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The federal government ended the COVID-19 public health emergency on May 11

As of May 12, COVID-19 vaccines, testing, and treatment are now covered like any other condition (unless otherwise required by state or local mandates):

  • COVID-19 vaccines are covered under preventive benefits at applicable plan cost shares, typically $0.
  • COVID-19 PCR tests are covered under the outpatient diagnostic lab benefit at applicable plan cost shares.
  • COVID-19 home antigen tests aren’t covered, which is consistent with current plan coverage that doesn’t cover over-the-counter tests.
  • COVID-19 treatment is covered under the drug benefit with applicable plan cost shares.
  • Out-of-network services for COVID-19 — such as home antigen tests, treatment, and vaccines — only are covered for urgent care and emergency services on HMO and EPO plans, when legally required, or when out-of-network coverage is included in a Kaiser Permanente member’s plan.

Your self-funded clients will need to follow all the changes outlined above unless the plan’s sponsor requests different coverage for COVID-19-related services.

For more details about the end of the federal COVID-19 public health emergency and how it may affect your clients, visit account.kp.org.

All plans offered and underwritten by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.

©2022 Kaiser Foundation Health Plan of Washington