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Apr 28, 2023

  • Large Group
  • Small Group
  • Individual
  • National
  • CA

COVID-19 PHE benefits extended six months in California for fully insured with option for ASO groups

The federal COVID-19 public health emergency (PHE) will end May 11, 2023. California state law extends PHE health plan requirements for six months, until November 11, 2023.

These benefits are extended for Fully Insured clients:

  • Diagnostic and screening testing for COVID-19.
  • COVID-19 immunization.
  • Items and services intended to prevent or mitigate COVID-19.
  • Therapeutics.
  • Up to 8 over-the-counter tests per month.

They will continue to be covered without:

  • Cost sharing.
  • Prior authorization.
  • Utilization management.
  • In-network requirements.

Out-of-network provider reimbursement must remain at least 125% of Medicare reimbursement through November 11, 2023, and at least 100% of Medicare reimbursement after that. This flyer (PDF) has more details about the extension for fully insured clients.

Administrative Service Only local clients in California can choose to customize their COVID-19 benefits as part of normal plan administration. Please request those benefit changes through your sales representative.

Please contact your Anthem sales representative for more information.

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