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Telemedicine Resources by Insurance Carrier

Insurance carriers have options for their subscribers to virtually meet with a doctor via their telemedine or telehealth options.  Many carriers are waiving the office co-pay charges due to the COVID-19 pandemic.   

 

CIP has put together a list of resources for you by carrier to get you information on how to access these benefits from the comfort of your home.  

This is informational purposes only and does not constitute medical advice, if you are having a life threatening emergency, please dial 9-1-1.  

Aetna Funding Advantage and Fully-insured

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In response to the rapidly evolving COVID-19 outbreak, CVS Health announced a series of steps designed to support the health and well-being of Aetna members, ensure patient access to medication, and remove barriers to care. 

 

Effective immediately, small group members will have access to the following resources:

 

• Co-pays for members will be waived 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 for all small group business.

 

• 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 video-conferencing) for all small group plan designs.

 

• CVS Pharmacy will waive charges for home delivery of prescription medications. With the Centers for Disease Control and Prevention encouraging people at higher risk for COVID-19 complications to stay at home as much as possible, this is a convenient option to avoid coming to the pharmacy for refills or new prescriptions.

 

• Aetna offers 90-day maintenance medication prescriptions and will waive early refill limits on 30-day prescription maintenance medications for all small group members.

 

• 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.

 
 

Allways Health Partners

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In response to the news and reports on the coronavirus (COVID-19), we want to make sure you know what AllWays Health Partners is doing to support all of our customers. We recognize this is a lengthy message but we want to ensure you have the information and resources you may need.

Easier access for members to get needed care

AllWays Health Partners recognizes the need to remove barriers and ensure timely access to high-quality care for our customers during this public health emergency. 

We have put in place coverage policies for COVID-19 related to testing and treatment, based on public health recommendations and industry guidelines that are informed by the best data and medical evidence available. 

To expedite access to critical health care services for COVID-19, in accordance with guidelines from the Centers for Disease Control (CDC) and the Massachusetts Department of Public Health, our coverage policies for commercial members include:

  • Removing cost-sharing (copayments, deductibles, or coinsurance) for testing and copayments for treatment at in-network facilities.

  • Extending these cost-sharing policies to testing for out-of-network facilities if in-network providers are unavailable and removing prior authorizations for HMO members to make it easier to access testing if necessary outside our network.

  • Removing all cost-sharing for telehealth services, i.e., Partners HealthCare On Demand, to enable our members to seek COVID-19-related care virtually, reducing the need to go to medical offices.

Dedicated phone lines and microsite to support COVID-19 knowledge

  • We've established a dedicated phone line to address our customers’ questions related to COVID-19 coverage. (Members who call the phone number on their ID card will be prompted on how to access the dedicated phone line.) For questions about testing or treatment, we recommend that members contact their health care providers.

  • As part of an integrated health system, we're pleased to share with you Partners HealthCare's coronavirus hotline for clinicians, patients, and the public: 617-724-7000.

  • On our website, we've created a Coronavirus Resource Hub featuring information about our health care coverage, guidance for businesses, and where to go for daily updates and tips on prevention.

Downloadable resources for AllWays Health Partners members

We want to remind you and our members about some existing benefits and services that may be especially helpful during this time of recommended social distancing. For example, our members have access to:

We ask for your support in sharing this information with your clients who offer AllWays Health Partners.

We're transitioning to a remote workforce, and what this means for you

As part of an integrated health care system, we are participating in preparations by Partners HealthCare to protect employees and patients.

Blue Cross Blue Shield of Massachusetts

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Blue Cross Blue Shield of Massachusetts has been monitoring and responding to the serious challenges posed by the outbreak of coronavirus strain COVID-19. We want to assure you that our priorities remain rock-solid: to ensure uninterrupted access to care for our customers and members. This weekend, the Boston Globe ran a story on new Division of Insurance guidance, highlighting Blue Cross’ plans specifically. See story.

We are reaching out to our customers directly to outline the steps we are taking. We have established a dedicated coronavirus helpline (1-888-372-1970) available for members to answer any questions about benefits, providers, and share other resources related to COVID-19.

 

We also have launched a regularly updated resource center that includes information about how to stay safe, a downloadable tip sheet for employers, a video featuring one of our physicians, and an FAQ. Our health news site, Coverage,, produces timely, original news articles reporting what health consumers need to know about COVID-19. Additionally, effective immediately, Blue Cross plans (excluding Medicare) will:

• Remove co-pay, co-insurance, or deductibles for testing, counseling, vaccination (once available), and other COVID-19 care provided at doctors’ offices, emergency rooms, and urgent care centers for all members, consistent with the guidance issued by the Massachusetts Division of Insurance.

• Remove co-pay for COVID-19 treatment provided at doctors’ offices, emergency rooms, and urgent care centers for all members, consistent with the guidance issued by the Massachusetts Division of Insurance. Any medically necessary treatment for coronavirus is covered under a member’s health plan within the United States or internationally.

• Remove co-pays, co-insurance, or deductibles for members with the Blue Cross telehealth benefit (Well Connection) for the screening, evaluation, and/or suggested treatment of COVID-19. Telehealth offers convenience (within the United States) as well as the opportunity to avoid potential exposure to contagion.

Note: We intend to take these actions to reduce barriers to access care for both our fully insured customers and our self-funded customers. Self-insured customers can opt-out of the removal of member liability entirely. If you decide to opt-out, please contact your BCBSMA Account Executive within two business days.

•Remove administrative barriers, such as prior authorizations and referrals, for medically appropriate care for COVID-19.

• Provide access to prescription medications for members with Blue Cross Blue Shield pharmacy benefits. Members will have access to early refills for all prescribed maintenance medications. We will ensure formulary flexibility if there are shortages or access issues. Members should reach out to Blue Cross directly for more information.

We also want you to know that our company has disaster response and pandemic preparedness plans in place. As we have in past outbreaks, we have begun to execute on these plans, which are designed to support our customers, members, and providers as well as maintain business continuity.

For example, our workforce is mobile-enabled and can work remotely to support customers, members, providers, and business partners. Our financial reserves can be used to pay for health care services and fund our operations should there be an interruption in the flow of business revenue because of a pandemic. We are in a strong position to lead and support all our constituents in an emergency.   

We are closely coordinating with federal and state health officials as well as the Blue Cross Blue Shield Association and will update you on next steps as needed. 

 

Harvard Pilgrim Health Care

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Harvard Pilgrim is actively monitoring the coronavirus disease (COVID-19) outbreak and what it means for our customers and communities. 

To facilitate our members’ ability to receive necessary testing for suspected COVID-19 exposure, and until further notice, Harvard Pilgrim is waiving cost sharing for:

• The COVID-19 test

• Doctors office, urgent care and emergency room services for COVID-19 testing

• Telemedicine services

This policy applies to our fully insured, Medicare Advantage and Medicare Supplement plans. Coverage will be provided in accordance with plan requirements.

Self-insured employer groups can also waive cost sharing requirements for these services. Self-insured clients will have the coverage outlined above unless notification is received.

In accordance with the Massachusetts Division of Insurance bulletin, members on our fully insured commercial Massachusetts plans do not have to pay any applicable copayments for treatment they receive for COVID-19 from providers that participate in our network. However, other member cost sharing, such as deductibles and coinsurance, may apply for COVID-19 treatment. Members will also have access to out-of-network providers for the initial COVID-19 test or treatment when no in-network providers are available.

Harvard Pilgrim will also:

• Cover the COVID-19 vaccination when it becomes available 

• Remove prior authorization and referral requirements, where applicable, so members can get timely medically necessary testing and treatment

Harvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of Connecticut, Harvard Pilgrim Health Care of New England and HPHC Insurance Company.

Member support and education Harvard Pilgrim has a robust population health program designed to support all of our members’ needs, with a focus on those who are most vulnerable. Harvard Pilgrim has taken steps to  proactively reach out to our most vulnerable members, as well as to ensure that our nurse care managers proactively address high-risk individuals in their daily interactions. 

To educate our members about containing the spread and staying healthy, we have established a coronavirus microsite (harvardpilgrim.org/coronavirus) that includes general preventive information and links to the CDC and state health agencies in Connecticut, Maine, Massachusetts and New Hampshire. It also includes an FAQ that lets members know about options for telemedicine and obtaining 90-day prescriptions for medicines they take regularly. 

 Business continuity Harvard Pilgrim’s business continuity plan includes strategies to address pandemic conditions such as COVID-19. These strategies ensure that Harvard Pilgrim can continue to serve our constituents as well as protect our employees.

 Harvard Pilgrim’s pandemic strategy focuses on:

• Reducing the transmission of an infectious agent within the workplace

• Decreasing illness among employees, contractors and visitors

• Maintaining mission critical business operations

• Reducing the economic impact of an infectious disease outbreak

 

Tufts Health Plan Commercial and Tufts Health Direct Members

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Tufts Health Plan is committed to providing our members with accurate, reliable information about access to health care services in response to the COVID-19 (“Coronavirus”) outbreak.

Effective immediately and until further notice, and in accordance with the Massachusetts Division of Insurance Bulletin and CDC Guidance, Tufts Health Plan will provide Tufts Health Plan Commercial and Direct Members with access to the following:

  • No out-of-pocket costs for medically necessary Coronavirus testing, counseling and vaccinations. This coverage applies at in-network providers, urgent care center, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.

  • No copayments for medically necessary Coronavirus treatment. This coverage applies at in-network providers, urgent care center, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.

This will also apply to members of our self-funded groups that have not opted-out.

Telehealth can help members avoid contact with the Coronavirus in medical offices

People with mild, flu-like symptoms should call their health care provider before going to a health care facility.

  • Many providers offer telehealth services. Ask your primary care provider if they do. All out-of-pocket costs for telehealth visits related to Coronavirus will be waived for the duration of this COVID-19 situation for Commercial members. Telehealth enables members to make inquiries regarding symptoms or treatment for the Coronavirus in order to reduce the need for members to go to medical offices where the risk of coming in contact with the Coronavirus may be higher. This will also apply to members of our self-funded groups that have not opted-out.

  • Tufts Health Plan Commercial members (not including Direct) can also use our telehealth solution powered by Teladoc1. With telehealth from Teladoc, members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world for $0 copay.  Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about Coronavirus.  For the duration of this crisis, there will be no member cost for this service to our employer-sponsored (self-funded) groups as well who have opted for this benefit.

  • Tufts Health Plan also offers access to our Nurse 24 telephonic service to all Tufts Health Plan Commercial and Direct members at no cost, through which you can speak to a registered nurse 24/7 to receive medical advice on appropriate care. Tufts Health Plan Commercial members should call 866.201.7919; Direct members should call 888.697.6546.

Prescription refills

We permit members a one-time refill of their prescriptions prior to the expiration date so that they will have a supply of their medications should they need it.

We also waive the refill limitation for one 30-day prescription of a maintenance medication to a 90-day duration.

If a member has multiple maintenance medications, each drug will be allowed to be waived just once.

 

Contacting Member Services

For clinical questions or concerns about the Coronavirus, please call 866.201.7919 (Massachusetts Commercial members) or 888.697.6546 (Tufts Health Direct members) for access to a registered nurse.

For other health plan coverage questions, please call the Member Services phone number on your member ID Card.

Where can individuals find additional information and updates about Coronavirus?

They should visit the CDC website at www.cdc.gov and click on “Coronavirus Disease 2019.”

Other excellent sources of information include the following:
The Massachusetts Department of Health
The Rhode Island Department of Public Health
The New Hampshire Department of Health and Human Services

 

Our policy in case the company needs to close down due to a pandemic

Tufts Health Plan has an extensive policy in place to ensure the continued service of our members and clients if we are required to close our physical locations in any of our markets.  All employees are able to work remotely to ensure continued service to our members, employers and brokers.  Please reference our overview of our continuity plan for our organization for more information, or your account service team.  We will continue to keep you abreast of any changes to this policy in the coming days or weeks. You can view the CCP here.

 

Tufts Health Plan Commercial members (not including Tufts Health Direct) can also use our telehealth solution powered by Teladoc. With telehealth from Teladoc, members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world and for plans issued or renewed in 2020 at $0 copay. Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about Coronavirus. For the duration of this crisis, there will be no member cost for this service to our employer-sponsored groups, including self-funded groups that have this benefit and have not opted out.

 

CIGNA Health Care

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Cigna will waive costs for COVID-19 testing-related care through May 31, 2020. Learn more

Due to the COVID-19 outbreak, our virtual care vendors (Amwell and MDLIVE) are experiencing a sharp increase in demand nationally causing wait times to be higher than normal. They are proud to serve as part of the national response to COVID-19. Not only can they greatly minimize the demands on in-person care across the country; they can help patients reduce unnecessary exposure.

We find that although wait times are currently higher than normal, patient satisfaction remains high. And to help customers access care, we are updating the myCigna.com virtual care landing page to make it easier to see we have two virtual care vendors.

Both vendors have plans in place to continue to deliver high quality care during this unprecedented time, including:

  • Real-time monitoring with communication and escalation as situations occur.

  • Ability to make real-time adjustments based on data available by state for COVID-19 as patient volume surges.

  • Provider incentives and bonuses to match provider supply during patient surges.

  • Extensive personal outreach to providers to inform providers of busy periods.

  • Targeted provider recruiting based on states with the highest patient demand for services.

 

Please be advised that any and all information, comments, analysis, and/or recommendations set forth above relative to the possible impact of COVID-19 on potential insurance coverage or other policy implications are intended solely for informational purposes and should not be relied upon as legal advice. Insurance brokers do not have authority to make coverage decisions as that ability rests solely with the issuing carrier. All claims should be submitted to the insurer for evaluation. The opinions expressed are not to be construed as any form of guarantee or warrantee. Comments above do not take into account any pending or future legislation introduced with the intent to override, alter or amend current policy language.