This article is for all providers caring for our members
Updated August 31, 2020 to add convalescent plasma as having received EUA approval for use in COVID-19 treatment.
Blue Cross Blue Shield of Massachusetts follows federal and state mandated requirements for SARS CoV-2 (COVID-19) treatment coverage. This article clarifies:
FDA/EUA approved pharmaceutical treatments for COVID-19 infection
Blue Cross Blue Shield of Massachusetts covers all FDA-approved drugs for COVID-19 with no cost share to the member throughout the duration of the public health emergency.
To date, there are no FDA-approved drugs for COVID-19. However, Remdesivir has received emergency utilization approval (EUA) for patients in an inpatient hospital setting who require treatment beyond respiratory support; and convalescent plasma has received emergency utilization approval (EUA) for hospitalized patients.
Drugs under investigation for COVID-19 infection
Drugs that are covered
Several drugs are under investigation through clinical trials as potential treatments for COVID-19 that have shown early benefit. Blue Cross Blue Shield of Massachusetts covers the following drugs when used outside a clinical trial for patients who are in an inpatient hospital setting and require treatment beyond respiratory support, at the discretion of their treating provider:
Please note that standard inpatient payment policy rules apply.
Drugs that are not covered
Blue Cross Blue Shield of Massachusetts does not cover drugs under investigation through clinical trials that have not demonstrated improvement in patient outcomes in early studies or are not recommended for use outside of the clinical trial setting by CDC, NIH, or DPH guidelines.
The following drugs are not covered outside of the clinical trial setting:
Coverage for Medicare Advantage patients in an inpatient hospital setting who require treatment beyond respiratory support is covered under Medicare Part A and follows CMS guidelines. For more information, see this CMS press release on New Hospital Procedure Codes for Therapeutics in Response to the COVID-19 Public Health Emergency