Coronavirus (COVID-19) Information and Updates

Now that the public health emergency (PHE) is ending as of May 11, 2023 your coverage for in- and out-of-network services will follow your plan policies, and some out-of-network providers you may have been able to see may no longer be covered or may be covered at a different cost share We encourage you to review your provider network and call the number on the back of your ID card with any questions.

If you have questions that are not covered below, or if you want to learn more about the actions we’ve taken to respond to the COVID-19 pandemic, feel free to contact us:

Members: call the number on the back of your member ID card.

Group Plan Administrators:  call Client Support at (866) 297-4718 or email 
 Providers:  Call (800) 481-1092
 Brokers: Call Broker Services at (888) 384-4840 

For the latest information regarding the affects of COVID-19 across the state and in your community, please visit the websites below:

You may also contact public health officials in your state by calling:

  • North Carolina residents can call (888) 675-4567.

Frequently Asked Questions


Should I get a vaccine?

The federal government has authorized the use of several vaccine products to protect Americans against COVID-19. The CDC, as well as state, local and territorial public health agencies across the country recommend COVID-19 vaccination for everyone age 6 months and older. We urge all members to strongly consider getting vaccinated.

FAQ sheets and other useful information about each vaccine can be found here:

FirstCarolinaCare members and members of Self-Funded group health plans administered by FirstCarolinaCare Insurance Company who are eligible for a primary vaccine or booster shot will be able to receive them with no out-of-pocket costs. 

Individuals can receive a vaccine through a public mass vaccination site or a healthcare provider. Contact your local public health agency for more information regarding vaccine availability in your area. Please be prepared to show  your insurance ID card when you go in to receive the vaccine.

Like other vaccines and preventive services, COVID vaccines are covered by most health plans issued or administered by FCC at no out-of-pocket costs when administered by participating providers.

Providers may charge a fee for the administration of the vaccine, and the cost of this administration fee will be covered without applying copays, coinsurance or deductibles for most FirstCarolinaCare plans and Self-Funded plans administered by FirstCarolinaCare. Cost-sharing may apply for members covered under certain grandfathered group health plans. If you have questions about your specific coverage, please call the number on the back of your member ID card.


What is the recommended treatment for those with the virus?

If you think you have developed COVID-19, call your healthcare provider for medical advice. Older patients and individuals who have severe underlying medical conditions or are immunocompromised should contact their healthcare provider early, even if their illness is mild. If you have severe symptoms, such as persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face, contact your healthcare provider or emergency room and seek care immediately. Your healthcare provider will determine if you have the signs and symptoms of COVID-19 and whether you should be tested. As always, if you need immediate emergency help, call 911.

For those who test positive for COVID-19, your healthcare provider will seek the latest CDC advice regarding treatment. This may range from simple supportive care that lessens symptoms to care that aides vital organ functions.

What is the Test to Treat program – and where can I find more information about it?

The Test to Treat program – led by the federal government – gives you a way to quickly access free, lifesaving treatment for COVID-19. Through this program, you are able to get tested for COVID-19, and – if you test positive and treatments are appropriate for you – you are able to receive a prescription from a healthcare provider and have that prescription filled, all at one single location. You can visit any one of the thousands of local community sites throughout the country. For more information, and to find a site near you, visit U.S. Department of Health and Human Services or call (800) 232-0233 (TTY 1-888-720-7489).

Important note: If you have COVID-19 symptoms and test positive, do not wait to get treated. If your provider determines you need the oral COVID-19 medications, you must take this within five days of your first COVID-19 symptoms.


Please note that the content provided within this website is only intended as a general summary of information and does not constitute your policy of insurance or summary plan description. The information on this website does not guarantee coverage or verify eligibility for benefits. The information provided on this website is designed to support, not replace, the relationship between FirstCarolinaCare Insurance Company and the members of the plans it offers and administers. Please see your member materials or contact the number on the back of your ID card for additional details specific to your health plan’s coverage. Should a member require subsequent medically necessary treatment for COVID-19 related medical conditions, FirstCarolinaCare Insurance Company will cover such treatment pursuant to the terms and conditions associated with the member’s health plan for the plans that FirstCarolinaCare Insurance Company itself offers. For Self-Funded employer plans that FirstCarolinaCare Insurance Company acts solely as the administrator, the employer / plan sponsor has the responsibility to make such determinations regarding what benefits are provided for COVID-19 treatment (subject to applicable law). This website’s content is subject to change without notice to the member. In any situation where the official printed publications of FirstCarolinaCare Insurance Company or a Self-Funded plan sponsor differ from the text contained in this website, the official printed documents take precedence. 

This coverage FAQ is based on the latest information from applicable resources which may include but are not limited to state regulations and guidance, state and federal law and CDC guidelines.

If I get tested for COVID-19, will my health plan cover the test?

If you get tested by a healthcare professional, our health plans will cover it under your plan's diagnostic testing benefit and cost share.

If you are tested for employment purposes, our health plans will not cover the testing or testing-related visit(s).*

With the public health emergency ending on May 11, 2023 coverage and guidelines may have changed. Please refer to your plan materials or call the number on the back of your ID card with questions.

*Some Self-Funded employer group plans administered by FirstCarolinaCare may cover employment-based screenings. Consult with your plan administrator for more details about this coverage.

Will my health plan cover over-the-counter COVID-19 diagnostic tests for home use?

OTC tests are no longer covered by FirstCarolinaCare. Visit for free over-the-counter tests from the government.

These processes and guidelines have changed as of the end of the PHE on May 11, 2023. Please refer to plan materials or call the number on the back of your ID card if you have questions.

What type of COVID-19 tests or testing does my health plan coverage apply to?

Tests that are administered by a healthcare professional, or that require processing at a laboratory, are subject to the coverage requirements previously outlined by your health plan.

Testing for employment purposes, including OTC tests purchased to satisfy employment-based screening requirements, are not covered by our health plans.*

*Some Self-Funded employer group plans administered by FirstCarolinaCare may cover employment-based screenings. Consult with your plan administrator for more details about this coverage.

I have a High Deductible Health Plan with a Health Savings Account. Will my plan cover testing for COVID-19 even if I haven’t yet met my deductible? Will I lose my tax incentives if I get tested before meeting my deductible?

Fully Insured High Deductible Health Plans will cover medically necessary diagnostic laboratory testing, even if you haven’t yet met your deductible, per your plan benefits. Self-Funded High Deductible Health Plans will vary by group. Usually, your plan cannot cover medical services that are not classified as preventive care until you meet your deductible. However, the Internal Revenue Service (IRS) has allowed us to cover services related to COVID-19 without jeopardizing the tax benefits associated with your Health Savings Account (HSA), even if deductibles have not been met. If you have questions, call the number on the back of your member ID card. 

Will my health plan provide benefits for treatment of COVID-19?

Your health plan will continue to provide benefits for medically necessary healthcare costs to treat infectious diseases, including COVID-19, based upon the terms of your specific health plan. Call the number on the back of your health plan ID card if you have any questions.

What if I get the virus and require emergency services – will my health plan provide benefits for these?

Many individuals who have contracted COVID-19 have not required any emergency services. However, in circumstances where emergency services are required, most health plans will provide benefits for these services at in-network levels regardless of which provider performs the services. Call the number on the back of your member ID card if you have any questions.

Will my health plan provide benefits for expenses incurred for medical supplies such as facemasks, gloves and disinfectants?

Most of these supplies are not covered by health plans. Call the number on the back of your health plan ID card if you have specific questions.

Does my health plan cover any type of telehealth and/or virtual doctor visits?

Most FirstCarolinaCare Insurance Company Fully Insured plans and FirstCarolinaCare Insurance Company-administered plans provide benefits for telehealth and/or virtual doctor visits. Telehealth services are a great way to avoid unnecessary travel to a doctor's office and are in line with the practice of social distancing. Call the number on the back of your member ID card if you have specific questions about the types of telehealth services that are eligible, or questions about cost sharing or in-network restrictions that may apply.

Your plan may specifically offer virtual visits with a doctor through FirstHealth On the GO. Member cost sharing may apply. Certain Self-Funded employer group plans may offer alternative platforms for virtual doctor visits and telephone help lines.

As always, please visit a hospital emergency department for all serious conditions and call 911 for all emergencies.

Can my health insurance carrier – or my Self-Funded employer/plan sponsor – cancel my insurance policy or health plan, or refuse to renew it, if I am diagnosed with COVID-19 in connection to a preexisting respiratory illness?

No. Most insurance policies and Self-Funded group health plans cannot impose any pre-existing condition exclusions, including in connection with COVID-19. 

To all of our valued members, if you have any questions or concerns about your coverage or your premium payments, please do not hesitate to call the number on the back of your member ID card.