity limit of 8, GEHA may count each test separately, even if multiple tests are sold in one package.
GEHA will continue to cover COVID-19 tests if they are ordered by a physician, non-physician practitioner, pharmacist or other authorized health care professional.
Member reimbursements for at-home over-the-counter COVID-19 tests occur within the same 30-day turn-around time for all GEHA claims processing.
GEHA is not required to provide coverage of testing (including an at-home over-the-counter COVID-19 test) that is for employment or academic institution attendance purposes.
For people covered by original fee-for-service Medicare, Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People with Medicare can access one lab performed test without cost sharing per patient per year without an order. At this time original Medicare cannot pay for at-home tests through this program. Medicare Advantage plans may offer coverage and payment for at-home over-the-counter COVID-19 tests, so consumers covered by Medicare Advantage should check with their plan.
HHS is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program here. HHS also has established more than 10,000 free community-based pharmacy testing sites around the country.
Your COVID-19 medical coverage
Important note: For GEHA to cover COVID-19 diagnostic or antibody tests as described above, the test must be performed at the direction of the doctor. If you think you need a test, talk to a provider right away. If you choose to be tested using QuestDirect or another direct-to-consumer program without a doctor’s order, you will be responsible for all costs of the testing.
GEHA is also covering the visit associated with COVID-19 testing. If you see a provider, virtually or in person, and that provider orders or administers a COVID-19 test, that visit, and its costs will also be covered. For in-network providers, you will pay nothing for the associated visit. For out-of-network providers, GEHA will pay 100% up to the plan allowance; you may be responsible for any difference between the allowance and the provider’s billed amount.
If the testing site does not bill insurance directly, you can submit a paper claim directly to GEHA in order to be reimbursed for the covered service. Please see this PDF claim form for information on how to submit the claim directly to GEHA for reimbursement. Important note: If you choose to be tested using QuestDirect or another direct-to-consumer program, you must include with your claim form a health care professional's order for the test, and an itemized statement with all description details, complete cost and proof of purchase; if not included, you will be responsible for all costs of the testing.
Effective now and through June 30, 2021, GEHA is waiving deductibles, coinsurance, and copayments for COVID-19 inpatient and outpatient treatment. For in-network providers, you will pay nothing. For out-of-network providers, GEHA will pay 100% up to the plan allowance; you may be responsible for any difference between the allowance and the provider’s billed amount.
As of July 1, 2021, your cost-sharing for COVID-19 inpatient and outpatient treatment will be according to your benefit plan. You will be responsible for any copay, coinsurance, deductible or out-of-network costs as indicated in your plan brochure.
Oral antiviral treatments Lagevrio (Molnupiravir) and Paxlovid (Nirmatrelvir/Ritonavir) are currently covered at $0 cost to members.
GEHA has eliminated prior authorization and referral requirements for medical benefits related to COVID-19.
GEHA, as a one-time courtesy, is waiving prescription refill limits on maintenance medications. Members can obtain an additional 30-day supply of medications at retail and an additional 90-day supply of medication through mail order. Members are responsible for any applicable copay/coinsurance on these early refills and are encouraged to call CVS Caremark at 844.443.4279 with questions.
Yes, GEHA provides 100% coverage for the COVID-19 vaccination.
No. These are all commonly used words for the same type of physician visit through your telephone, tablet or computer.
GEHA has expanded our access to telehealth coverage. The use of these visits allows members to connect with care providers from home, minimizing potential exposure to infection while keeping emergency rooms and urgent care clinics available for those with the highest level of need.
Through August 31, 2020, GEHA provided expanded access to telehealth visits by waiving any copays, coinsurance or deductibles for all in-network telehealth appointments and by covering out-of-network providers at 100% up to the plan allowance.
As of September 1, 2020:
GEHA is waiving deductibles, coinsurance, and copayments for COVID-19 related telehealth visits. For in-network providers, you will pay nothing. For out-of-network providers, GEHA will pay 100% up to the plan allowance; you may be responsible for any difference between the allowance and the provider’s billed amount. Telehealth cost share for non-COVID-19 related visits will match what is reflected in your Plan brochure.
As of July 1, 2021: Your cost-sharing for COVID-19 inpatient and outpatient treatment (including telehealth) will be according to your benefit plan. MDLIVE telehealth visits will still be covered 100% (deductible applies for the HDHP plan). All other telehealth visits will take the appropriate copay, coinsurance and deductible outlined in your member materials.
Members can learn more about MDLIVE by calling Customer Care at 800.821.6136 or by visiting geha.com/MDLIVE.
Yes, they are offering e-clinic visits with MinuteClinic providers in 33 states and Washington, D.C. MAKE AN APPOINTMENT
Behavioral telehealth visits are covered the same as other telehealth visits. See above How are telehealth visits covered?
As dental offices reopen, many are prioritizing their patients with previously mid-progress treatment as they begin to reschedule routine dental care appointments. Contact your dentist for more information.
Effective from March 1 through July 31, 2020 only, we will accept claims for an exam through a teledentistry consultation, only when required to determine a member’s need for emergency care. By allowing this additional consultation type during the COVID-19 timeframe, we are increasing the member maximum from two exams to three exams for 2020. This maximum can be met through any combination of allowed exam types, typically via routine cleaning/exam appointments.
You can call GEHA Customer Care at 800.821.6136 during our normal business hours, which are 7 a.m. to 7 p.m. Central time, Monday through Friday (except holidays). Or you can send an email to Customer Care using our secure Contact GEHA form.
The virus is thought to spread mainly from person-to-person.
- Between people who are in close contact with one another. The CDC defines “close contact” as being within 6 feet of someone starting two days before illness onset until the time the patient is isolated. This includes asymptomatic patients, two days prior to test specimen collection.
- Through respiratory droplets produced when an infected person coughs, sneezes or talks. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
- Droplets can also land on surfaces and objects and be transferred by touch.
Some studies have suggested that COVID-19 may be spread by people who are not showing symptoms (asymptomatic). The best way to prevent illness is to avoid being exposed to this virus.
Additional information on this topic is available at cdc.gov/Coronavirus
- Cover your mouth and nost with a mask when around others, as you can spread COVID-19 even if you don't feel sick.
-
Wash your hands often with soap and water for at
least 20 seconds
- If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact with people who are sick at home.
- Practice social distancing outside your home by maintaining at least 6 feet distance from others and decrease frequency of contact. Even those who don't have symptoms (asymptomatic) can spread the disease.
- Cover your coughs and sneezes.
- Clean and disinfect frequently touched surfaces daily.
- Monitor your health daily.
Additional information on this topic is available at cdc.gov/Coronavirus
People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore Throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This list does not include all possible symptoms. CDC provides other information on symptoms at cdc.gov/Coronavirus
- Wear a mask over your nost and mouth.
- Cover your mouth and nose with a tissue when you cough or sneeze.
- Clean your hands often.
-
Stay home except to get medical care.
- Most people with COVID-19 have mild illness and can recover at home without medical care. Do not leave your home, except to get medical care.
- Take care of yourself. Get rest and stay hydrated. Take over-the-counter medicines, such as acetaminophen, to help you feel better.
- Stay in touch with your doctor. Call before you get medical care. Be sure to get care if you have trouble breathing or have any other emergency warning signs or if you think it is an emergency (see next section).
- Avoid public transportation, ride-sharing or taxis.
- Separate yourself from other people as much as possible, stay in a specific room and away from other people and pets in your home.
- Avoid sharing personal household items.
- Clean all “high-touch” surfaces daily.
- Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone.
- Monitor your symptoms. Follow care instructions from your healthcare provider and local health department.
Additional information on this topic is available at cdc.gov/Coronavirus
Look for emergency warning signs* for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake or stay awake
- Bluish lips or face
Call 911 or call ahead to your local emergency facility to notify the operator that you are seeking care for someone who has or may have COVID-19.
Additional information on this topic is available at cdc.gov/Coronavirus
Coronaviruses, like the one that causes COVID-19, are thought to spread mostly person-to-person through respiratory droplets when someone coughs, sneezes or talks. It is possible that a person can get COVID-19 by touching a surface or object, including food or food packaging, that has the virus on it and then touching their own mouth, nose or possibly their eyes. However, this is not thought to be the main way the virus spreads. The risk of infection by the virus from food products, food packaging or bags is thought to be very low. Currently, no cases of COVID-19 have been identified where infection was thought to have occurred by touching food, food packaging or shopping bags.
The risk of getting COVID-19 from food you cook yourself or from handling and consuming food from restaurants and takeout or drive-thru meals is thought to be very low. Currently, there is no evidence that food is associated with spreading the virus that causes COVID-19.
After shopping, handling food packages or before preparing or eating food, it is important to always wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
Additional counsel is available through cdc.gov/Coronavirus
- Stay home if sick.
- Use online services when available.
- Wear masks in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain.
- Use social distancing (stay at least 6 feet away from others).
- Use hand sanitizer after leaving stores.
- Wash your hands with soap and water for at least 20 seconds when you get home.
Additional information on this topic, including specific guidance on grocery shopping, banking, getting gas and take-out, is available at cdc.gov/Coronavirus
GEHA has several methods for you to speak to someone.
You can schedule a call to speak to a Customer Care adviser when it fits into your schedule. SET APPOINTMENT
You also have access to a personal care team that can help you with symptoms or concerns. CALL 800.821.6136
You can also speak with a registered nurse at any time of the day. CALL 888.257.4342
We recommend the CDC’s “Recommendation to Pause Use of Johnson & Johnson’s Janssen COVID-19 Vaccine” webpage for the latest information and updates.
Please note: GEHA's COVID-19 vaccination credit program ended on Dec. 31, 2021.
Up to two eligible GEHA medical plan members per household, ages 18 and older, enrolled in a GEHA wellness program, and who have not reached their annual wellness program reward limit.
Eligible members will be able to sign up for GEHA’s COVID-19 Vaccination Incentive Program and submit proof of vaccination beginning Thursday, July 1, 2021. To be eligible to receive the incentive, the first COVID-19 vaccination must occur on or before December 31, 2021. Program participants will have until December 31, 2021, to submit a request for the reward. The program is retroactive to 2020 so all eligible GEHA members who received a COVID-19 vaccine prior to December 31, 2021, may also submit a request to receive a $75 credit to their GEHA wellness account.
Visit your GEHA wellness program portal to provide proof of complete COVID-19 vaccination and receive $75 to their GEHA wellness account.
- HDHP*, Standard and High medical plan members should log into the HealthBalance portal to submit your vaccination status. Click on the dashboard image that says, “Self-report your COVID-19 vaccine for Health Rewards.”
- Elevate and Elevate Plus medical plan members need to log into the Rally portal to submit your vaccination status. Click on the “Rewards” tab and select the “COVID-19 Vaccination” program activity.
*HDHP members who are also enrolled in an HSA may only use their card for qualified dental and vision expenses until the yearly plan deductible has been satisfied.
Members* can use these incentive funds on qualified medical expenses such as office visits, copays, prescription drugs, eyeglasses, contacts and X-rays.
*HDHP members who are also enrolled in an HSA may only use their card for qualified dental and vision expenses until the yearly plan deductible has been satisfied.
Meet our experts
Federal employees are here for us day in and day out. We want you to meet the GEHA experts who are here for you at this challenging time.‘I got the COVID-19 vaccine. Here's why.’
In the case of COVID-19, researchers were able to quickly get to potential vaccines because of previous research on related viruses like SARS and faster, more innoavtive ways to manufacture vaccines. It was this critical head start that allowed us to get to clinical testing with record speed.
Read more
Help is here
Call Customer Care
Call a nurse
Connect with an online doctor
COVID-19 self-checker
Rally Health's tool will check your COVID-19 risk levels. Although the full Rally experience is for our Elevate/Elevate Plus members, this self-checker is open to all.
Thank you, members
COVID-19 has touched our lives in a way many of us could not imagine. While the situation continues to change almost daily, GEHA wants you to know that you and your family are our number one priority. We are here to help you navigate your health and wellness, so we can all keep moving forward. The information on this page will be updated frequently to make you aware of additional benefit changes. If you have specific questions about your benefits, please call us at 800.821.6136.
We are here for you now, and we’ll be there for you when life gets back to normal.
Additional resources
Centers for Disease Control (CDC) updates
Visit cdc.govCOVID-19 test site finder
Find testing near youWorld Health Organization (WHO) updates
Visit who.int*If the deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charges.
The frequently asked questions apply to all GEHA medical plan members, including Medicare primary members. The information presented by GEHA in these frequently asked questions does not constitute medical advice for any person who requires direct medical attention. It should not be used as a substitute for medical care or the advice of your physician. Please consult your medical provider for any symptoms that are severe or concerning.
This is a brief description of the features of the Government Employees Health Association, Inc.’s medical plans regarding COVID-19 benefits. Please refer to the GEHA Federal brochures available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.