The federal government announced in January that both national emergencies addressing COVID-19 will end on May 11, 2023. 

Effective May 12, 2023, when medical and pharmacy plans will no longer be subject to federal coverage requirements for COVID-19 testing, vaccinations, and treatment coverage, Cigna Healthcare standard coverage for integrated pharmacy and medical plans will be reinstated:

Pharmacy plan coverage

• COVID-19 vaccines will be covered on all formularies under the preventive benefit, at 100% in-network only.
• FDA-approved antivirals and therapeutics will be covered with the cost share subject to plan design.
• Over-the-counter (OTC) COVID-19 tests will no longer be covered, if applicable. The Internal Revenue Service does consider these tests an eligible expense reimbursable under health savings accounts and flexible spending accounts. Customers may use funds to pay for OTC kits separate from the health plan.

Medical plan coverage 

Covered as Preventive:

• COVID-19 vaccines will be covered under the preventive benefit, same as the flu shot, at 100% in-network only. Availability of out-of-network coverage with applicable cost share is based on plan design.

Covered as medically necessary/appropriate with applicable cost share based on plan design and place of service:

• PCR lab testing – coverage under your Lab benefit
• FDA-approved antivirals and therapeutics
• COVID treatment

No longer covered:

• Over-the-counter (OTC) COVID-19 tests. The Internal Revenue Service does consider these tests an eligible medical expense reimbursable under health savings accounts and flexible spending accounts. Customers may use funds to pay for OTC kits separate from the health plan.