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Important Notifications

Due to Coronavirus in the United States HHS Secretary Alex M. Azar declared a Public Health Emergency.

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.

What you need to know about COVID-19

Coronavirus Disease 2019 (COVID-19) is a new disease that causes respiratory illness in people and can spread from person to person. People of all ages can be infected. Older adults and people with pre-existing medical conditions like asthma, diabetes and heart disease may be more likely to become severely ill if infected. Many details about this disease are still unknown, such as treatment options, how the virus works, and the total impact of the illness.

What is the coronavirus?

COVID-19 is a respiratory disease that is caused by a new virus called a coronavirus, which has become a public health emergency. The number of cases continue to increase nationally and globally.

What are the symptoms?

The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. COVID-19 can be contagious before a person begins showing symptoms.

What else causes similar symptoms?

Influenza (the flu), a contagious respiratory illness caused by the influenza viruses (Type A and Type B), has high activity in the United States at this time. Everyone 6 months of age and older should get a flu vaccine.

I may have symptoms. What do I do?

If you have been exposed or begin showing symptoms of the virus or flu, contact your healthcare provider or health department immediately.

Protect yourself and your community.

We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:

  • Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizing rub (must contain at least 60 percent alcohol).
  • Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
  • Promptly dispose of tissues in a wastebasket after use.
  • Clean public surfaces thoroughly.
  • Stay home when you are sick.
  • Avoid shaking hands.
  • Avoid close contact with people who are sick.
  • Get a flu vaccine.

Does my plan cover COVID-19 testing/screening services?

Yes. When medically necessary diagnostic testing or medical screening services are ordered and/or referred by a licensed healthcare provider, we will cover the cost of medically necessary COVID-19 tests and the associated physician’s visit. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services.

Is prior authorization required for COVID-19 testing/screening services under my plan coverage?

No. We will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing and medical screening services, when medically necessary services are ordered and/or referred by a licensed healthcare provider.

Where may I receive COVID-19 testing/screening services under my plan coverage?

Medically necessary COVID-19 diagnostic testing and/or medical screening services and the associated physician’s visit will be covered when ordered, referred and/or performed in the following in-network locations:

  • Physician’s/Practitioner’s Office
  • Independent Laboratory/Diagnostic Facility   
  • Urgent Care Facility
  • Emergency Department Facility

Are you unsure if you have been exposed to or at-risk of being infected with COVID-19? Schedule a virtual care visit with a provider. It is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. 

Will I be responsible for any out-of-pocket costs for COVID-19 testing/screening services?

No. We will cover medically necessary COVID-19 diagnostic testing and/or medical screening services at no charge to you, when such services are ordered and/or referred by a licensed healthcare provider. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services along with the associated physician’s visit.

If I need treatment for coronavirus, is that covered by my plan?

Any medically necessary treatment related to COVID-19 would be considered a covered benefit. We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

Will I be able to refill my prescriptions before the refill date?

Yes, members will be able to refill prescriptions prior to the refill date.

Are there strategies for coping with the COVID-19 outbreak?

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.

  • Take care of your body. Take deep breaths, stretch or meditate.
  • Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking.
  • Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
  • For more information, see the CDC’s suggestions for mental health and coping during COVID-19.

For more information, including travel advisories, please visit cdc.gov.

 

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From 6 p.m. PT Saturday, April 4, to 6 a.m. PT Sunday, April 5, you may encounter intermittent disruption to our services. We apologize for any inconvenience.