The Health Plan will cover the cost of copays, co-insurance, and deductibles for COVID-19 testing for all Commercial, Medicare and Medicaid lines of business when recommended by a medical professional. Its exclusive independent lab provider, LabCorp is making its NAA test available for ordering by physicians or authorized healthcare providers anywhere in the United States.
For The Health Plan’s self-funded (ASO) members, they will also waive cost-sharing for diagnostic testing related to COVID-19, unless they receive notice in writing of the group’s intent not to implement this temporary relief option.
At this time, the Centers for Disease Control and Prevention (CDC) and state labs currently performing the testing are not billing for COVID-19 testing, so members should not incur costs when tested by these labs.
The Health Plan remains committed to ensuring access to medications is available during this time. Members have multiple options to obtain medication through The Health Plan, including the ability for Medicare and fully-insured members to fill 90-day supplies of long-term medications via mail order or local retail pharmacies. The Pharmacy Services Department will be available to assist with any extenuating circumstances such as ensuring formulary flexibility if medication shortages or access issues arise.
The Health Plan recommends contacting your doctor’s office first if you suspect you might have a flu or coronavirus infection. But to help reduce potential exposure, The Health Plan also encourages members to utilize telemedicine services if they are available as part of a member’s plan. The Health Plan will waive member cost share where applicable for telemedicine visits for the next 90 days. Telemedicine is a safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer-enabled web cam.
The Health Plan is providing the latest information on precautions members should take to help prevent the spread of COVID-19 and who should seek medical attention on its website.
March 11, 2020
Coronavirus 2019 (COVID-19) is a respiratory illness caused by a novel coronavirus designated SARS-CoV-2. The outbreak of COVID-19 originated in Wuhan City, Hubei Province, China. With thousands of confirmed cases being reported in a rapidly growing number of countries worldwide and the number of national cases growing, the West Virginia Public Employees Insurance Agency (PEIA) is establishing a policy to define the benefit and reimbursement regarding COVID-19 testing and treatment.
Effective March 1, 2020, PEIA will cover COVID-19 testing at 100% of the contracted allowance, at a network provider, for members who meet CDC guidelines for testing. This will apply to PEIA PPB Plans A, B, C and D. This means that members will have no out-of-pocket expense for the actual test. Deductibles, copayments, and coinsurance will also be waived for any physician or facility services incurred in the process of being tested.
Treatment of any members, who test positive for the virus, will be covered at normal benefit levels.
The CDC is periodically updating who should be tested. Please refer to the following link for the latest updates. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
If you believe you have been exposed to or have symptoms consistent with COVID-19, please call your local health department, primary care provider or iSelectMD 844-433-8123 for further instructions.
West Virginia has set up a hotline for its citizens and providers for up to date and accurate information regarding COVID-19. The hotline is toll-free, and operators are available 24/7 at 800-887-4304.
In addition, Optum, part of UnitedHealth Group, is opening its Emotional-Support Help Line. Professionally trained, mental health staff are there to support people who may be suffering from fear or stress created by COVID-19. Optum’s Emotional-Support Help Line number is 866-342-6892 and will be open 24 hours a day, seven days a week. The service is free of charge and open to all PEIA members.