COVID-19 Coverage

Updated April 2023

Based on COVID-19 trends, the Department of Health and Human Services (HHS) plans to expire the federal Public Health Emergency (PHE) for COVID-19 on May 11, 2023.

We remain committed to providing access to the care and coverage you need — when you need it most. Here's how!

Preventive Coverage
All members are eligible for no-cost COVID-19 vaccinations and booster shots following FDA guidance by age group. 

Telehealth
PPO Plus members have free access to telehealth with Sana Care providers.

PPO Plus HSA High Deductible Health Plan (HDHP) members are subject to IRS guidelines for cost-sharing as follows:

• 2022 Employer Plans: Standard rates apply until the deductible is met. 
• 2023 Employer Plans: Beginning June, 1, 2023, 2023 HDHP members are eligible for no-cost telehealth, pre-deductible, through Sana Care partners, including PlushCare, Blueberry, and Ginger.

Treatments
COVID-19-related treatments are subject to copays and cost-sharing, as defined in your plan documents.

Testing
PPO Plus members have free access to testing. 

PPO Plus HSA High Deductible Health Plan (HDHP) members are subject to IRS guidelines for cost-sharing as follows:

• 2022 Employer Plans: Members have access to free testing, with cost-sharing waived.
• 2023 Employer Plans
  • Plans starting before June 1, 2023 have access to free testing, with cost-sharing waived.
  • Plans starting on or after June 1, 2023 are subject to IRS coverage guidelines, which currently allow plans to cover testing in full.

Tests must be FDA-approved or qualify for Emergency Use Authorizations (EUA).

Members are eligible to be reimbursed for up to eight FDA-approved OTC home tests per plan member, per calendar month. Select pharmacies now accept insurance for OTC COVID-19 test kits.

If your pharmacy is unable to bill insurance for OTC COVID-19 test kits, please follow the steps below to submit a reimbursement request.

1. 1. Go to the Submit a Claim tab to start a new claim. 
   2. Enter the vendor name under Provider Name. (ex: CVS or Walgreens)
   3. Enter the vendor phone number under Provider Phone. (see receipt)
   4. Enter the purchase date under Service 1.
   5. Enter the name and quantity of tests under Service Code or Description.
   6. Enter the total charge amount and amount paid. This number should match.
   7. Upload a clear, itemized receipt showing the name of the test, date of purchase, and quantity.
   8. Confirm your info is correct, then click Finish & Submit Claim.

In most cases, reimbursements are processed and paid in under two weeks. Occasionally this can take 30-60 days. You will receive an email with an electronic check and instructions for direct deposit into your bank account. 

You can sign in to your Sana account and track your claim through the Medical Claims tab. 

Over-the-Counter (OTC) Home Test Notes & Restrictions

• • Reimbursement requests should not include mandatory testing required by businesses, for example, required testing as a condition of employment or to attend recreational events. See your plan documents for more information.
  • FDA-approved home tests currently include BinaxNOW, IHealth COVID-19 Antigen Rapid Tests, and others. Please verify FDA approval for the home test category before purchasing. Many times, FDA approval status is listed on the box of the home test kit. 
  • Shipping costs are excluded from reimbursement.
  • Bulk orders and multi-packs:
    • The number of individual tests per box count toward your monthly allowable limit. (example: a 2-pack counts as two tests)
    • If purchasing larger quantities for dependents, please submit individual claims for each family member, not to exceed eight tests per member, per calendar month.

If you have any questions please feel free to call us at (833) 726-2123 or send an email to hello@sanabenefits.com.