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Helping you understand COVID-19 so you can stay safe and well-informed. See below for responses to some commonly asked questions about the COVID-19 vaccine, testing, treatment, and more.
At-home COVID test reimbursement
GA

At-home COVID test reimbursement

    • If you go to the pharmacy counter, you may be able to present your member ID and ask them to bill your insurance just like you would a medication at no cost to you. Please note that many pharmacies are still working to set up this process and may require that you pay out of pocket for now. If that happens please see below for how to get reimbursed.Additionally, you are able to order tests for free directly from the federal government via this site: https://www.covidtests.gov/ You can obtain a test through our network of pharmacies. Find one near you.
    • Don’t sweat – if you purchased the tests on or after January 15, 2022, you’ll still be able to get reimbursed. Just follow the steps below:(Note: If you’re a Cigna + Oscar or Cigna Administered by Oscar small group member, we’ll share more info soon about how you’ll be reimbursed. You won’t be reimbursed if you follow the process below.)
      1. Please visit Caremark.com and sign in or register. Be sure to have your member ID available if you haven’t previously created an account with Caremark. (You can always access your member ID number through your online account here.
      2. Select “Plan & benefits”
      3. Select “Submit a prescription claim” and follow the prompts listed there.
      • Your tests must be purchased on or after January 15, 2022. 
      • Your tests must be FDA authorized.
      • You must be an active member enrolled in individually purchased health care or on a small group plan. Reimbursement doesn’t apply to Medicare Advantage plans.
      • You will be reimbursed for up to 8 tests (not 8 test kits) per member per 30 day period. Ideally, the receipt should only include the purchase of tests and no other items (i.e. a receipt that includes only the at-home COVID test(s) purchased and not other non-reimbursable purchases) is preferred as it will allow us to process your request more quickly.
    • FDA Authorized OTC COVID self-tests will be reimbursed and include the following.
      • Abbott BinaxNOW 
      • SD Biosensor COVID At Home Test
      • Siemens’s CLINITEST Self Test
      • iHealth COVID-19 Self Test
      • Access Bio’s CareStart Self Test
      • BD Veritor At-Home Test
      • InBios SCov-2 Detect Self Test
      • OraSure InteliSwab Rapid Test
      • Cellitrion DiaTrust Home Test
      • QuickVue At Home Test
      • ACON Flowflex Home Test
      • Ellume Home Test
      • Detect COVID-19 Test
      • Lucira Check-it COVID-19 Test
      • Cue Covid-19 at home test

COVID-19 vaccines

    • Three COVID-19 vaccines are authorized for use as a booster dose at this time. Pfizer-BioNTech or Moderna (COVID-19 mRNA vaccines) are preferred. You may get Johnson & Johnson’s Janssen COVID-19 vaccine in some situations. For more information and up to date recommendations on boosters, please visit the CDC website.
    • The COVID-19 vaccines that are currently available have been reviewed and recommended by the Advisory Committee on Immunization Practices (ACIP) and the CDC.The CDC recommends vaccines that it has declared safe and effective. According to the CDC, millions of people in the United States have received COVID-19 vaccines, and these vaccines have undergone the most intensive safety monitoring in U.S. history.Prior to the CDC’s recommendations, clinical trials are being conducted to evaluate approved COVID-19 vaccines in many thousands of study participants. These trials generate scientific data and other information used by FDA to determine vaccine safety and effectiveness. You can learn more from the CDC, or from Oscar Medical Group’s Dr. Stephanie Reznick in these videos on our blog: Stopping a pandemic requires using all the tools available, and getting vaccinated is one of many steps you can take to protect yourself and others, including those who are at risk for severe illness or death. COVID-19 vaccination and following CDC’s recommendations to protect yourself and others will offer the best protection from COVID-19.
    • The cost of the COVID-19 vaccine is $01 wherever it is available, such as at your local pharmacy like CVS. Select CVS locations are administering COVID-19 vaccines by appointment only, and based on local eligibility and availability guidelines. You can check your eligibility and schedule appointments where available through the CVS tool. Our $0 cost-share COVID-19 vaccine policy covers COVID-19 immunizations that have been approved by the federal government and national public health institutes like the CDC.2 This is a quickly evolving situation and Oscar will keep you updated as more information is shared. You can find the latest news on COVID-19 vaccines and related regulations on the CDC’s website. 
    • At facilities that are covered by your Oscar plan, you will have a $0 copay at the time of your visit(s). At facilities that are outside of your plan’s coverage network, Oscar will reimburse you for the full cost of the vaccines. 
      • For Oscar Individual & Family members, COVID-19 vaccines are covered upfront when administered at an in-network facility. Members who receive the vaccine at an out-of-network facility will need to submit a reimbursement form directly to CVS Caremark for reimbursement within 30-45 days. 
      • For Cigna + Oscar members, COVID-19 vaccines are covered upfront when administered at a local Express Scripts-affiliated facility.3 Members who receive the vaccine at another facility will need to submit a reimbursement form directly to Express Scripts. The form can be submitted electronically through your Express Scripts account.
      • For Oscar Medicare Advantage members, please note that the cost of both the COVID-19 vaccine  will be covered at $0 co-pay. Oscar is working with providers to make sure that they submit claims to Original Medicare.
    • The CDC recommends COVID-19 vaccines, including boosters, for everyone ages 6 months and older. Use CDC’s COVID-19 booster tool to learn if and when you can get boosters to stay up to date with your COVID-19 vaccines. Staying up to date means getting all recommended COVID-19 vaccines including boosters when eligible. People who are moderately or severely immunocompromised have specific COVID-19 vaccine recommendations, which include a third dose to complete their primary series, as well as two booster doses for those eligible.You can find the latest updates and guidance from your state health department website via this page.
    • Consider if you have any allergies to ingredients in the vaccine (which can be found here) and if so discuss it with your allergist or PCP before having the vaccine. The CDC recommends that people who are starting their vaccine series or getting a booster dose get either Pfizer-BioNTech or Moderna. It is not recommended that you premedicate with ibuprofen, acetaminophen, or other pain relievers/anti-inflammatories before receiving the vaccine.
    • You should take every precaution to stay safe and avoid exposure to COVID-19 during your visit. Follow CDC guidelines for reducing your risk, including but not limited to wearing a mask, covering your nose and mouth, and stay at least 6 feet away from others while inside and in lines. Following vaccination, you should stay on site so that health care professionals can monitor you for any allergic or adverse reactions. According to the CDC, people who have had severe allergic reactions or who have had any type of immediate allergic reaction to a vaccine or injectable therapy should be monitored for at least 30 minutes after getting the vaccine. All other people should be monitored for at least 15 minutes after getting the vaccine.You should also receive a vaccination card or printout that tells you what COVID-19 vaccine you received, the date you received it, and where you received it, as well as a paper or electronic version of a fact sheet that tells you more about the specific COVID-19 vaccine you are being offered.Depending on the specific vaccine you get, two doses may be required, with a second shot 3-4 weeks after your first shot needed to get the most protection the vaccine has to offer against this serious disease. Oscar will cover the cost of both doses of the COVID-19 vaccine at $0 co-pay.
    • COVID-19 vaccination will help protect you from getting COVID-19. You may have some side effects, which is a normal sign that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days. So far, most people have only experienced minor side effects, if any at all. With most COVID-19 vaccines, you will need two shots in order for them to work most effectively. The CDC recommends that you get the second shot even if you have side effects after the first one, unless a vaccination provider or your doctor tells you not to get a second shot. According to the CDC, the most common side effects of the currently available COVID-19 vaccines, and recommended actions based on side effects you might experience, include but are not limited to: 
      • Potential side effect: Pain or swelling on the arm where you got the shot.
        • CDC recommended action: Apply a clean, cool, wet washcloth over the area, and/or use or exercise your arm.
      • Potential side effects: Fever, chills, tiredness, throughout the rest of your body, and/or headaches.
        • CDC recommended action: To reduce discomfort from fever, drink plenty of fluids and/or dress lightly.
      If you have pain or discomfort, the CDC recommends talking to your doctor about taking an over-the-counter medicine, such as ibuprofen or acetaminophen. Icing the area can be helpful. You can also use v-safe, the CDC’s free, smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. You should call your doctor if the redness or tenderness where you got the shot increases after 24 hours, and/or if your side effects are worrying you or do not seem to be going away after a few days. If you have a concerning side effect you’d like to report, you can do so through the Vaccine Adverse Event Reporting System (VAERS).If you have any questions or need help finding a local Oscar provider, you can contact your Care Team through your online account or the Oscar App, or at (855) 672-2755. If you have medical questions, such as about side effects and other potential risks, your Care Team can also help you schedule an appointment with Oscar Virtual Urgent Care, available 24/7 from the comfort of home.4 It takes time for your body to build protection after any vaccination. COVID-19 vaccines that require 2 shots will not optimally protect you until a week or two after your second shot. It is important that you continue to take steps to reduce your risk throughout the vaccination process, and to reduce the risk of others.

    • The CDC says that you can receive the second dose, if applicable, of your COVID vaccine up to 6 weeks after the first dose.  While not providing explicit guidance for those who have waited more than 6 weeks, the CDC does state that there is not a reason to start the series over.

    • Some people who are immunocompromised don’t build adequate levels of protection after receiving their two-dose initial mRNA COVID-19 vaccination. Getting an additional dose can sometimes help them build more protection against the disease. Immunocompromised patients are eligible to get a third dose of Pfizer or Moderna mRNA vaccines at least 28 days after their second dose. These patients should still receive a booster six months after receiving their third dose, as the third dose is considered part of the initial series for immunocompromised individuals and not a booster.

      A “booster shot” refers to another dose of a vaccine that is given to someone who built enough protection after vaccination, but then that protection decreased over time.

COVID-19 & health insurance

      • If you’re feeling symptoms or think you were exposed to COVID-19, it’s important to know whether you have the virus or not so you can take action to get the care you need, while continuing to protect yourself and others.
      • Oscar will waive cost-sharing of diagnostic testing for COVID-19, including antibody (serology tests)and any FDA-approved at-home COVID-19 diagnostic tests, through the duration of the Oscar members will pay $0 cost-share for COVID-19 testing, including the cost of the visit associated with the test and the test itself, whenever a test is recommended by a physician.
      • Oscar does not cover testing for surveillance and back to work purposes.
    • Your Oscar plan will cover treatment associated with COVID-19. For Oscar Individual and Oscar for Business plan members, we waived the cost of treatment for COVID-19 through August 31, 2021, when delivered by in-network providers and some out-of-network providers.5
      • Your Oscar plan covered treatment associated with COVID-19 under your plan's normal cost-sharing rate.
      • There were also some exceptions based on federal and local regulations, such as for COVID-19 treatment delivered via telemedicine as outlined in the FAQ below.
      • Login to your Oscar account online or through the Oscar app to review your plan details and message your Care Team about any questions you may have. Oscar will continue to assess our policies to make sure they are best serving the needs of our members as the pandemic continues to evolve. Please visit this page for the latest updates.
    • Oscar understands the importance of having access to medical services while many of us are staying at home to help reduce the spread of COVID-19. We continue to offer $0 telemedicine to most of our members through Oscar's Virtual Urgent Care.Oscar also has expanded telemedicine coverages policies in the following states:
      • NJ: Oscar will continue to waive member cost sharing for in-network telemedicine and telehealth visits for the duration of both the state of emergency and the public health emergency related to COVID-19 declared by the Governor.
      • All other states: Oscar will cover medically-necessary telemedicine care with in-network providers, subject to cost-sharing as if done in-person.
      We will reassess policy dates as needed.
    • If you are concerned you’ve contracted COVID-19 and/or need help deciding if you need medical care, the CDC recommends contacting your primary care physician as a first step. If you are experiencing a medical emergency, please call 9-1-1. If it is not a medical emergency, you can contact Oscar’s Virtual Urgent Care, available 24/7 at $0 on most plans. Established Virtual Primary Care patients can reach out to their PCP directly through the Oscar app.
    • We offer worldwide emergency coverage for life or limb emergencies. Out of network emergency care is covered if delivered at an emergency department until the member is stabilized. If you received care overseas, Oscar will need specific information to process your claim. We recommend obtaining the documentation before returning home. Contact your Care Team to discuss what documentation is needed. Be sure to reference the latest CDC guidelines for domestic, international and cruise ship travel.     

COVID-19 & seeking care

    • COVID-19 is the infectious disease caused by the most recently discovered coronavirus, SARS-CoV-2. Coronaviruses are a family of viruses which also include SARS, MERS and the common cold.

    • The most common symptoms of COVID-19 are fever, dry cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. Some people have aches and pains, nasal congestion, runny nose, sore throat, or diarrhea. These symptoms are usually mild and begin gradually. Symptoms may appear 2-14 days after exposure, according to the CDC.Over-the-counter cold and flu medications can be used to manage symptoms. If your symptoms worsen, such as a fever that does not decrease with medications such as acetaminophen, you should contact a healthcare professional. Please note, a fever alone that improves with over-the-counter medication does not typically require additional medical care. Your Care Team can help you determine if you need medical attention, schedule a call with a Oscar Virtual Urgent Care, or find an appointment with a provider, if necessary.If you develop emergency warning signs for COVID-19, you should seek medical attention immediately. According to the CDC, emergency warning signs include:
      • Difficulty breathing where you are not able to walk across a room without needing to stop, or worsening lightheadedness.
      • Have shortness of breath with lips turning blue.
      • Persistent pain or pressure in the chest.
      • Passing out or having an altered mental status (unusual confusion).
      If you are experiencing emergency symptoms, please call 9-1-1 immediately. Some people become infected without developing any symptoms or feeling unwell. Most (about 80%) recover from the disease without requiring special treatment. Older people, and those with underlying medical problems—such as high blood pressure, heart problems or diabetes—are believed to be more at risk to develop serious illness. Learn more in the Q&A for people at high-risk below.
    • Over the course of the pandemic, there has been some debate about whether COVID19 spreads as an airborne versus a droplet infection, with the latter spreading farther in the air. The CDC states the virus spreads from person-to-person in the following ways:The virus spreads from person-to-person:
      • Breathing in the virus from the air, such as after an infected person coughs or sneezes.
      • Virus coming in contact with one's mucous membranes (nostrils, eyes, mouth), such as from an infected person coughing or sneezing.
      • Touching mucous membranes with hands contaminated with the virus.
      You are unlikely to get COVID-19 by touching a surface or object that has the virus. COVID-19 can be spread by people who are not showing symptoms. Vaccinated people who become infected with COVID-19, can also pass on the infection. Please note, the CDC states that fully vaccinated people do not need to quarantine after being exposed to the virus unless they develop symptoms, although they should wear a mask around others and try to get tested 5 days after the exposure.Important update for CO members: State of CO COVID-19 Exposure Notification 6
    • To avoid being exposed to the virus and to prevent illness, the CDC recommends the following:
      • Becoming fully vaccinated
      • Avoid close contact with people who are sick.
      • Maintain social distancing of at least 6 feet from others not within your household.
      • Avoid touching your eyes, nose, and mouth.
      • Stay home when you are sick.
      • Cover your mouth and nose with a cloth face cover when around others.
      • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
      • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
      • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom and before eating; and after coughing, sneezing, or blowing your nose.
      • If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol. Beware of the FDA recall list of hand sanitizers containing methanol, which are not safe to be used.
      • Monitor your health daily.
    • While anyone is at risk of COVID-19 if they are exposed, some people are more likely to become very sick if they are infected. People at higher risk include:
      • Older adults
      • People who have serious chronic medical conditions like:
        • Heart disease or other serious heart conditions
        • Sickle cell disease
        • Diabetes
        • Lung disease, including moderate to severe asthma
        • Obesity (BMI of 30 or higher)
        • People with chronic kidney disease, including those undergoing dialysis
        • People with liver disease
        • And others as noted on the CDC website.
      • People are considered to be immunocompromised if they have:
        • Been receiving active cancer treatment for tumors or cancers of the blood
        • Received an organ transplant and are taking medicine to suppress the immune system
        • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
        • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
        • Advanced or untreated HIV infection
        • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response
      People should talk to their healthcare provider about their medical condition, and whether getting an additional primary shot is appropriate for them.
    • Per the CDC, masking recommendations are based on community spread level, which can be checked here.
    • If you’re experiencing COVID-19 symptoms outlined above , like a fever or cough, you should stay home and monitor your symptoms, such as by taking your temperature. Please note that a fever alone is not an indicator of the need to seek medical attention.If your symptoms worsen and you need help deciding if you need medical care, the CDC recommends contacting your primary care physician as a first step. Your provider can assess your symptoms and recommend the best course of action for you. We recommend calling provider offices in advance of going in-person. You can also contact Oscar’s Virtual Urgent Care. If you are experiencing a medical emergency, please call 9-1-1.If you have other clinical questions, like what over-the-counter medication to use, reach out to your provider or Virtual Urgent Care.If you have been told to isolate by a doctor, you should stay isolated in your home and stay in a room separate from others as much as possible. If a mask is available, please wear it to avoid infecting others, or wear a face covering. Try to use separate utensils than those used by others in your home. A household member should disinfect all high touch areas (tables, countertops, doorknobs, faucets, etc.) frequently.
    • Oscar’s Direct Coverage program leverages a national network where pharmacies in the network may adjudicate a claim for OTC COVID tests, without a prescription, and with no up-front out-of-pocket costs to the member, under the plan’s pharmacy benefit. Additionally, many of the pharmacies in the national network offer delivery or shipping direct to members’ homes, offices, or other locations. If you go to the pharmacy counter, you may be able to present your member ID and ask them to bill your insurance just like you would a medication at no cost to you. Learn more about at-home testing reimbursement here. If you prefer for a healthcare professional to administer testing, find a testing site near you. If you are in an area experiencing a surge in COVID cases, there may be testing shortages or long wait times; you can call the testing center ahead of time for more information. Your local board of health may have additional resources for testing in surge situations.  For more information on COVID testing, please see the CDC website.If you are experiencing a health emergency, such as serious difficulty breathing, please call 9-1-1 immediately and let them know you are concerned you may have COVID-19.
      • Make sure you are fully vaccinated – including a booster shot when due – as soon as possible, unless otherwise advised by your doctor.
      • Ask your doctor if you should receive a third dose (for immunocompromised patients).
      • Continue to wear a mask in public (consider using a KN94 or other high grade mask), follow social distancing recommendations, and wash your hands frequently/use hand sanitizer with at least 60% alcohol in it.

    • Some people who have been infected with Covid-19 can experience long lasting effects from their infection. This is also referred to as post--COVID syndrome.  These patients continue to have symptoms weeks, and sometimes months, after the initial infection.  Symptoms are extremely varied and non-specific (meaning a lot of other conditions can cause similar symptoms), but common symptoms include fatigue, shortness of breath, chest pain, and cough.  Some patients complain of dizziness, neurologic issues, brain fog, skin conditions, issues with their digestive tract, and so on. 

      A lot remains unknown about post-COVID syndrome, but the medical community continues to work hard to discover how to improve how it is diagnosed and treated.  In the meantime, symptom-based treatments have been successful.

    • It appears that those with pre-infection chronic conditions or more serious infections with COVID are at higher risk, but even young, previously healthy patients who develop an asymptomatic infection may go on to develop one or more long-Covid symptoms.

    • If you think you have symptoms of long Covid please reach out to your PCP or another healthcare professional to discuss next steps. Many hospital systems have post-COVID clinics, but may have long wait lists.  Remember not all post-COVID clinics are in network for Oscar members.

General health care during the pandemic

    • We are also allowing members to obtain a 90-day supply of durable medical equipment (DME), but please note that Virtual Urgent Care cannot prescribe DME. You can still get deliveries, and your Care team is always available to check on the status of your DME equipment. They can help you contact the vendor to schedule delivery. Get in touch with your Care team by sending them a message or calling 1-855-672-2755.
Footnotes
This content on this entire page does not constitute medical advice and is not meant to be a substitute for professional medical advice, including diagnosis or treatment. Contact your physician with any questions you may have regarding COVID-19 or your personal health. If you are experiencing a medical emergency, dial 9-1-1 for immediate assistance.
1
Oscar covers the COVID-19 vaccine at $0 co-pay for members with Individual & Family and Small Group plans. Oscar Medicare Advantage members, please note that the cost of both the COVID-19 vaccine and the associated visit(s) will be covered at $0 co-pay. Oscar is working with providers to make sure that they submit claims to Original Medicare.
2
Oscar will cover at no cost share COVID-19 immunizations within 15 business days after the immunization has been recommended by the Advisory Committee on Immunization Practices (ACIP) and adopted by the CDC, and as required under applicable state laws and regulations.
3
This is not an all-inclusive list of pharmacies, and is subject to change at Express Scripts’s discretion.
4
Oscar’s Virtual Care offerings vary by market and may not be available in your service area. Oscar’s Virtual Care offerings are not available in US territories or internationally. Prescriptions, visits and services may be limited per provider discretion. Virtual Providers are employed by Oscar Medical Group and are not employed by Oscar Insurance.
5
Please also note that this cost-share waiver does not apply to post-acute care, long-term treatment, or related Durable Medical Equipment.
6
Important update from the State of Colorado: COVID-19 Exposure Notification System: On October 25, in partnership with Google and Apple, the state of Colorado launched its COVID-19 statewide exposure notification system. The service can quickly notify users if they’ve been exposed to COVID-19 so they can reduce the risk to loved ones and community, seek medical advice, and slow the spread of the virus. The State of CO encourages you to strongly consider activating CO Exposure Notifications. By opting in, your Android or iPhone device will share anonymous tokens with other CO Exposure Notifications users using your phone’s Bluetooth. If another user you’ve been near tests positive for COVID-19 within a 14-day period, the service will notify you. If you test positive, you can easily and anonymously notify others to stop the spread of COVID-19. This is a voluntary service and you can turn it off at any time. The service was created with your privacy in mind. Everything is anonymous. The service does not use your GPS to track your location and no personally identifiable is collected, stored, or transmitted. We encourage you to strongly consider activating CO Exposure Notifications. Knowing about an exposure allows you to reduce the risk to your family, friends, neighbors, coworkers and community. For more information about the technology, including FAQs and instructions for downloading the application, please visit addyourphone.com, and for additional COVID-19 resources, see covid19.colorado.gov.

Contact your Care Team

If you have any questions, you can check in with your Oscar Care Team via your online account or the Oscar App, or at (855) 672-2755.

Login to your Oscar account