COVID-19: What You Need to Know

COVID-19 Services You Receive from In-Network Providers Are Covered at No Cost

Community Care Health is required by law to provide coverage for COVID-19 services from both in-network and out-of-network providers. This includes tests, immunizations, and treatments.

However, starting May 1, 2024, you will have to share in the cost of those services if you receive them from out-of-network providers. Your cost-share will be 50% of their reasonable and customary value. This is known as “R&C.” You will also have to pay for the difference, if any, between the R&C amount and the provider’s billed charges. This could be a lot of money and these amounts will not apply to your out-of-pocket maximum.

All of these services are available from in-network providers at no cost to you; so there is no need to get them from out-of-network providers. Important: If there are no in-network providers who are readily available to provide these services, or if you need the services on an urgent basis and cannot reach an in-network provider, Community Care Health will cover the services at no cost to you. Call Customer Service if you need help in finding a provider or have questions about your coverage. They can be reached at 1-855-343-2247, Monday-Friday, from 8:00 a.m. to 5:00 p.m.

Reimbursement for Over-the-Counter COVID-19 Tests

Community Care Health members who have purchased COVID-19 Tests are eligible for cost reimbursement. Please review complete and return the Member Claim Form to be reimbursed.

COVID-19 Test Reimbursement Form

U.S. Government Makes Free COVID-19 Tests Available Again

U.S. households can receive up to eight COVID-19 at-home test kits after the program re-opened on September 25, 2023. Simply visit the web site, enter your name, email address (if you wish to receive updates on the shipping status) and shipping address to order your COVID-19 at-home test kits. No credit card or payment of any kind is required.
Order Today

Member FAQs

A1. Yes. Community Care Health will cover FDA approved COVID-19 vaccines. There will be NO cost to Community Care Health members if the vaccine is received from in-network providers.

A2. Yes. Community Care Health will cover FDA approved vaccines in accordance with the requirements established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act. This includes any vaccines administered over more than one injection.

A3. Yes, in addition to vaccines, Community Care Health will cover COVID-19 tests and treatments. These services are covered at no charge and no cost-sharing (i.e., co-pays, co-insurance, deductibles or out-of-pocket costs) if you receive these services from an in-network provider.

A4. Community Care Health is required by law to provide coverage for COVID-19 services from out-of-network providers. However, starting May 1, 2024, you will have to share in the cost of those services. Your cost-share will be 50% of their reasonable and customary value. This is known as “R&C.” You will also have to pay for the difference, if any, between the R&C amount and the provider’s billed charges.

A5. If there are no in-network providers who are readily available to provide the services, or if you need the services on an urgent basis and cannot reach an in-network provider, Community Care Health will cover the services at no cost to you if you receive them from an out-of-network provider. Please call Customer Service at 1-855-343-2247 if you need help in finding a provider or have other questions about your coverage.

A6.  Please visit the State of California’s website, or the CDC website where you can get additional up-to-date information about COVID-19 and the vaccine. You can also access the Fresno County’s website. If you haven’t been vaccinated yet, click here to find a vaccine.

A7. According to the CDC, People with COVID-19 may have a wide range of symptoms – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Possible symptoms include the following:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

A8. While there is no failsafe way to prevent getting COVID-19, recommendations include:

  • Washing your hands for at least 20 seconds;
  • Covering up cough/sneeze with tissue and disposing of immediately;
  • Social distancing by keeping people at least 6 feet away where; and,
  • Staying home is highly recommended to prevent further spreading if you suspect you have been exposed.

A9. Stay informed and protect yourself and those around you:

  • If you are sick, stay home (and keep sick children home). It’s the best way to avoid the spread of illness.
  • If you have flu-like symptoms such as a fever, cough or sore throat, or difficulty breathing, please call your primary care doctor’s office and do not go to doctor’s office until you’ve spoken to the office and received instructions. If you need immediate medical attention, please dial 911 or go to your nearest emergency room.
  • Cough or sneeze into a tissue or your elbow and wash your hands afterwards.
  • Clean and disinfect frequently touched objects and surfaces.
  • To help reduce the risk of exposing you and others to the flu, common cold and COVID-19, we ask that you take advantage of telehealth options available to CCH members whenever possible (including Teladoc: (1-800-Teladoc).

Contact the Fresno County Health Department if you develop symptoms, and have been in close contact with a person known to have COVID-19 or if you live in or have recently been in an area with ongoing spread of COVID-19.  For guidance, contact the Fresno County Health Department at (559) 600-3332

A10. Yes, all Community Care Health members have access to Teladoc (1-800-Teladoc).

A11. If you do feel ill or believe you have been exposed, please call your doctor first and/or use Telehealth services (see A9 above).  As in any situation, if you believe you are experiencing a life threatening emergency, please call 911 and describe your situation, or go to the nearest hospital/emergency room.

A12. Yes. Community Care Health will cover medically necessary treatment of COVID-19 from both an in-network or out-of-network provider. However, you may be responsible for a share of the cost of the services from out-of-network providers. See Q1 above for more information on the cost share differences.

A13.  For general information and to stay informed please visit the Fresno Department of Public Health or call 1-559-600-INFO (4636). The Centers for Disease Control and Prevention (CDC) continues to monitor COVID-19.  Please refer to their website.