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COVID-19 and Your Healthcare Provider

Information last updated on March 19, 2020

On March 11, 2020, the IRS issued Notice 2020-15, which allows high deductible health plans (HDHPs) to pay for COVID-19 testing and treatment without a deductible. This Legal Update video explains more.

The World Health Organization (WHO) has designated the recent coronavirus outbreak (COVID-19) a global public health emergency. According to the Centers for Disease Control and Prevention (CDC), coronaviruses are common in animal species. Although most don’t affect humans, the most recent strain, COVID-19, does and can easily spread from person to person.

What Is Coronavirus?

According to the World Health Organization (WHO), coronavirus is a family of viruses that cause illnesses ranging from the common cold to more severe diseases. Common signs of infection include headache, fever, cough, sore throat, runny nose and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death. Individuals who are elderly or pregnant, and anyone with preexisting medical conditions are at the greatest risk of becoming seriously ill from coronaviruses.

How Does Coronavirus Spread?

Although the ongoing outbreak likely resulted from people who were exposed to infected animals, COVID-19 can spread between people through their respiratory secretions, especially when they cough or sneeze.

According the Centers for Disease Control and Prevention (CDC), the spread of COVID-19 from person-to-person most likely occurs among close contacts who are within about 6 feet of each other. It’s unclear at this time if a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.

How is my carrier handling COVID-19?

Aetna will be sending out Care Packages to those Aetna members diagnosed with Coronavirus:

Healing Better COVID-19 kits will be delivered to the member’s home (at their last known address) within 1-3 days of Aetna receiving notification of diagnosis. Members diagnosed with Coronavirus COVID-19 will be identified using Aetna Risk Management’s running database of inpatient hospitalizations and self-reports.

The kit will come in two different varieties. Members who have been hospitalized will receive a kit with a more robust set of personal and household cleaning supplies (“Full Suite”) while all other members will receive a lighter set of supplies (“Limited Suite”). The exact supplies contained in the kits are subject to change based on CVS retail supply chain restrictions. There is no cost to either the member or the client for these kits currently.

All kits will include an introductory note and educational content intended to reinforce the answers to frequently asked questions around managing symptoms and preventing the spread of the virus, adapted from current CDC guidelines. The kit will also reference additional resources such as the Aetna COVID-19 microsite (Aetna.com/coronavirus) and 24/7 Resources for Living hotline for emotional support and counseling services.

Examples of products included in the Full Suite kit provided to members identified through hospitalization include: 1 bag of cough drops; lavender Scented Shower Vapor Tablets, Facial Tissue; Antibacterial hand soap; Disinfecting Wipes Lemon Fresh; Hand lotion. Note: Products and information supplied to members through this program may vary due to supply chain restrictions and new information made available by the CDC and others as the Coronavirus situation evolves.

The Full Suite kit is intended to assist members with the most severe symptoms upon their return from the hospital, at which time they may be in isolation and unable to purchase personal or household supplies. The kit allows the member to return home to items waiting at his or her doorstep while reinforcing important information around preventing the spread of the virus to family and the community. Clinical experts agree that patients normally need to hear information multiples times before internalizing it, especially during periods of high stress. As misinformation spreads about the virus, the content included in the kit will reinforce the correct protocols per CDC guidelines.

The first batch of Full Suite kits will begin shipping to Aetna commercial members identified through hospitalization on March 18th, 2020. Members who were previously infected and would not benefit from the kit will receive an email outreach on Monday, March 16th with FAQs to cope with their illness, as well as a link to our dedicated microsite and direct line to Resources For Living.

The Limited Suite kits will be available by the end of March. Availability and structure of the program may change as the nationwide situation continues to develop.

CVS Health to Assist with Coronavirus Testing/Waiving charges for Home Delivery

Given the physical presence of CVS Pharmacies in communities across the country and ability to reach millions of consumers with innovative, local solutions, we’re in a unique position to help address the COVID-19 pandemic. We’re working with the administration and other partners to help facilitate COVID-19 testing with a common goal of increasing frequency and efficiency.

While details are still being worked out based on the number of tests available and geographic needs, it’s important for CVS Pharmacy customers to understand that they won’t be impacted. We expect testing will take place in secure areas of parking lots at select stores – not inside – and individuals being tested will not have to leave their cars. We look forward to sharing more details as they become available.

More information on the steps CVS Health has already taken to address the COVID-19 pandemic — including waiving charges for home delivery of prescription medications and making diagnostic testing and Aetna-covered telemedicine visits available with no co-pay — is available at our frequently updated COVID-19 resource center.

$0 Copay Telemedicine Testing

For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason. Aetna members should 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 videoconferencing) for all Commercial plan designs. Self-insured plan sponsors will be able to opt-out of this program at their discretion.

Through Aetna’s Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms. The package will also include personal and household cleaning supplies to help keep others in the home protected from potential exposure.

Through existing care management programs, Aetna will proactively reach out to members most at-risk for COVID-19. Care managers will walk members through what they can do to protect themselves, where to get information on the virus, and where to go to get tested.

Aetna resources available to both plan sponsors and members regarding COVID-19:

Updates are also being posted to aetna.com website under the top banner labeled Stay informed about coronavirus. Be sure to check back frequently as new information becomes available.

All Allied health plans that cover basic lab & diagnostic testing, automatically include testing for COVID-19.

If you use your LabOne benefits (through Quest Diagnostics), the cost of testing is free.

If you are not using the LabOne benefit, the cost is still a covered benefit, subject to normal out-of-pocket costs.

The test must be ordered by a medical professional who is equipped to take the proper respiratory specimen from individuals meeting the Center for Disease Control (CDC) clinical and/or epidemiological criteria for COVID-19 testing.

To learn more about LabOne testing through Quest Diagnostics visit www.questdiagnostics.com/home/Covid-19.

Responding to the Coronavirus Outbreak

Helping to ensure the security and peace of mind of our members is our top priority. We wanted to let you know how we are responding to help you and your employees access needed medical care related to the coronavirus outbreak.

As you know, the first case of coronavirus, otherwise known as COVID-19, was recently confirmed in Nebraska. We want to take this opportunity to assure you that we have a plan in place to continue to provide quality service to our customers while also protecting the health and safety of our employees.

Coverage for coronavirus testing and treatment

For all members, Blue Cross and Blue Shield of Nebraska will cover, with no cost share, the appropriate medically necessary diagnostic testing for COVID-19, where it is not covered as part of the Public Health Service response. Diagnostic testing includes the testing kit and interpretation of the COVID-19 test. Please note that medically necessary treatment of COVID-19 will be payable subject to the plan’s usual deductible, coinsurance and copay amounts.

Coverage for prescription medications

Effective immediately, we are increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (according to the terms of the member’s plan). We also encourage members to use their plan’s 90-day mail order benefit.

Patients 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.

Coverage for telehealth visits

Starting Monday, March 16, 2020, Blue Cross and Blue Shield of Nebraska will cover, with no cost share to the member, the cost of all telehealth visits until further notice.

This expanded coverage applies to all types of health plans, including high deductible health plans, regardless of whether or not the member’s plan currently offers benefits for telehealth.

To register to use services provided by Blue Cross and Blue Shield of Nebraska’s preferred telehealth provider, AmWell, members will need to enter their BCBSNE ID number, along with the appropriate service key and code. There is one service key for all eligible members; the coupon code to be used depends on what type of plan the member has.

Service Key (for all members)

Coupon Codes

BCBSNE BCBSNEFREE – for all members covered under an employer group plan, and individuals covered under our Armor Health plan
MSFREE – for BCBSNE members covered under one of our Medicare Supplement plans
MAFREE – for BCBSNE members covered under one of our Medicare Advantage plans

These codes and more information about accessing telehealth are on our website at NebraskaBlue.com/Telehealth.

FAQ

  • Does testing include office visit and facility charges incurred for testing or just the testing alone? Only the testing is covered at 100%. Any other charges for the office visit or treatment would be covered with the normal member cost shares.
  • How, if at all, is testing covered differently on a traditional copay plan vs. a qualified high deductible plan? The testing is covered at 100% for either plan. What the member cost share would be depends on how the provider bills for the service. If the member has a copay, the normal copay would apply (if the provider bills for an office visit, etc.). On the HSA, again the member would be responsible for an office visit charge, etc.
  • Would testing be covered at 100% for all testing or would require a known exposure in order to be covered at 100%? Coverage at 100% is not contingent on a known exposure. However, the doctor may not authorize a test without a known exposure.

More information and resources

NebraskaBlue.com/Coronavirus provides important information for members about coverage for coronavirus testing and treatment, expanded access to prescription drugs and telehealth services and more, and will be updated regularly.

As an additional resource for you, the CDC has created an interim guide for businesses and employers to help plan and respond to COVID-19.

If you have any questions, please reach out to a member of your Blue Cross and Blue Shield of Nebraska sales or account management team.

Lincoln is diligently monitoring developments related to the Coronavirus (COVID-19), declared by the World Health Organization as a public health emergency of international concern. As a leader in leave and disability, we are here to partner with you to help you lead your employees during this rapidly evolving situation.

Informational Tools to Support You

We’re sharing the following materials to support you and your employees:

  • Revised Frequently Asked Questions (FAQ) document: Since our last touch base, we’ve updated our FAQ to include more information that may be helpful for you.
  • Employer Best Practice Recommendations: Our Chief Medical Officer, Dr. David Berube, compiled a list of best practice considerations for you.

Also, for transparency, we are pleased to share our business continuity protocols that would be leveraged should a Lincoln office be impacted by the virus.

We’ll share more guidance as the situation evolves and welcome any additional questions you may have through your Lincoln sales or service contact.

Medica has announced a coverage change related to the diagnostic testing for COVID-19 that follow guidelines issued through the U.S. Centers for Disease Control and state health departments. Medica will waive co-pays, co-insurance, and deductibles related to COVID-19 testing for all individuals and Medicare members.

To help limit the spread of COVID-19, Medica provides coverage for virtual care or telehealth services, often a more convenient way to access health care services from home. When appropriate, members are encouraged to utilize virtual care benefits.

The health and well-being of members is a priority and Medica will continue to monitor the status of COVID-19 and its impact on our members.

What MetLife is doing for our customers

MetLife has launched a comprehensive approach to assess business readiness across all critical functions and markets through the lens of a global pandemic. This includes a review of a number of areas including operational readiness, employee mobility, infrastructure resiliency and information security.

MetLife remains committed to ensuring our customers get the service they expect and the timely handling of claims. To achieve this, we are:

  • Activating our business continuity planning to assess readiness throughout the enterprise
  • Conducting a review of end to end plans and interdependencies
  • Stress testing critical processes and systems including information technology and security
  • Determining alternate solutions for all critical processes, including resources and technology
  • Testing employee mobility and connectivity by enacting elements of our business continuity plan in a controlled environment
  • Scenario planning for a high number of resources being out due to illness and counter-measures and supplemental staffing should this situation arise

Additionally, MetLife is prepared to handle a shift to a remote workforce with the majority of our team already equipped to work remotely and securely.

Federal Leave Legislation

How does the Federal Leave Legislation in Response to the Coronavirus impact my business?

For employers of more than 500 Employees

How does the Federal Leave Legislation in Response to the Coronavirus impact my business?

For employers of less than 500 Employees

Mutual of Omaha continues to monitor coronavirus (COVID-19)

As you’ve likely seen in recent news coverage, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) are closely monitoring a global outbreak of respiratory illness referred to as the coronavirus or COVID-19. Although the situation continues to evolve, we would like to share a few updates with you around ensuring the safety of both our employees and our commitment to our customers.

Business Continuity Plan in Place

Mutual of Omaha has a multi-disciplinary team of subject matter experts meeting daily to closely monitor, assess and respond to the coronavirus situation as it develops. We are activating precautionary measures in our office locations nationwide and working with associates regarding travel and other health-related questions and concerns. Mutual of Omaha remains committed to providing superior service to our customers, business partners, policyowners and insureds, and we are taking active steps to prevent any interruption in our business processes.

Group Disability Claims

As with any illness, disability and similar leave claims related to the COVID-19 virus will be evaluated according to the terms of the policy and the facts specific to that claim. Generally, a person who is not sick but misses work due to a quarantine is not entitled to disability benefits. However, certain paid leave programs may be involved depending on the situation, so as always, it is best to review the applicable policy, plan or program documentation.

Also, due to the nature and typical length of isolation, we expect that some absences will fall under employers’ paid sick or PTO plans. Mutual of Omaha is here to help if you’d like to review how your disability plan fits with other paid leave policies.

AbsenceProSM – FMLA Claims

One of the primary questions related to the coronavirus is whether leave taken due to COVID-19 qualifies for protection under FMLA. Click here for a document on information and guidance.

Additional information and resources are available through the U.S. Centers for Disease Control and Prevention and the World Health Organization.

Employee Assistance Program (EAP)

Customers who have EAP services with us have access to a broad range of resources and services. This includes:

  • Access to EAP Professionals 24 hours a day, seven days a week (Toll-free Number: 800-316-2796)
  • Face-to-face sessions with a counselor, if eligible
  • A comprehensive online legal and financial resource library

If you have any questions, please contact your local Sales Representative.

National General Reduces Financial Burden and Improves Ease of Access to COVID-19 Diagnostic Testing

NEW YORK, March 09, 2020 (GLOBE NEWSWIRE) — To help limit the spread of COVID-19, National General Holdings Corp. (NASDAQ:NGHC) will waive 100% of customers’ out-of-pocket costs for COVID-19 diagnostic tests and will ease access for customers seeking diagnostic testing. This waiver will extend to all National General Short Term Medical customers and will be made available to employers in the National General Benefits Solutions Program.

As part of the effort regarding COVID-19 diagnostic testing, National General will:

  1. Waive all member cost-sharing for COVID-19 diagnostic tests and related services, including the associated office visit, emergency room, or urgent care charges. The waiver applies to any out-of-pocket costs, including deductibles, copays, and co-insurance for diagnostic testing related to COVID-19.
  2. Waive all prior authorization requirements as they relate to COVID-19 diagnostic testing.
  3. Allow early refills and up to a 90-day supply of a member’s prescription drugs in the event of hardship related to COVID-19.

Customers concerned about exposure to COVID-19 should contact their healthcare provider or state health department. National General’s customer service call center will be available to assist if customers have any questions about COVID-19 testing-related services.

About National General Holdings Corp.

National General Holdings Corp., headquartered in New York City, is a specialty personal lines insurance holding company. National General traces its roots to 1939, has a financial strength rating of A- (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products.

Prinicpal is prepared for potential effects of COVID-19 (coronavirus), and we’ll be here to help you address questions from your employers and their employees.

Read what Principal is doing to manage the impact of COVID-19 in our business.

Get answers to common questions regarding how COVID-19 applies to your coverage.

Dealing with the effects of COVID-19 (coronavirus) on you, your investments, your retirement account, and your business

This information will be updated if needed, as Principal continues to monitor the situation and address common questions.

You can also get the latest on all COVID-19 resources from Principal as they continue to share information on our approach, market volatility and what individuals, businesses and advisors can do to manage uncertainty.

UnitedHealth Group Reinforces Actions Taken to Provide Members and Patients with COVID-19 Support and Resources

  • UnitedHealthcare has waived all diagnostic test cost-sharing for insured members
  • OptumCare clinicians are trained, well-prepared and addressing patients’ needs
  • Optum’s Emotional-Support Help Line is free of charge to help anyone dealing with stress and anxiety

Read the March 9th press release

Watch the UHC video regarding Covid-19

Virtual visit providers have developed guidelines for members who think they may have been infected by COVID-19.

Teladoc

The Teladoc Health team has been monitoring this situation closely. Recent activities to support members who may be impacted by the coronavirus include:

  • Keeping global medical leadership team updated on the latest information regarding the COVID-19 and the most recent recommendations by the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC).
  • Training all front-line clinicians on how to evaluate respiratory illnesses given the outbreak of this infection.
  • Launching a coronavirus landing page* on Teladoc.com, which provides information about the virus and helps members navigate the best ways to receive care

*Members are being steered to this landing page through social and digital media.

AmWell

Following CDC guidelines, AmWell clinicians screen to determine who should be sent to an in-person facility for further testing and who is at low risk for contracting COVID-19 by:

  • Evaluating a patient’s symptoms
  • Understanding a patient’s risk factors (e.g., recent travel or exposure to persons under investigation for COVID-19)

Doctor On Demand

  • Doctor On Demand has distributed several practice-wide communications, educating providers about the latest developments regarding COVID-19. These educational communications are intended to ensure providers have the appropriate tools and resources to assist patients calling in with general questions about the coronavirus or about their risk of exposure.
  • Doctor On Demand launched a 2-minute assessment to help patients determine what precautions they should take in the event COVID-19 impacts their community. The assessment provides prevention recommendations, as well as categorizing individuals based on their risk level. High-risk individuals are directed to a doctor’s office to develop an individualized care plan. The assessment is available via the Doctor On Demand website and app.
  • Doctor On Demand is a beneficial resource for patients to utilize when differentiating between symptoms of the flu or common cold, or when they should seek in-person care for testing of COVID-19. Doctors can ask recommended historical questions as listed in the Interim 2019 Novel Coronavirus (2019-nCoV) Patient Under Investigation (PUI) form, and can reassure patients if they don’t meet the criteria as outlined by the WHO and CDC.
  • A thorough medical evaluation to include a patient’s travel history and symptoms, as well as referral to the appropriate level of care for any patient who is determined to be a potential PUI, per the CDC’s guidelines.
  • These patients are then reported to the appropriate public health department as recommended by the CDC and given instructions on how to seek local care, including contacting the local health care facility prior to arrival to ensure that isolation precautions are followed for the safety of others in the facility.

COVID-19 Outbreak Response Frequently Asked Quesitons

Unum is taking several steps to ensure we can support customers and their employees through the coronavirus (COVID-19) pandemic. As always, the health and safety of our customers, colleagues, and communities remain our top priority. Our business continuity program prepares us to respond to disruptive events through robust planning, regular testing, and constant monitoring – ensuring we can continue to support you and your employees as the situation progresses.

How is Unum Responding to Coronavirus?

We have created a cross-functional team that is closely monitoring developments as inquiries begin to emerge from our customers and providing guidance on the impact a quarantine or Coronavirus diagnosis will have on our policies. Our company is prepared to work closely with employers and policyholders to answer their questions and meet their needs.

Short-Term Disability and Long-Term Disability

Unum is continuing to actively monitor the situation as things develop, but at this time from a disability determination standpoint.

We would evaluate each situation where an individual is quarantined on a case-by-case basis.

If an illness results from the underlying condition for which the individual was quarantined, it would be treated as any other condition. For example, complications arising from receipt of the Coronavirus would be considered a disability if those complications result in restrictions and limitations that satisfy the contractual definition of disability and are not otherwise excluded by the policy.

Additionally, there are a few states that have unpaid leave where quarantine is a qualifying leave reason.

Unpaid State leaves – Standard Leave Administration if qualifying event (unless the Employer has specifically opted out of these laws, which would be listed in service agreement)

  • MN Quarantine
  • SC Quarantine
  • ME Public Health

Quarantine, in and of itself, would not be considered a medical impairment, similar to how loss of license alone does not result in disability if not accompanied by medical symptoms.

Important health plan benefit updates regarding coronavirus (COVID-19)

Last week, we communicated to our members and groups about benefit updates regarding coronavirus (COVID-19) and this week we have an important update.

Effective March 16, 2020, all Wellmark members will have access to virtual health care visits with no cost-share. To avoid the spread of COVID-19, we encourage our members to take advantage of virtual visits with their current primary care physician, if they have this capability. For those who don’t currently have a primary care physician, please use an in-network provider or Doctor on Demand®. The cost-share for such visits, including those for mental health reasons, are waived for the next 90 days. At that time, we will reassess. This update applies to all fully-insured and self-funded plans.

The other updates we communicated previously still apply to Wellmark’s fully-insured members. If your plan is self-funded by an employer or other entity, there may be some variation. Wellmark is currently working with our self-funded groups on how they wish to implement these or similar updates to their benefit plans with respect to COVID-19.

  • Waiving prior authorization processes. Wellmark will waive prior authorization processes for covered services related to COVID-19 to ensure patients receive the right care at the right time and location.
  • Covering diagnostic tests for COVID-19. Members will have no cost-share for appropriate testing to establish the diagnosis of COVID-19.
  • Increasing access to prescription medications. Wellmark prescription drug benefit plans allow for early refill (up to 30 days of medication) and we encourage the use of your 90-day retail and mail order benefits for maintenance drugs. We also will ensure formulary flexibility if there are medication shortages or other access issues. Members will not be liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.
  • 24/7 support. Members also have access to Wellmark’s BeWell 24/7 service that connects them to real people who can help with a variety of health-related concerns 24/7.

If you are a Wellmark Medicare Supplement member, please visit Medicare.gov to learn what is covered related to your COVID-19 health care needs. As your supplemental carrier, Wellmark will continue to pay for out-of-pocket expenses according to your policy related to Medicare covered services, such as deductibles, copays and coinsurance. Visit your prescription drug plan’s website (YourMedicareSolutions.com/Covid-19 or JourneyRxMedicare.com/Covid-19) to see specific information about drug coverage related to coronavirus.

COVID-19 vs. Other Common Illnesses

COVID-19

Flu

Upper Respiratory Infection

How long it takes to develop?

Occurs 2 to 14 days after exposure

How long it takes to develop?

Starts quickly, symptoms develop immediately

How long it takes to develop?

Develops slowly over time

How it spreads

Spreads from person to person through coughing and sneezing and it can also be spread through infected surfaces or objects

Note: Exposure is higher if traveling from or living in regions where others have contracted it.

List of regions impacted

How it spreads

Spreads from person to person through coughing, sneezing, talking, or touching germs on an object

How it spreads

Spreads from person to person through coughing, sneezing, or touching germs on an object

What are the symptoms?

Fever, cough, and shortness of breath

What are the symptoms?

Fever, chills, cough, sore throat, body aches, headaches, fatigue

What are the symptoms?

Coughing, runny nose, congestion, pain or pressure behind the face, scratchy or sore throat

Information provided by: Teladoc