Insurance coverage information for HealthPartners members

If you have HealthPartners insurance, we understand you may have questions about coverage for COVID-19 testing, treatment or vaccines. Here you can find our latest health plan information for COVID-19.

Have questions about your specific situation? Call Member Services at the number on the back of your member ID card. We’re here to help.

COVID-19 testing coverage

All HealthPartners members have 100% coverage for COVID-19 diagnostic tests that are:

  1. Performed by a doctor or appropriately licensed provider in a clinical setting, AND
  2. For medically necessary purposes, AND
  3. On the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) list or a state-approved test list

Medically necessary diagnostic tests include tests for people experiencing symptoms of COVID-19 as well as tests for asymptomatic people who may have had close contact with COVID-19.

Examples of diagnostic tests that may not be covered include tests solely for travel or employment purposes as well as other tests not considered medically necessary.

Effective January 15, 2022, certain HealthPartners members have 100% coverage for COVID-19 diagnostic tests that can be purchased over the counter and completed at home. Coverage is available for:

  • Fully insured employer plan members
  • Self-insured employer plan members who have pharmacy benefits through HealthPartners
  • Individual and family plan members

If you’re not sure what kind of plan you have, please call Member Services at the number on the back of your member ID card.

Each eligible member has coverage for up to eight at-home diagnostic tests per month.

  • A “test” refers to a single nose or throat swab – if a test kit you purchase contains multiple swabs, each swab is counted separately.
  • All tests that have received an Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) are eligible for coverage.
  • Tests that have not received an EUA from the FDA are ineligible for coverage.

Please save receipts for at-home diagnostic tests you buy on or after January 15, 2022. We also recommend saving information (like the boxes) for the specific diagnostic tests you purchase. Documentation will be required to receive reimbursement under your coverage.

More information about coverage details and how to request reimbursement will be available soon.

Please note that not all at-home diagnostic tests may be covered. Examples include tests solely for travel or employment purposes as well as other tests not considered medically necessary.

During the COVID-19 pandemic, HealthPartners covers all COVID-19 antibody tests that are:

  1. Ordered by a doctor or appropriately licensed provider, AND
  2. For medically necessary purposes, AND
  3. On the Food and Drug Administration (FDA) Emergency Use Authorization (EUA) list or a state-approved test list

HealthPartners covers the full cost of antibody (serology) testing that meets the above guidelines. These tests are used to determine if a person has previously had, and recovered, from COVID-19. Tests are done by testing a sample of a person’s blood.

It’s important that antibody tests be ordered by a doctor or other appropriately licensed provider. If you order a test on your own, it may not be covered.

Yes. All e-care, phone and video visits associated with COVID-19 testing are covered, including visits at Virtuwell, Doctor on Demand, Teladoc and other e-care providers. If COVID-19 testing is not performed, these visits are subject to your standard coverage.

COVID-19 vaccine coverage

Yes. The cost of COVID-19 vaccines is covered 100% – with no cost sharing (copays, deductibles, etc.) – for all HealthPartners members. In addition, Medicare is covering the cost for most Medicare beneficiaries.

All forms of the vaccine are covered – including booster shots and immunocompromised doses. Neither the type of vaccine nor the dosage affects your coverage.

Covered COVID-19 testing and vaccination locations

It’s important to be tested at a lab that’s using a test authorized by the FDA or a state health authority. You should consult with your doctor to find an appropriate testing site within your plan’s network.

HealthPartners Care Group provides COVID-19 testing at many locations. You can also search other in-network providers.

We strongly recommend seeking testing and vaccination at in-network locations, when possible. This makes it faster and easier to pay your costs.

Testing and vaccination at out-of-network locations is covered 100%. However, we’ll need some additional information to pay your claim.

For additional questions, please call Member Services at the number on the back of your Member ID card.

COVID-19 treatment and virtual visit coverage

In the majority of COVID-19 cases, people are directed to self-care, self-quarantine, and contact their doctor or provider as needed. Most people recover from COVID-19 without needing additional medical treatment.

If you do need acute medical care directly related to your diagnosis of COVID-19, it’s covered. Your cost-sharing amount depends on which kind of plan you have and when you receive care:

  • Fully insured employer plan, individual and family plan, and Medicare plan members – Cost-sharing amounts related to acute COVID-19 treatment are waived for care received on or before December 31, 2021. In addition, if you were admitted to a hospital on or before December 31, 2021, cost-sharing amounts related to acute COVID-19 treatment are waived for the full duration of your admission. Your plan’s standard cost-sharing amounts apply for care received, or hospital admissions beginning, on or after January 1, 2022.
  • Minnesota Medical Assistance (Medicaid) plan members ­– Cost-sharing amounts related to acute COVID-19 treatment, including hospital admissions, are waived until the federal and state governments end the public health emergency.
  • Self-insured employer plan members – Please call Member Services at the number on the back of your member ID card to understand your acute COVID-19 treatment coverage for care received, or hospital admissions beginning, on or before December 31, 2021. Your plan’s standard cost-sharing amounts apply for care received, or hospital admissions beginning, on or after January 1, 2022.

To review your plan coverage, sign in to your HealthPartners account or call the Member Services number on the back of your member ID card.

(Please note that any applicable cost-sharing waivers do not apply to care for ongoing complications after an acute COVID-19 infection has passed. For this kind of ongoing care, your standard coverage and cost-sharing amounts apply.)

Virtual visits for services not related to COVID-19 testing and diagnosis follow the member’s regular plan coverage and cost sharing.

For example, a virtual office visit for an illness will be covered under your Office Visit for Illness or Injury benefit, just like an in-person visit would be. This includes virtual visits for physical therapy, speech therapy and occupational therapy.

To review your plan coverage, sign in to your HealthPartners account or call the Member Services number on the back of your member ID card.