As the landscape changes with the coronavirus pandemic, we want to keep you up to date on legislation and recommendations to keep you and your family safe. Following are important notes on two topics: (1) COVID-19 mandatory coverage; and (2) expanded coverage of telehealth visits.
While early recommendations focused on the coverage for testing at $0 out of pocket to health plan members, the final legislation requires private health plans to provide coverage for COVID-19 diagnostic testing, including the cost of a provider, urgent care center, and emergency room visits in order to receive testing. Coverage must be provided at no cost to the covered member. Treatment for COVID-19 will continue to be covered as it otherwise would be under the terms of your plan for similar illnesses.
There’s nothing you need to do other than follow the COVID-19 safety guidelines established by the CDC and your state public health officials. As your health plan administrator, Healthcare Highways already updated its systems to support this new coverage related to a COVID-19 diagnosis or suspected case.
Healthcare Highways Health Plan follows the general guidelines of the Centers for Medicare & Medicaid Services (CMS). Recently, CMS broadened access to telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. So, what does this mean to you?
Call your PCP for guidance. Your primary care physician is your best resource for getting answers to your questions or concerns about coronavirus. They can determine if you are a candidate for testing, and provide you with the right authorization and information to obtain the test. Call first, as many are now providing telephonic office visits in lieu of or in place of physical office visits.
To help the healthcare provider’s office take steps to keep other people from getting infected or exposed, you should wear a facemask in public and especially before you enter a healthcare provider’s office.
If you need assistance ﬁnding a local provider, accessing your information, or have a question on COVID-19 or your coverage, our Customer Experience Team is here to provide extra support 844-869-5640, 8 AM to 5 PM, Monday through Friday.