Benefit information about COVID-19

Benefit information about COVID-19

We are actively working with federal, state and local partners to respond to the outbreak of the novel coronavirus (COVID-19). During the national and state public health emergency, the South Carolina Department of Health and Human Services (SCDHHS) has issued several temporary policy changes for the health and safety of Healthy Connections Medicaid members.

Coverage of COVID-19 vaccine

  • You can receive a vaccine at no cost to you.

Effective for dates of service on or after February 4, 2020:

Coverage of COVID-19 Testing

  • Select HealthSM by Select Health of South Carolina will cover COVID-19 testing.
  • COVID- 19 testing will not require prior authorization or a copay.
  • If you have any questions about whether you should be tested, call your primary care provider (PCP). They will work with the South Carolina Department of Health and Environmental Control (SCDHEC) and the Centers for Disease Control and Prevention (CDC) to see if you need to be tested for COVID-19.
  • Find a testing site near you at the SCDHEC website. Testing done at a clinic, lab, or pharmacy is more reliable than a self-test, especially if you don’t have symptoms, according to the CDC. Home testing is also available if you can’t get to a testing site. You may need a photo ID and your First Choice member ID card at the testing site or pharmacy.
  • A self-test, also called a “home test” or an “over-the-counter” test, offers fast results and can be done on your own, as needed. 
    • First Choice covers up to eight self-tests per month from a Medicaid-enrolled pharmacy. 
    • The following 5 tests will be covered:
      • BinaxNOWTM COVID-19 Antigen Self Test
      • QuickVue® At-Home OTC COVID-19 Test
      • InteliSwab® COVID-19 Rapid Test
      • IHEALTH® COVID-19 Antigen Rapid Test
      • CareStartTM COVID-19 Antigen Test
    • First Choice cannot pay a member directly for a test they have purchased on their own. First Choice will only reimburse the pharmacy for at-home COVID-19 tests.
    • You can also have 4 no-cost test kits mailed to your home by visiting covidtests.gov.
    • Visit the U.S. Food & Drug Administration (FDA) to learn how to properly use and store COVID-19 at-home tests to avoid potential harm.
  • Providers, for more information on diagnosis code guidance, please visit the CDC’s official coding guidelines available here on CDC’s website (PDF).

Effective for dates of service on or after March 15, 2020:

Waiver of Copays

  • Members will have no copayments for office visits.

Pharmacy benefit

  • Members may refill their prescription medicines (non-opioid/non-controlled substance) earlier than usual to help ensure a sufficient supply.
  • Members may receive a temporary, 72-hour supply of medicines that normally require a prior authorization.
  • Use of out-of-network pharmacies will be authorized upon member request when access to in-network pharmacies is difficult, unsafe, or not practical.

Access to health care

  • Use of certified out-of-network and/or out-of-state providers will be allowed for medically necessary services.
  • Members may also receive health care services by phone or through video interaction with their health care provider.

Important numbers and resources                                                                    

Members needing assistance, please call:

  • First Choice Member Services at 1-888-276-2020 (TTY 1-888-765-9586).
  • 24/7 Nurse Call Line at 1-800-304-5436.

Providers needing assistance, please call:

  • 1-888-559-1010 for Utilization Management or Authorizations, if applicable.
  • 1-866-368-4562 for Utilization Management Fax Line.
  • 1-888-276-2020 for Member Eligibility.

For the most up-to-date information about coronavirus and COVID-19, visit:

Our Frequently Asked Questions webpage.

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