As a community health plan, we’re working to limit the spread of this virus and promote access to testing, vaccination and medically necessary treatment.
WellFirst Health — Provided by SSM Health Plan — strongly encourages all eligible individuals to receive a COVID-19 vaccine and booster.
Our health plan covers FDA-approved COVID-19 vaccine(s) (SARS CoV-2) with no member cost-sharing, consistent with the requirements set forth by the CARES Act. If you are interested in receiving a vaccine or booster, there are several options available to you including, health care providers, pharmacies, federal and community-based vaccine clinics, local and tribal health departments, etc.
For more information on COVID-19 vaccine eligibility, please visit the CDC’s COVID-19 vaccine website.
We are doing our part to ensure members have access to the testing they need.
Medically appropriate provider ordered tests for members with known or suspected symptoms, a known or suspected exposure, or those entering a medical facility for services (e.g., pre-operative testing) are provided at no cost to members during the public health emergency.
Tests purchased to fulfill employer directed testing requirements are not eligible for reimbursement.
Learn more about over-the-counter testing.
When a provider orders COVID-19 antibody testing, member cost sharing is waived.
During the public health emergency, when a provider orders FDA-approved monoclonal antibody treatment (consistent with their respective emergency use authorization (EUA)), member cost sharing is waived for Medicare members. For our commercial members, this treatment is covered with no member cost through October 31, 2022.
Information on antiviral therapies may be found on the CDC website.
The U.S. Centers for Disease Control and Prevention offers guidance on symptoms and when to contact your medical provider.
If you're experiencing symptoms, you can initiate an e-visit. A provider will determine the right care for you. If testing is recommended, you will be directed to the nearest testing site.
If you are not experiencing symptoms but are concerned about a potential exposure, you should seek free testing through the nearest community testing site.
We are currently expanding our coverage of telehealth services. This allows additional methods of health care access for members such as Skype, FaceTime or Zoom.
These services are available to our Commercial HMO/POS (Individual Coverage), Marketplace (healthcare.gov), and Medicare members.