Covid Testing and Treatment Coverage Rules Have Changed for Some ACERA Members Enrolled in Kaiser Permanente Plans
Changes at the federal level may have resulted in changes to coverages for Medicare-eligible ACERA retirees enrolled in the Kaiser Permanente Senior Advantage Plan. See the table below for current coverage levels and rules.
The State of California has issued an extension until November 12, 2023 before Covid coverage changes take effect for non-Medicare (under age 65) enrollees in the Kaiser Permanente HMO. See the table below for current coverage levels effective until that date.
For questions, visit www.kp.org or call Kaiser Permanente at 1-800-464-4000.
Kaiser Permanente Covid Coverage Levels and Rules
|
Kaiser Permanente HMO (Under Age 65) Coverages valid until 11/12/2023 |
Kaiser Permanente Senior Advantage (Medicare, Over Age 65) |
|
|---|---|---|
| Vaccine | Covered at $0 (Preventive) | Covered at $0 (Preventive) |
| Lab Testing | Covered at $0 copay |
Testing at Kaiser is covered under the outpatient diagnostic lab benefit at applicable plan cost-sharing.
Required testing for other purposes, such as for work, school, or travel is not covered if you indicate those purposes on the testing intake form. |
| Treatment | Covered with applicable hospital copay |
Inpatient treatment is covered under the inpatient benefit at applicable plan cost-sharing.
Rx treatment will be covered under the Medicare Part B drug benefit with applicable plan cost-sharing. |
| At Home Antigen Tests |
Get up to 8 free antigen tests per month at any Kaiser pharmacy.
For purchases of antigen test outside of Kaiser, you may submit reimbursement claims for up to 8 tests per month at $12 maximum per test. Sign in at kp.org to submit claims. |
No longer covered as of May 12, 2023 |