** April 18, 2023- Covid-19 Public Health Emergency Ending May 11, 2023 **
As a business organizational Coronavirus Preparedness Plan is necessary step but how about your sponsored group healthcare plan? Does your your Insurance cover Coronavirus testing and treatment?
There has been a lot of news coverage recently about the Coronavirus: Type COVID-19 outbreak. You and your family may have questions about the outbreak and want to know how to stay healthy. For the latest information, please visit the New York State Department of Health, NJ, CT and the Centers for Disease Control and Prevention websites. You will find updates on this rapidly changing situation, plus prevention advice and instructions.
In most traditional group health plan arrangements, testing for COVID-19 should be covered like other diagnostic tests (e.g., the flu test or rapid strep test) when medically necessary. States like NY, CA, OR and Washington have issued requiring (among other things) insurance carriers to cover services associated with testing for the COVID-19 without cost-sharing. It is likely that other States will adapt similair rules shortly.
March 25, 2020- NY “Emergency COVID-19 Paid Sick Leave” How is COVID-19 quarantine defined under the NY law? Under what circumstances does a quarantine qualify for benefits under this act?“Emergency COVID-19 Paid Sick Leave” applies to employees who are ordered by the State of NY, Department of Health, a local Board of Health, or any other governmental entity to be under mandatory or precautionary quarantine/isolation due to COVID-19. More
New York vs. New Jersey: How Does Their Statutory Disability Insurance Coverages Compare?
1. For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason.
- Aetna is recommending members use telemedicine as their first line of defense in order to limit potential exposure in physician offices.
- Cost sharing will be waived for all video visits through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing).
Click on the links below for Teledoc Coronavirus Flyers.
2. Aetna will waive co-pays for all diagnostic testing related to COVID-19.
- This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location.
- Aetna will waive the member costs associated with diagnostic testing at any authorized location.
Testing will be covered. During this public health crisis, AmeriHealth New Jersey will cover as a preventive service and waive cost sharing (such as co pays and coinsurance) for the COVID 19 test when performed at a hospital or an approved laboratory.
Telemedicine is available. To help reduce potential exposure, AmeriHealth New Jersey also encourages members to utilize telemedicine services if they are available as part of a member’s plan. To encourage use of these services, AmeriHealth New Jersey will waive member co pays where applicable for telemedicine visits for the next 90 days. To access telemedicine options, members should login to our member website at amerihealthnj.com.
Treatment will be covered. At this time, there is no specific antiviral treatment or vaccine for COVID 19. Members should receive care from their doctor to help relieve symptoms as they would other viral respiratory infections. AmeriHealth New Jersey continues to cover medically necessary health care costs to treat infectious diseases, including COVID 19, based on the terms of the member’s insurance plan.
Prescriptions can be filled. AmeriHealth New Jersey has lifted prescription refill restrictions on maintenance medications, such as the “refill too soon” limit, for members in states that have declared a state of emergency because of the virus. We are carefully monitoring COVID 19 developments and will make adjustments to policies as appropriate. We recommend that members call the Pharmacy Services number on their ID cards as needed if they require additional medication refills due to a potential quarantine situation.
• Telemedicine: TELADOC EmblemHealth To reduce urgent care and emergency room visits during the outbreak as well as provide peace of mind, members can access their available telemedicine benefit by going to teladoc.com or call 800-TELA-DOC (800-835-2362).
• 24/7 Nurse Line: As always, EmblemHealth’s 24-Hour Nurse Line, is available and members can speak with an experienced, licensed nurse anytime. Members can call 877-444-7988 for confidential, one- on-one health counseling and accurate information to help make informed health care decisions.
• Benefits and cost-sharing: Cost-sharing as required by the state for testing, as well in-network cost-sharing for physician’s office visits, urgent care visits and emergency room visits associated with testing are being waived. EmblemHealth will not require preauthorization for COVID-19 testing.
• Provider assistance and tools: Ensuring affordability and keeping costs down is all our responsibility including our providers. We are working closely to ensure our providers have the latest information and tools to help in diagnostic practices and testing protocols.
• AdvantageCare Physicians access: ACPNY is prepared to receive people in need of care. Isolation rooms, screening protocols, and direct contact with testing centers, are in place to ensure proper care and the protection of our employees and patients. People should call their primary care physician before seeking care at a physical location.
Empire and Anthem Blue Cross
Amid the growing concerns about the spread of COVID-19 in communities across the country, Anthem is eliminating the burden of additional costs for members in its affiliated health plans by providing coverage of the coronavirus screening test at no out-of-pocket cost.
Will my Empire benefits cover COVID-19 testing and care?
Don’t worry — if your in-network provider orders a coronavirus test, your Empire health plan will cover the cost for the test and the in-network provider care visit and you will not be subject to any cost sharing.
Empire is waiving these costs for all affiliated fully-insured, Individual, Medicaid and Medicare plans. For high deductible health plans your deductible will apply. For self-funded plans, check with your employer or call the number on your ID card.
Please encourage your employees to visit anthem.com/blog, anthem.com/ca/blog, or empireblue.com/blog where they can always find the most up-to-date information.
The updated flier will soon be available in Spanish and other required languages (including Chinese, Vietnamese, Korean, Tagalog, and Cantonese).
View our press release here.
HealthFirst COVID-19 Resource Page – Healthfirst is actively monitoring the Coronavirus (COVID-19) outbreak and is here to help you get access to the care you need. Continue to check this page as it will be updated as new information becomes available.
Will my Healthfirst benefits cover Coronavirus (COVID-19) testing and evaluation?
Healthfirst is waiving co-pays for all diagnostic testing and evaluations related to coronavirus. This means that if your PCP or in-network provider orders a coronavirus test, your Healthfirst health plan will cover the cost for the test and the in-network provider visit related to the coronavirus evaluation. You will not be subject to any cost sharing for the test or the in-network provider visit.
Call your doctor if you develop a fever, have a cough, or have difficulty breathing. Let your doctor know if you’ve been in close contact with a person known to have Coronavirus (COVID-19), or if you live in or have recently traveled to an area where the coronavirus virus has spread. Be sure to carefully follow your doctors’ instructions.
You can also receive virtual care. The Healthfirst Teladoc (telehealth) service is available for eligible members* and is covered for coronavirus related services. If you think you may be infected, Teladoc doctors can answer questions about the disease, evaluate your risk, and advise you on next steps. The Teladoc clinical team is trained on the latest protocols for local and national notification, testing, and management of people under investigation for the coronavirus.
Request a Teladoc visit by phone at 1-800-Teladoc (1-800-835-2362) or by visiting this website.
New Jersey’s largest health insurance provider, Horizon Blue Cross Blue Shield of New Jersey, will cover all COVID-19 tests, the company announced in a press release.
Horizon said there would be a number of other coverage changes for their over 3.2 million members in relation to COVID-19, also known as coronavirus or the novel coronavirus. They include:
Effective Immediately, Horizon BCBSNJ is taking these steps:
- Waiving prior authorizations for a visit to a primary care physician, urgent care center, or emergency room for evaluation of upper respiratory symptoms, fever, shortness of breath or other conditions that may represent COVID-19.
- Waiving prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
- Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.
- Waiver of Prior Authorization for diagnosis of COVID-19
- We will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19.
- Horizon will cover the full cost of the COVID-19 test
- Waive early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encourage members to use 90-day mail order benefit. Horizon will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.
- Increased access to prescription medications Access to Telehealth and Nurse Advice Hotlines
- 24/7 access to free telehealth services staffed by nurses trained to help patients who believe they are experiencing COVID-19 symptoms. Members can also use these services for other ailments in order to avoid trips to the doctors office or urgent care facilities. Those service are available through the company’s free “Horizon Blue” app, the www.HorizonBlue.com online portal, or by phone at 1-888-624-3096. Members may also use those services to consult with a nurse about other health concerns and potentially avoid a visit to a physician office or urgent care facility.
- Relaxation applies to covered services delivered by video or telephone from in-network and out-of-network health professionals.
- Waiving member cost-sharing for covered services provided by an in-network health care professional for telemedicine visit.
- Applies to all covered IN-NETWORK ONLY services delivered by telemedicine including those provided by primary care doctors, specialists, therapists, mental health and substance use treatment professionals, or urgent care doctors.
- April 20, 2020 – Horizon COVID-19 Resource Guide
- Apri 6, 2020 – Horizon COVID-19 Resource Guide
March 31, 2020 Horizon Update: effective 4/1 credit card payments will be accepted by phone. No fees. Call 1-800-225-1955
March 31, 2020 Horizon Update- Waiving Rules to Speed Hospital Admissions
All fees associated with COVID-19 testing are waived for MVP members in Commercial fully insured plans, Medicare plans, Medicaid Managed Care, and Child Health Plus. The directive issued by DFS does not apply to self-funded plans, but MVP’s self-funded employer groups have the option to implement the waived cost-share. The same rules for New York will apply to Vermont Commercial members of MVP.
MVP will continue to monitor the COVID-19 situation and share the most up-to-date information at mvphealthcare.com/COVID19.
For additional resources about COVID-19, please go to:
- Centers for Disease Control and Prevention (CDC):https://www.cdc.gov/coronavirus/2019-ncov/index.html
- World Health Organization (WHO):https://www.who.int/emergencies/diseases/novel-coronavirus-2019
- NYS Department of Health:https://health.ny.gov/diseases/communicable/coronavirus/
- Vermont Department of Health:https://www.healthvermont.gov/response/infectious-disease/2019-novel-coronavirus
In response to the growing number of cases related to COVID-19 (colloquially known as the coronavirus), we want to let you know that Oscar is here to help keep your employees safe and informed as the situation progresses.
To support the health and safety of your clients, we are making the following resources available to Oscar members:
- Waiving cost-sharing for COVID-19 diagnostic testing. If your client’s doctor recommends they should be tested for COVID-19, they will not be charged for the lab test.
- Continuing to offer $0 telemedicine services (Doctor on Call).* Telemedicine is a great option for people who think they could have COVID-19. Our telemedicine PCPs can recommend COVID-19 testing and direct your clients to the right place for testing.
- An online COVID-19 resource center: hioscar.com/covid19. We created this webpage so Oscar members can stay up-to-date on the latest information and understand their care options.
- Oscar | How to help your clients worried about premium payments
As a commitment to our members and their communities, UnitedHealth Group has done the following:
- Waived all COVID-19 diagnostic test cost-sharing for insured members.
- Provided FREE access to Optum’s Emotional-Support Help Line at (866) 342-6892 (available 24 hours a day, seven days a week) for anyone dealing with stress or anxiety related to COVID-19.
- Prepared and trained OptumCare clinicians across the country to support COVID-19 patients’ needs.
- March 25, 2020–Oxford/Unitedhealthcare COVID-19 FAQ
- UHC Teledoc Coronavirus FAQ
- Oxford 2.0 Virtual Visits Member Flier
- Amwell Virtual Visits for Oxford members that do not already have this benefit
- UHC COVID-19 Information
Learn more from UnitedHealth Group’s full announcement.
For additional resources including an uhc-member-faq-coronavirus-2020 available to members, please see Important Information for Members from UnitedHealthcare on COVID-19. We will continue to provide updates as we monitor the situation.
What we know about the virus
Coronaviruses are an extremely common cause of colds and other upper respiratory infections. The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people — especially the very young, elderly, or people who have a weakened immune system — may develop a more serious infection, such as bronchitis or pneumonia.
Should you worry about catching this virus?
Unless you’ve been in close contact with someone who has the coronavirus — right now, this typically means a traveler from Wuhan, China who actually has the virus — you’re likely to be safe. In the US, for example, all five cases of the virus were recent travelers to Wuhan. The CDC maintains the risk is low to Americans, however, “we need to be preparing as if this is a pandemic, but I continue to hope that it is not,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases.
How can I protect myself?
Much like prevention of the spread of any other infectious disease, basic hygiene principles are key to curbing the spread of this virus.
- Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60 percent alcohol if soap and water are not available.
- Avoid touching your eyes, nose and mouth with unwashed hands.
- Avoid close contact with people who are sick.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces.
- As more information becomes available, public health organizations like the Centers for Disease Control (CDC) in the US and the World Health Organization (WHO) will be sharing key information and strategies worldwide.
- SHRM Webcast: Coronavirus: Legal and Workplace Implications Thursday, March @ 2PM ET. Get the facts. Lead your organization’s response to the coronavirus crisis. Learn the proper steps to take to keep your workforce safe, implications of federal laws and more. You must be an active SHRM member to attend.
- For the latest COVID-19 guidance and resources visit our COVID-19 Resource Center at: Coronavirus Resource Dashboard
Avoid Premium Payment Delays ACH
As the COVID-19 situation continues to evolve, we would like to remind brokers that ACH/EFT payments are a great way to avoid processing delays With many carriers now working remotely, it’s likely that live checks will be subject to delayed processing.
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