Messages from Carriers
As you may have seen, medical experts are encouraging “social distancing” as a way to reduce to the number of individuals who become ill. We believe that it is important for us as a healthcare company to commit to this approach.
As a result, all Aetna Senior Supplemental Insurance associates who are able to work from home will do so effective March 12, 2020 until further notice. We will evaluate this policy on a weekly basis until the COVID-19 threat diminishes. While most of our associates will not be at the office, we are committed to servicing your needs and expect minimal disruption.
While we will continue to accept paper applications and phone calls, we encourage you to use all of the electronic resources available to you on aetnaseniorproducts.com during this time for faster service.
“Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional.
For our members, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers. You must still use Medicare certified facilities and providers.
Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the emergency notice is closed or April 27, 2020 whichever is earlier.”
“Ameritas is monitoring the latest coronavirus developments and following updates from the World Health Organization and Centers for Disease Control. Our top priority is the health, safety and well-being of out customers, associates and financial professionals.
Our digital systems allow us to serve our people and sustain our businesses. Our focus will be on minimizing disruptions that may occur as the situation evolves.”
“If your doctor orders a coronavirus test, your Anthem Blue Cross/Anthem Blue Cross Life and Health Insurance Company (Anthem) health plan will cover the cost for the test and the doctor visit, and you won’t have any cost sharing for it. Anthem is waiving these costs for all Medicare plans.
Some Anthem health plans include LiveHealth Online. It lets you see a doctor through a live video chat on your phone, tablet, or computer. If your plan offers LiveHealth Online, just log in at anthem.com/ca to use it. If you’re not sure whether your plan offers it, call us at the Member Services number on your ID. If it doesn’t, we can talk about your options.”
“At Blue Shield of California, the safety and well-being of our members and communities is our top priority. We acknowledge that these are challenging times and want to provide you with the most up-to-date information to best serve your clients.”
Please see our Covid-19 Updates page for more information.
“As individuals in the United States are being diagnosed with COVID-19 (Coronavirus), we recognize BlueShield of Northeastern New York members may have concerns. The cost of the test is fully covered for our members. COVID-19 testing is only available through a referring physician at specific sites as designated by the CDC.
Any member who suspects they have symptoms of coronavirus should first call their doctor or use telemedicine. Members with Doctor on Demand in their plan can visit bsneny.com/telemedicine to register and set up a visit.
Members are encouraged to use their mail order benefit to obtain a 90-day supply of their prescription medication.”
“To ensure that diagnosis is affordable for all of our members and to fight the spread of illness, we have updated our coverage policy as follows:
* COVID-19 diagnostic test is covered as preventive care, at no cost to members
* Early medication refills for members who are impacted by the outbreak is authorized
If you have any questions about what services are covered for members, please email the Broker Service Unit at email@example.com or call us at 888-325-1747. We are available Monday through Friday, 8AM to 6PM CT.”
“If you feel you need to see a doctor, Capital BlueCross members can get assistance without leaving home and risking infection. Check your benefit coverage to see if your plan covers Virtual Care. With your smartphone, tablet, or computer, you can log in and talk to a doctor in the privacy of your own home, 24/7. Free to Capital BlueCross members and available 24/7, registered nurses have answers to your questions. Call 800-452-2583, TTY: 711”
“Cigna customers will have access to coronavirus (COVID-19) testing, as prescribed by health practitioners, and the company will waive all co-pays or cost-shares to help fight the rapid spread of the virus in the U.S. and for its globally mobile customers.
Recognizing that health outbreaks can increase feelings of stress, anxiety and sleeplessness and in some cases, loss, Cigna is also staffing a second phone line for customers. This 24-hour toll-free telephone help line will connect customers and caregivers directly with qualified clinicians who can provide support and guidance on coping and resiliency. 1-866-912-1687
To mitigate exposure risks, customers are reminded that telehealth options are available for seeking on-demand medical attention, as appropriate. To access telehealth options, visit mycigna.com and select the Connect Now button on the home page to talk with a doctor or nurse any time day or night.”
“In an effort to protect the health of its members, effective immediately, Clover Health, will provide coverage for the Coronavirus (COVID-19) diagnostic lab testing. Additionally, Clover will waive any associated member co-pays or cost-shares.”
“We have temporarily relaxed refill restrictions and members are able to refill maintenance prescriptions earlier. Members can speak with their pharmacist about this option if their doctor thinks it is important to have extra medication on hand.”
“OTC Benefit is available to members for delivery of many household essentials such as toothpaste, sanitizer, and pain relievers. If members are interested in using this benefit, they may order items online at www.cvs.com/otchs/clover or members can call 1-800-628-2770 (TTY 1-877-672-2689) 9am – 8pm EST, Monday – Friday.”
“Members should call their doctor if they are feeling sick, especially if they have a fever or cough. Clover Health covers telehealth (both phone and video visits) for our members with their regular doctors. Members can also talk to a doctor over the phone, 24 hours a day, 7 days a week by calling our partner Tealdoc at 1-800-835-2362.”
“EmblemHealth has taken steps to ensure that all of our members have peace of mind of knowing that they will have access to the services they need.
As we, like other health plans, step up to meet the challenges of these times, by absorbing out-of-pocket costs associated with the benefits members and employees have purchased, we are asking our partners to take similar steps by accepting treatment rates set for Medicare and Medicaid for everyone who needs these services.
We are providing our members with comprehensive information on our website about the virus and are updating it regularly based on the information coming from the CDC, the NY Department of Health and the New York City Department of Health and Mental Hygiene.
“Medicare Members- Medicare Part B (Medical Insurance) covers COVID-19 testing. This test is covered when your doctor or a health care provider orders it, if you get the test on or after February 4, 2020.”
“To ensure that cost is not a barrier in preventing the spread of the novel coronavirus (COVID-19), Geisinger Health Plan (GHP) will cover any out-of-pocket fees for coronavirus testing when ordered by a member’s treating medical provider. This policy will waive any applicable deductibles, co-payments, or other cost-sharing for COVID-19 testing at an approved laboratory for all GHP members who meet Centers for Disease Control and Prevention (DCD) guidelines for testing. Geisinger has set up a dedicated, 24⁄7 coronavirus hotline for those with questions about care reccommendations and more at 570-284-3657.
Regarding our internal operations, all Geisinger meetings that are not essential to daily work or patient care should be cancelled or postponed until after April 30, 2020. If an essential meeting must occur, it will be limited to fewer than 50 in-person participants. Examples of non-essential meetings include grand rounds, education events, and support group meetings, among others.
We will continue to conduct home visits, group meetings, clinic site visits, senior centers and 65 Forward events. Remote Skypesessions or conference calls will be utilized when appropriate.”
“Highmark will cover coronavirus testing, when recommended by a medical professional, for members of our fully-insured group customers, as well as members of our Medicare Advantage and ACA plans.”
“Effective immediately, we are waiving the out-of-pocket costs associated with COVID-19 testing and increasing the availability of telemedicine options to reduce additional exposure. We are also implementing some important actions such as early refills of prescription medicines and connecting people with a reassuring voice on the phone.
Humana will waive out-of-pocket costs associated with testing for COVID-19 for patients who meet CDC guidelines at approved laboratory locations. This will apply to Humana’s Medicare Advantage, Medicaid and commercial employer-sponsored plans.
Humana has trained a specialized group of call center employees to help support members with specific coronavirus questions and concerns, including live assistance with telemedicine. Members can call Humana’s toll-free customer support line, which can be found on the back of their member I.D. card, to be connected to this dedicated team of professionals.”
“Independence will cover and waive cost-sharing (such as co-pays and coinsurance) for the COVID-19 test when performed at a hospital or an approved laboratory.
To help reduce potential exposure, Independence encourages members to utilize telemedicine services if they are available as part of a member’s plan. To support use of these services, Independence will waive co-pays for telemedicine visits for the next 90 days. To access telemedicine options, members should login to our member website at ibx.com.
Independence has lifted prescription refill restrictions, such as the “refill too soon” limit, for all commercial, individual, and Medicare Advantage members with Independence pharmacy benefits. We also encourage members to use their 90-day mail order benefit.”
“AdvantageMD will cover testing for coronavirus. If you are diagnosed with coronavirus, Advantage MD will cover the care you receive based on your benefits. You will pay your normal cost-shares, including any copays, coinsurance or deductible.
Many common medications are made in China. The spread of the virus may or may not affect the supply and distribution of these drugs. If there is a shortage, you should talk to your provider about a safe and effective alternative. You can also consider getting a 90-day supply of any medication you take on a regular basis.”
“Every effort is being made to ensure this situation will not affect the timeliness or quality of our service. As a precaution, we are taking steps to ask employees to work from home as business reasonably allows and suspending all non-essential travel. We are limiting in-person meetings and no longer allowing outside visitors to our offices. Additional sanitizing protocols have also been implemented. Should a COVID-19 outbreak directly affect any of our locations, we have steps in place for operational resilience and the mitigation of business disruption.”
“Molina covers testing for COVID-19 as long as you meet the guidelines for testing and have a doctor’s order, this testing can be done in any approved laboratory location. For now, you will not be charged a co-pay or cost share for this testing if you meet these rules.
Where it is a covered benefit, Molina members should consider telemedicine as an option. All Molina Medicaid and Marketplace members are strongly encouraged to use our covered telemedicine services, available 24/7 from your phone or computer, before visiting a doctor’s office or urgent care location.
Effective Immediately: Marketplace members’ out of pocket will be waived for all Teledoc virtual urgent care visits.
Refill timing will be relaxed to allow emergency early fills. Molina will allow 90-day prescriptions. Check with your pharmacy for details and eligibility. CVS mail order pharmacy offers free delivery.”
“Oscar is waiving cost-sharing for diagnostic testing for COVID-19 for all our members, when the test is recommended by a doctor. This includes in-network and out-of-network testing facilities. Normal cost-sharing will apply for other aspects of the visit in most states.
If a member has a question about how to find a provider, we encourage them to send their Concierge Team a message from their account on hioscar.com or the Oscar app, or contact us at 855-672-2755.”
“To help reduce any potential exposure, we are waiving member copayments and coinsurance for all telehealth visits through our partner MDLIVE® through June 4, 2020. If ordered by a physician, we will cover all out-of-pocket costs associated with COVID-19 diagnostic testing at any in-network lab location. Feel free to share our FAQs and factsheet with your clients who may have prevention and coverage questions.”
“Effective immediately, we’ve taken the following steps to support our members:
If a doctor believes someone needs to be tested for COVID-19, there is no pre-authorization required.
We will cover the cost of a COVID-19 test with no cost share to fully insured members if a provider determines a test is necessary.
Our “refill too soon” policy for medications, except opioids, has been adjusted to help members prepare as needed.”
“On March 9, 2020, CVS Health announced additional COVID-19 resources to increase patient access to medications.
Beginning immediately, CVS Pharmacy will waive charges for home delivery of prescription medications, which will help patients avoid visiting their local CVS Pharmacy for refills or new prescriptions.
Aetna will offer 90-day maintenance medication prescriptions for insured and Medicare members.
CVS Caremark is working with all PBM clients to waive early refill limits on 30-day prescription maintenance medications.”
“Medicare members – Medicare Part B (Medical Insurance) covers COVID-19 testing. This test is covered when your doctor or a health care provider orders it, if you get the test on or after February 4, 2020.
When a state of emergency is declared for a specific state or region, we implement early refill overrides for prescription medications for members living in those specific areas. Pharmacists can make the override at the point of sale.
The Health Plan is increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan).
Members are also encouraged to use their 90-day mail order benefit for prescription medications.
The Health Plan will ensure formulary flexibility if shortages or access issues do occur. Members will not be liable for additional charges that stem from obtaining a non-preferred medication if the preferred medication is not available due to shortage or access issues.
Emergency prescription drug overrides are available as part of our standard exception process on an individual member basis.”
“UPMC Health Plan is actively working to identify and remove any barriers that could unnecessarily delay or prevent patients and members from receiving appropriate diagnosis and treatment during this time. In order to ensure that no UPMC Health Plan member faces a financial barrier to receiving needed testing, UPMC Health Plan will waive any applicable deductibles, co-payments, or other cost-sharing for COVID-19 testing when ordered by a member’s treating medical provider.
Effective immediately, this no-cost coverage of COVID-19 testing as a preventive service will apply for members in UPMC for Life Medicare Advantage plans.
UPMC Health Plan encourages any member with symptoms or suspected exposure to COVID-19 to immediately contact their health care provider or request a live, remote telehealth consultation available through the 24/7 UPMC AnywhereCare app.
For questions about locating a provider or available testing laboratory, the member services team is available from 7AM to 7PM, Monday through Friday, 8AM to 3PM on Saturday, and can be reached at 1-844-220-4785 (TTY: 711).”
“UnitedHealthcare has waived member costs for approved diagnostic testing for COVID-19 for all commercial insured, Medicaid and Medicare members who may be affected by COVID-19.
Optum, part of UnitedHealth Group, has opened its Emotional-Support Help Line. Professionally trained, mental health staff are available to provide support to people who may be suffering from fear or stress as a result of COVID-19. Optum’s Emotional-Support Help Line number is 866-342-6892 and is open 24 hours a day, seven days a week.”