Based on action taken by the Biden Administration, the public health emergency (PHE) related to COVID-19 ends on May 11, 2023.

The PHE was declared on January 31, 2020, and as periodically renewed by the Secretary of Health and Human Services and deals with the testing and other coverage requirements by your plan as of March 18, 2020.

The PHE requirements included coverage of:

• COVID-19 diagnostic testing products, without cost sharing, both in- and out-of-network.
• Items and services furnished during office visits, urgent care visits and emergency room visits that result in an order for or administration of a COVID-19 diagnostic test, without cost sharing, both in- and out-of-network.
• Up to 8 over-the-counter at-home COVID-19 tests per month without cost sharing.
• COVID-19 vaccines without cost sharing, from both in- and out-of-network providers.

Beginning May 12, 2023 (the first day after the PHE ends), the health plan’s coverage of the items listed above will be as other similar services as reflected in the Schedule of Benefits:

• Coverage of COVID-19 diagnostic testing products at regular benefits. I.e., members may be responsible for a portion of the cost towards the deductibles, coinsurance, copayments, etc.
• Coverage of items and services furnished during office visits, urgent care visits and emergency room visits that result in an order for or administration of a COVID-19 diagnostic test at regular benefits. I.e., you may be responsible for a portion of the cost towards the deductibles, coinsurance, copayments, etc.
• Over-the-counter at-home COVID-19 tests will not be covered under your plan.
• Coverage of in-network COVID-19 vaccines without cost sharing, as required by the preventive services requirements of the Affordable Care Act. Coverage of out-of-network vaccines on the same basis as other vaccinations/immunizations are covered under your plan.

If you have any questions regarding the benefits as applied under the group health plan, you may contact Med-Pay’s Customer Service Department at (417) 886-6886 or (800) 777-9087 8:30 a.m. – 4:30 p.m. Monday – Thursday and 8:30 a.m. – 4:15 p.m. Friday.

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