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CareValue and Carrier Operations for COVID-19

We understand that your clients have questions regarding their healthcare options and safety as the novel coronavirus (COVID-19) continues to impact the nation. Our top priority is to ensure your beneficiaries have access to care and that our shared communities are safe.

We are keeping a close watch on the outbreak and will continue to provide updates on our CareValue broker webpage as well as regular email communications.

In response to the coronavirus outbreak, our sales teams are adjusting our engagement with our brokers to make online or phone meetings the standard, rather than in-person for the next 30 days. As our workforce makes this adjustment, our commitment to provide important services to you the brokers is unchanged.

Thank you for your help in keeping your beneficiaries and communities safe. We’re here to answer any questions you have and will be sending regular communications.

Updates by Carrier

We’ll continue to update this page to ensure we have the most up-to-date status of the carriers we work with according to the information those carriers have provided to us.

Aetna

We are pleased to announce that Aetna is waiving cost-sharing and co-pays for inpatient hospital admissions related to COVID-19 for Aetna’s commercially insured members, part of several additional steps to help members access the care that they need during the COVID-19 pandemic.

You can read the complete CVS Health press release here.

We will continue to publish updates and information as well as additional questions and responses through the Aetna COVID-19 Resource site.  We recommend that you bookmark this site and refer to it to gain the most up-to-date Aetna COVID-19 information.

A mailbox has been set up for you to submit any general Aetna COVID-19 additional questions: COVID19_Aetna_Producer_Questions@AETNA.com.

Aetna will waive co-pays for all diagnostic testing related to COVID-19, according to CVS Health. That includes all member costs associated with diagnostic testing for Commercial, Medicare, and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of the program at their discretion. Aetna is also offering zero co-pay telemedicine visits for any reason, and it is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all fully insured members. People diagnosed with COVID-19 will receive a care package. CVS Health is also offering several programs to help people address associated anxiety and stress.

Aetna, a CVS Health company, will waive member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.”

AIG

“We continue to be ready to serve you whether for new business or inforce. We have activated our business continuity plan, which means that our employees have now transitioned to remote working where appropriate. We are committed to working through this initial transition quickly and striving for our service levels to reflect normal operating standards as quickly as possible. Our employees have stepped up at this critical time and we are proud of the stories of great collaboration across the organization.

While much has changed, much remains the same. Protecting against life’s uncertainties remains at the heart of what we do in the life insurance business. The current environment is impacting the way everyone conducts business, and we are here to help. As consumers face uncertainty, together we can help provide the peace of mind that comes with a solid protection foundation.

Please watch for upcoming communications from us providing resources to help you continue serving your clients and growing your business in this environment. You can always find life insurance product information and valuable tools on our marketing sites. Or visit our producer portal to submit new business requirements, check policy status, access forms and applications, view department contact information and more.”

Allwell

“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.”

Ameritas

“Ameritas is monitoring the latest coronavirus developments and following updates from the World Health Organization and Centers for Disease Control. Our top priority is the health, safety and well-being of out customers, associates and financial professionals.

Our digital systems allow us to protect our employees and still provide customer service. We continue to bill and collect premium, and pay claims and commissions, as usual. And we’re focused on minimizing disruptions.

As the situation evolves nationwide, we will keep you posted of any new developments at Ameritas that affect you and your customers.

We’ve received many questions about our customers’ dental and vision coverage status during this uncertain time. We know many people will not be able to make premium payments during this crisis because of reduced hours, layoffs and furloughs, or temporary closures.

Our customers’ well-being is our first priority. Therefore, we are extending our premium grace period to 60 days while continuing coverage and claims payment. Ameritas will adhere to any state-mandated premium grace periods as a temporary exception to our policy during this time.

We will work with customers on an individual basis to help meet their needs. Please read our FAQ for details about coverage, claims, and much more. We will also direct customers to this FAQ on our website.

Finding the right words and encouraging ideas to send to your clients and their employees is challenging during this turbulent time. Perhaps our Tips for Surviving Market Volatility During COVID-19 Virus Uncertainty can help. We can also provide a Spanish language version.

If you have questions and about your business with Ameritas, please contact us at cs@ameritas.com, and include COVID in your email subject line.”

Anthem

Anthem will cover the cost of coronavirus testing with no out-of-pocket cost. Anthem also confirms that prior authorization is not required for diagnostic services related to COVID-19 testing. The company recommends using telehealth when possible to help prevent the spread of a virus. It is also encouraging its members to talk to their doctor about whether it is appropriate for them to change from a 30-day supply of their regular medications to a 90-day supply.

On March 17, Anthem also announced new resources for its members. First, it is working to accelerate the availability of a Coronavirus Assessment tool on the Sydney Care mobile app, which members can download at no cost. Second, Anthem’s affiliated plans will continue to waive copays, coinsurance and deductibles for diagnostic tests for COVID-19, and extending this to include waiver of copays, coinsurance, and deductibles for visits associated with in-network COVID-19 testing, whether the care is received in a doctor’s office, urgent care center or emergency department. Third, Anthem is relaxing early prescription refill limits for members who wish to receive a 30-day supply of most maintenance medications, where permissible. Fourth, for 90 days, Anthem plans will waive any cost sharing for telehealth visits, including visits for mental health care, for fully insured employer plans, individual plans, Medicare plans, and Medicaid plans, where permissible. This includes visits using Anthem’s telemedicine service, as well as care received from other telehealth providers delivering virtual care. The Anthem Foundation continues to support the Red Cross, Direct Relief, Americares, and Feeding America, and is working to redirect up to $2 million to local Boys and Girls Clubs to help distribute meals to children and families in need. The company is matching employee donations to the Anthem Foundation’s program.

Anthem is increasing physician availability through its telemedicine service, LiveHealth Online (LHO), including encouraging in-network doctors to join the platform, given the surge in demand. LHO is a safe and helpful way to use Anthem benefits to see a doctor and receive health guidance related to COVID-19, without leaving home or work.

Anthem is contributing $1 million to the Rapid Response Loan Fund, which was established by the Indy Chamber. The loan fund is intended to help the roughly 43,000 small business in central Indiana.

Anthem has also launched the Anthem Medical Associate Volunteer Program, which is designed to allow associates with professional medical training volunteer and assist in their local community’s response to COVID-19.

In addition, Anthem suspended prior authorization requirements for patient transfers as well as for the use of medical equipment critical to COVID-19 treatment.”

BCBSWNY

“In light of these unprecedented times, we are announcing that BlueCross BlueShield of Western New York is eliminating any and all costs for our members related to COVID-19 testing and treatment. This includes our nearly 500,000 Medicare Advantage, Medicaid, and fully insured Commercial members. No co-pays, no cost-shares, no-coinsurance on the part of our members will be required effective April 1 through May 31, 2020. This includes any testing, care or treatment provided anywhere in the United States for our members.
We’ve been here for our members for more than 80 years, and we want them to know that we are here for them now. In these unprecedented times, BlueCross BlueShield remains committed to supporting the health of our members, those providing this essential care, and our community. As part of that commitment, we’re taking this significant action so that our members have access to diagnosis and treatment as needed. We are here for our members.”

The company’s announcement today builds on its overall efforts to connect members to care and support the community during this time. BlueCross BlueShield is:
– Eliminating prior authorization requirements for COVID-19 testing and treatment;
– Covering the full cost of COVID-19 testing and the care visit where the test is given;
– Covering the full cost of COVID-19 treatment regardless of where care is being provided in the United States; (BlueCross will also implement this policy for self-funded customers who elect to offer this coverage.)
– Covering the full cost for all telehealth services, including those that are not related to COVID-19;
– Authorizing 90 day mail order benefit for refills of all applicable prescriptions, allowing members to remain in their homes as much as possible;
– Donating $100,000 to the Western New York COVID-19 Community Response Fund to address the most critical and immediate community needs related to the coronavirus as well as other efforts;
– Dedicating a team, personally reaching out to members to offer support during this time of uncertainty;
– Providing timely information and updates for members, employer groups and providers at www.bcbswny.com/coronavirus. Additionally, BlueCross BlueShield is taking every effort to keep its more than 1,500 employees healthy.

The local health plan transitioned its workforce to work-from-home arrangements while maintaining uninterrupted lines of communication and support for members, doctors, hospitals, and the community.

BSNENY

“In light of these unprecedented times, we are announcing that BlueShield of Northeastern New York is eliminating any and all costs for our members related to COVID-19 testing and treatment. This includes our Medicare Advantage and fully insured Commercial members. No co-pays, no cost-shares, no-coinsurance on the part of our members will be required effective April 1 through May 31, 2020. This includes any testing, care or treatment provided anywhere in the United States for our members.

We’ve been here for our members for more than 70 years, and we want them to know that we are here for them now. In these unprecedented times, BlueShield remains committed to supporting the health of our members, those providing this essential care, and our community. As part of that commitment, we’re taking this significant action so that our members have access to diagnosis and treatment as needed. We are here for our members.”

The company’s announcement today builds on its overall efforts to connect members to care and support the community during this time. BlueShield is:
– Eliminating prior authorization requirements for COVID-19 testing and treatment;
– Covering the full cost of COVID-19 testing and the care visit where the test is given;
– Covering the full cost of COVID-19 treatment regardless of where care is being provided in the United States; (BlueShield will also implement this policy for self-funded customers who elect to offer this coverage.)
– Covering the full cost for all telehealth services, including those that are not related to COVID-19;
– Authorizing 90-day mail order benefit for refills of all applicable prescriptions, allowing members to remain in their homes as much as possible;
– Donating $25,0000 to the Capital Region Community COVID-19 Response Fund to address the most critical and immediate community needs related to the coronavirus as well as other efforts;
– Dedicating a team, personally reaching out to members to offer support during this time of uncertainty;
– Providing timely information and updates for members, employer groups and providers at www.bsneny.com/coronavirus. Additionally, BlueShield is taking every effort to keep its employees healthy. The local health plan transitioned its workforce to work-from-home arrangements while maintaining uninterrupted lines of communication and support for members, doctors, hospitals, and the community.

BlueShield is closely monitoring this evolving situation and will continue to make decisions that are in the best interest of their members.

Centene

Centene will cover COVID-19 testing and screening services for Medicaid, Medicare and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening. The company will not require prior authorization, prior certification, prior notification or step therapy protocols for these services.

Centene will cover the cost of COVID-19-related treatments for Medicare, Medicaid and Marketplace members. Centene is also eliminating the need for providers to collect co-pays and removing authorization requirements for COVID-19 related treatment.”

Cigna

Cigna is covering the cost of coronavirus testing, waiving all co-pays or cost-shares for fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans available through the Affordable Care Act. Organizations that offer Administrative Services Only (ASO) plans will also have the option to include coronavirus testing as a preventive benefit. Recognizing that health outbreaks can increase feelings of stress, anxiety and sleeplessness and sometimes loss. Cigna is also staffing a second phone line for customers.

Cigna also announced it will waive customers’ out-of-pocket costs for COVID-19 testing-related visits with in-network providers, whether at a doctor’s office, urgent care clinic, emergency room or via telehealth, through May 31, 2020. This includes customers in the United States who are covered under Cigna employer/union sponsored group insurance plans, globally mobile plans, Medicare Advantage, Medicaid and the Individual and Family plans. Employers and other entities that sponsor self-insured plans administered by Cigna will be given the opportunity to adopt a similar coverage policy. The company is making it easier for customers with immunosuppression, chronic conditions or who are experiencing transportation challenges to be treated virtually by in-network physicians with those capabilities, through May 31, 2020. Cigna’s Express Scripts Pharmacy offers free home delivery of up to 90-day supplies of prescription maintenance medications. Cigna has opened a 24-hour toll-free help line (1-866-912-1687) to connect people directly with qualified clinicians who can provide support and guidance. Additionally, Cigna will offer a webinar to the general public raising awareness about tools and techniques for stress management and building resiliency, along with the ability to join telephonic mindfulness sessions.

Cigna will waive prior authorizations for the transfer of its non-COVID-19 customers from acute inpatient hospitals to in-network long term acute care hospitals to help manage the demands of increasingly high volumes of COVID-19 patients.

Cigna is waiving customer cost-sharing and co-payments for COVID-19 treatment through May 31. The policy applies to customers in the U.S. who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage, and Individual and Family Plans. Cigna will also administer the waiver to self-insured group health plans.”

ConnectiCare

ConnectiCare is covering telehealth visits for covered medical and mental health services at no cost through May 31, 2020.”

EmblemHealth

EmblemHealth is partnering with Medly Pharmacy to provide direct, at-home delivery of prescriptions to members, as part of its COVID-19 response.

“EmblemHealth has taken steps to ensure that all of our members have peace of mind of knowing that they will have access to the services they need.

As we, like other health plans, step up to meet the challenges of these times, by absorbing out-of-pocket costs associated with the benefits members and employees have purchased, we are asking our partners to take similar steps by accepting treatment rates set for Medicare and Medicaid for everyone who needs these services.

We are providing our members with comprehensive information on our website about the virus and are updating it regularly based on the information coming from the CDC, the NY Department of Health and the New York City Department of Health and Mental Hygiene.”

Envision

“Envision has introduced three new attestation options on our electronic enrollments.

At the bottom of the electronic enrollment, there has been two attestation boxes to choose from. Now due to the COVID-19, we have three additional attestations of getting the client/member’s signature. We have received approval from our legal team and our compliance team.

Due to COVID-19, I am unable to meet with my client to obtain a signed application and Scope of Appointment (SOA). Please select one of the following options:

  • I attest that I spoke to the member on the phone and they agree to enroll in EnvisionRxPlus. I will collect the paper documents at a later date and be prepared to be audited at plan discretion.
  • I attest my client has sent me a picture image of the signed SOA and application through a smart phone or email. I will keep this documentation for my records and will be prepared to be audited at plan discretion.
  • I attest that I have recorded my client agreement to enroll in EnvisionRxPlus through a web communication software such as Zoom or Go To Meeting. I will save a copy of this recording or transcript of it and be prepared to be audited at plan discretion. There is no need for paper SOA or application.

For the first option, if the client gives approval over the phone, you still need a signed application and Scope of Appointment (SOA), but you can collect these documents at a later date. When you send them the SOA to sign, you need to verify the application date and the signature date are the same. Enter the date you completed the phone enrollment and not the date they are mailing the signed documents back to you.

For the second option, the client has a smart phone, can scan and email images, or can borrow a family member’s phone to take a picture and save it to their records as signatures.

For the third option, if a WebEx, Go To or Zoom meeting can be organized, that will be the face-to-face. However, you must obtain the transcript or recording of that meeting to save, as you would have the signed documents.

We hope this helps to alleviate some of the worries of this “no face-to-face “ time we are currently experiencing.

Due to the COVID-19, we are working, but from home we have all the equipment and connections we need to continue giving great support to our agencies and agents. Any questions or concerns feel free as always to reach out to EnvisionAgentSupport@envisionrx.com.”

Excellus

“For insured members and members with self-funded employers, the Health Plan will waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance for members if diagnosed with COVID-19.

We will also make dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19.

The Health Plan will cover medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19 at no cost share to member. Across all our insured health plans (Commercial, Medicaid Managed Care, HARP, Essential Plan, Child Health Plus, Medicare Part B, Medicare Advantage), and self-insured plans this testing will be covered, with no cost share to the member, where it is not covered as part of the Public Health Service response. The Health Plan will also ensure that patient testing and any subsequently needed care are done in close coordination with federal, state and public health authorities.

  • Members who are in insured commercial and self-insured plans will have coverage with no out-of-pocket expense to them, for in-network provider office visits, in-network urgent care visits and emergency room visits resulting in testing for COVID-19. If an in-network provider is not available, the Health Plan will cover testing at an out-of-network provider with no out-of-pocket expense to the member.
  • Members who are enrolled in Medicaid Managed Care, HARP or Child Health Plus will have the cost of coronavirus testing by an in-network provider covered with no out-of-pocket expense. If an in-network provider is not available, the Health Plan will cover testing at an out-of-network provider with no out-of-pocket expense to the member.
  • Medicare members – Medicare Part B (Medical Insurance) covers COVID-19 testing. This test is covered when your doctor or a health care provider orders it, if you get the test on or after February 4, 2020.
  • Members with high deductible health plans will not be responsible for copayments, coinsurance and deductibles for 2019 Novel Coronavirus (COVID-19)-related testing even if the deductible has not been met, under new guidance from the Internal Revenue Service. This also means that an individual with an HDHP that covers these costs may continue to contribute to a health savings account (HSA).
  • A telehealth visit is also an option to do initial screenings or when you can’t reach your personal physician. Telehealth services are covered under all product lines with no member cost share during the state of emergency if telehealth is part of your benefit package.

General guidance regarding the effect of COVID-19 on prescription drug coverage

We are closely monitoring the supply of medications that are available during the coronavirus outbreak.

When a state of emergency is declared for a specific state or region, we implement early refill overrides for prescription medications for members living in those specific areas. Pharmacists can make the override at the point of sale.

The Health Plan is increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan).

Members are also encouraged to use their 90-day mail order benefit for prescription medications.

The Health Plan will ensure formulary flexibility if shortages or access issues do occur. Members 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.

Emergency prescription drug overrides are available as part of our standard exception process on an individual member basis.”

Geisinger

“Geisinger Health Plan will waive out-of-pocket costs for COVID-19 testing and is not requiring prior authorization for diagnostic services related to these tests. We are relaxing refill quantity and frequency restrictions to offer 90-day maintenance medication prescriptions for Commercial and Medicare members and allowing members to refill their prescriptions early. Its large TPA groups may opt out of these programs at their discretion.

Geisinger is also making telehealth services available for all members at no cost through June 15. Services are provided via Teladoc online or by phone, and may be used for any routine medical need.

Geisinger has partnered with the Central Pennsylvania Food Bank, Harrisburg, and Weinberg Northeast Food Bank, Pittston, to distribute emergency food boxes to health plan members, patients and those in need in the community. These boxes are being delivered from Geisinger’s Fresh Food Farmacy locations and include shelf stable supplies, recipes, educational information and other resources. Geisinger is targeting food insecure health plan members, however, any patient or community member in need is eligible. To ensure the safety of the community and prevent potential exposure to COVID-19, staff will be doing curbside or front porch deliveries.”

Guarantee Trust Life

“As you might imagine, the past ten days has been very eventful at Guarantee Trust. We have lots of moving pieces and heightened levels of activity to support a very thorough plan of operations which has two main objectives. One objective is to provide the safest possible work environment for our employee population and the second, and equally important, objective is to provide outstanding uninterrupted service to our policyholders and field representatives.

As of yesterday, we had better than 50 percent of our workforce working remote. By Monday all of our employees will be able to work remote. Employees under the age of 60 with no underlying health issues are permitted to come to our office if they so choose but most of our employees will be working remote. We have done a truly good job at shifting the entire way we work in a very short period of time.
Several things worth noting are that Guarantee Trust has never been as financially sound as it is today. We are open and ready to process as much business as you can send our way. It is also true that we have never been as competent as we are today and while we wish the circumstances driving reality were not what they are, we are excited to demonstrate our preparedness to function well in a challenging environment.”

Humana

Humana will waive out-of-pocket costs associated with COVID-19 testing. This applies to Medicare Advantage, Medicaid, and commercial employer-sponsored plans. Self-insured plan sponsors will be able to opt-out. The company is also waiving telemedicine costs for all urgent care for the next 90 days and is allowing early refills on regular prescription medications.

Humana is waiving member cost share for all telehealth services delivered by participating/in-network providers, including telehealth services delivered through MDLive to Medicare Advantage members and to commercial members in Puerto Rico, as well as all telehealth services delivered through Doctor on Demand to commercial members.

Humana is waiving consumer costs for treatment related to COVID-19-covered services. Costs related to treatment for COVID-19, including inpatient hospital admissions, will be waived for enrollees of Medicare Advantage plans, fully insured commercial members, Medicare Supplement, and Medicaid.

The waiver applies to all medical costs related to COVID-19 treatment, as well any FDA-approved medications or vaccines.

There is no current end date for the waiver.”

Medico

“Every effort is being made to ensure this situation will not affect the timeliness or quality of our service. As a precaution, we are taking steps to ask employees to work from home as business reasonably allows and suspending all non-essential travel. We are limiting in-person meetings and no longer allowing outside visitors to our offices. Additional sanitizing protocols have also been implemented. Should a COVID-19 outbreak directly affect any of our locations, we have steps in place for operational resilience and the mitigation of business disruption.

Ensuring you have the tools and resources needed is always important to us – especially during times like these when you can no longer rely on face-to-face interaction with your clients. To help you stay safe while continuing to sell, we’ve compiled a list of tools and resources on our agent website. We will also begin mailing all policy packets directly to new policyholders to comply with social distancing best practices and eliminate the need for you to hand deliver materials.

Please contact Agent Services at 800-547-2401, option 3, if there is anything we can do to assist you.”

Molina Healthcare

Molina Healthcare will waive all member costs associated with testing for COVID-19. Any related visit to a primary care doctor, urgent care or emergency care does not require prior authorization.

Molina Healthcare has launched a Coronavirus Chatbot, an enhanced digital tool for members seeking information about COVID-19 risk factors and their own personal risk profile. This new self-appraisal feature is available for members looking for current insight, risk factors, live help, and appropriate action to take if symptoms are present.”

Mutual of Omaha

“We want to take this opportunity to share how we’re responding to this situation:

  • 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.
  • Mutual of Omaha remains committed to providing superior service to our policyholders and we are taking active steps to prevent any interruption in our business processes.
  • If you have any questions regarding your insurance policy, we encourage you to access your account from home 247using our online portal, Customer Access, or our automated phone system (800-775-6000) to view policy information, update payment/billing information and more.
  • Please note that out of an abundance of caution, Mutual of Omaha is practicing social distancing and has asked all associates who are able, to work from home. We appreciate your patience and understanding as we take steps to protect the health and safety of our associates and ensure uninterrupted service to our customers.
  • As additional information for our Medicare supplement customers, please be advised of the following:
    • Should your doctor or medical provider determine you need to be tested, your Medicare Part B (Medical Insurance) will cover the test. To learn more, visit gov
    • Your Medicare supplement plan covers foreign travel emergency (up to plan limits); the plan is the same as stated in your policy
    • Be assured that we continue to pay claims without disruption, which allows you to remain focused on your health.

In an effort to continue to provide updates to our business partners around COVID-19, and offer one spot for housing this information, we have created the below webpage. This webpage will keep you updated in real-time with any changes or enhancements we make to our benefits handling and other key items related to COVID-19. We will add additional resources as they become available http://www.mutualofomaha.com/group-benefits/covid-19.

As COVID-19 cases increase within the United States and around the world, Mutual of Omaha is issuing the following underwriting guidance on new and pending applications for life and health products (Accidental Death, Long-Term Care, Disability Income, Critical Illness, Cancer, and Heart Attack & Stroke), effective immediately:

  • If the proposed insured or any member of his or her household has traveled or resided outside of the United States within the past 30 days, the application will be postponed until 30 days following their return.
  • If the proposed insured or any member of his or her household has come into close contact with anyone known to the insured to have tested positive for COVID-19, the application will be postponed until 30 days following their exposure.
  • In addition, anyone testing positive for the COVID-19 virus or those who have been hospitalized or quarantined for the virus will have their application postponed for a minimum of 90 days.

Due to the rapid changes arising from this pandemic, we are continuously monitoring the updates published by the U.S. Department of State and the CDC, as well as local, state or other federal agencies. We will provide additional updates as new information becomes available.”

SilverScript

“On March 9, 2020, CVS Health announced additional COVID-19 resources to increase patient access to medications.

Beginning immediately, CVS Pharmacy will waive charges for home delivery of prescription medications, which will help patients avoid visiting their local CVS Pharmacy for refills or new prescriptions.

Aetna will offer 90-day maintenance medication prescriptions for insured and Medicare members.

CVS Caremark is working with all PBM clients to waive early refill limits on 30-day prescription maintenance medications.”

Transamerica

“We want to assure you that Transamerica is continually monitoring developments and guidelines from the Centers for Disease Control and Prevention (CDC) to determine what steps we need to take to help protect our employees while they’re on the job and safeguard our ability to serve the customers and business associates who depend on us.

The heart of Transamerica’s business is risk management, and we have robust plans in place to ensure continuity of service to our customers, clients, distributors, agents, and advisors. Transamerica remains committed to providing high-quality service, and our leadership team continues to keep the security of our customers in mind in light of ongoing events.

You may be assured to learn that Transamerica is:

  • Servicing customer calls and emails from multiple customer care centers, allowing easy transfer of customer care among diverse geographic locations.
  • Increasing our work-from-home capacity. A significant number of employees can already conduct business as usual from home or another location, which provides stability for our distribution processes, operations and business practices.
  • Banning employees’ travel to all regions identified by the CDC Level as 3 and implementing self-quarantine procedures for any who return from countries on that list, as well as curtailing most domestic travel.
  • Ramping up our use of virtual meetings.
  • Working with our third party vendors to help ensure their responsiveness to ongoing events.
  • Keeping everyone’s well-being in mind by taking precautionary measures consistent with CDC recommendations to help minimize exposure among our employees and business associates.

As we adjust, certain business functions could be affected, including:

  • Newly submitted business: We are experiencing processing delays, meaning you may experience longer timeframes than usual as we work to issue and place business. During this time, our New Business teams will communicate via email rather than by phone for critical issues and concerns about submitted business.
  • Resources/hours: We are making sure our processing expertise is well balanced between the phone lines and business processing. To meet this need, we’re adjusting our contact center’s operating hours. Effective Friday, March 27, it will operate from 9:30AM to 4PM ET, aligning with the same hours as the U.S. stock market.
    • Our sales desks will keep their normal business hours.
  • Communication: To ensure our contact center representatives are focused on the most critical service efforts, we ask that you use other channels for non-urgent needs, including:
    • Portals: Available 247, they offer many standard self-service options, such as information on pending policies and status updates.
    • Email: Use the same email(s) as usual.
    • IVRs: We are updating our contact center messaging to remind you of our changes.
  • Claims: We remain committed to paying claims in a timely manner. At this time, we may be unable to follow up as thoroughly as usual on customer requirements. If you have customers with outstanding claims who need guidance, please email us at one of the following boxes:
  • Our Operations Distribution Relationship Team: While we always aim to provide the best support possible, our capabilities might be limited at this time. Please follow the processes listed above for all status checks and escalations. Requests for administrative decisions should follow our normal procedures and communication pathways through the processing teams. Contact via the Operations Distribution Relationship email should be limited to the re-review of administrative decisions only.”

UnitedHealthcare

UnitedHealthcare is waiving costs for COVID-19 testing provided at approved locations in accordance with the CDC guidelines, as well as waiving copays, coinsurance and deductibles for visits associated with COVID-19 testing, whether the care is received in a physician’s office, an urgent care center or an emergency department. This coverage applies to Medicare Advantage and Medicaid members as well as commercial members. United is also expanding provider telehealth access and waiving member cost sharing for COVID-19 testing-related visits.

UnitedHealthcare is also opening a special enrollment period for some of its existing commercial customers beginning March 23 through April 6 due to the COVID-19 pandemic. UnitedHealthcare is also suspending prior authorization requirements to a post-acute care setting through May 31 and suspending them when a member transfers to a new provider through May 31.

UnitedHealthcare is waiving member cost sharing for the treatment of COVID-19 through May 31, 2020 for its fully insured commercial, Medicare Advantage, and Medicaid plans.

Starting March 31, 2020 until June 18, 2020, UnitedHealth will also waive cost sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, and fully insured individual and group market health plans.”

Univera Healthcare

“Medicare members – Medicare Part B (Medical Insurance) covers COVID-19 testing. This test is covered when your doctor or a health care provider orders it, if you get the test on or after February 4, 2020.

When a state of emergency is declared for a specific state or region, we implement early refill overrides for prescription medications for members living in those specific areas. Pharmacists can make the override at the point of sale.

The Health Plan is increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan).

Members are also encouraged to use their 90-day mail order benefit for prescription medications.

The Health Plan will ensure formulary flexibility if shortages or access issues do occur. Members 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.

Emergency prescription drug overrides are available as part of our standard exception process on an individual member basis.”

UPMC

UPMC and UPMC Health Plan will waive any applicable deductibles, copayments, or other cost-sharing for COVID-19 testing when ordered by a member’s treating medical provider. This no-cost coverage of COVID-19 testing as a preventive service will apply for members in all of UPMC’s commercial UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, and UPMC for You Medical Assistance plans. Self-insured or administrative services only (ASO) employer groups will be permitted to opt-out of preventive coverage at their discretion.

UPMC Health Plan is waiving all member cost sharing payments for all in-network virtual health care visits with UPMC telehealth providers. The waiver lasts until June 15, 2020.

UPMC is also waiving early refill limits on medications filled at retail and specialty pharmacies until June 15, 2020.

UPMC is also working with a bank to help small businesses find available loans from state or federal programs.”

Emergency prescription drug overrides are available as part of our standard exception process on an individual member basis.”

VSP

“Each of us has a responsibility to take steps to impact the greater good in times of crisis. In recent weeks, we’ve all received guidance on social distancing, learned about “essential” businesses, and felt concerned for our strained health care system as it responds to the COVID-19 virus.

At VSP® Vision Care, we’re committed to doing our part to “flatten the curve” and protect the health and safety of our members. That’s why, through the month of April, VSP has expanded access to medical eye care services* for most VSP members and their covered dependents. It is effective today, through April 30, 2020 for members who do not already have this benefit.

By doing so, these members now have access to supplemental medical eye care for the detection, treatment, and management of ocular and visual conditions, including conjunctivitis, eye trauma, or sudden changes in vision. They can see their VSP network doctor in-person or remotely. Members can also use their routine VSP coverage for lost or broken glasses or replacement contact lenses to meet immediate eyewear needs by contacting their VSP network doctor.

Access to optometrists during this pandemic allows our members to maintain health and visual acuity while easing the burden on primary care physicians and emergency rooms. Visiting the ER may increase exposure to disease, as well as take services away from critically ill patients.

For members whose plan already covers essential medical eye care services, there is no change, and they can continue receiving these services from their VSP network doctor.

VSP network doctors do so much more than help with vision correction. They diagnose and treat conditions including conjunctivitis, eye trauma, and sudden changes in vision.”

WellCare

“WellCare will be extending coverage for COVID-19. This important step is being taken in partnership with other major insurers and with the support of the White House Coronavirus Task Force.

We intend to cover COVID-19 testing and screening services for Medicare members and are waiving all associated member cost share amounts for COVID-19 testing and screening. To ensure that our members receive the care they need as quickly as possible, WellCare will not require prior authorization, prior certification, prior notification or step therapy protocols for these services.

This coverage extension follows the Centers for Medicare & Medicaid Services’ (CMS) guidance that coronavirus tests will be fully covered without cost-sharing for Medicare and Medicaid plans, a decision that WellCare fully supports for our members covered under these programs. We also support the administration’s guidance to provide more flexibility to Medicare Advantage and Part D plans. The specific guidance includes:

  • Waiving cost-sharing for COVID-19 tests
  • Waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
  • Removing prior authorization requirements
  • Waiving prescription refill limits
  • Relaxing restrictions on home or mail delivery of prescription drugs
  • Expanding access for certain telehealth services

WellCare has been working in close partnership with state, local and federal authorities to serve and protect patients during the COVID-19 outbreak, including ensuring that its members and providers have the most up-to-date information to protect themselves and their families from the virus. We remain committed to protecting our communities during the outbreak.

Agents on MedicareValue can use their SEAL (Secure Enrollment Application Link) to send their personalised link to their clients to self-enroll in their non-dual MAPD plans.”

Other/Events

The Coronavirus Aid, Relief and Economic Security (CARES) Act Passed into Law

Congress passed a $2 trillion economic stimulus package by an overwhelming vote in the Senate and the House. President Trump is expected to sign the bill immediately.

Individuals and Businesses: The CARES Act functions largely as an economic stimulus by providing cash payments to individuals below a certain income, providing extra unemployment benefits and allowing self-employed individuals to apply for unemployment. For businesses, aid is provided through emergency grants, forgivable loans and relief for existing loans. These provisions are intended to assist employers to help them stay in business, keep employees on their payroll, and allow them to continue to support employees through employee benefits and health insurance.

Healthcare: The CARES Act also includes $100 billion for hospitals and $150 billion for state and local governments to combat the COVID-19 pandemic. The bill expands coverage beyond what was in last week’s Families First bill by requiring health insurers to pay for coronavirus testing beyond those that are FDA-approved, including lab and state-developed tests as well as other tests approved by HHS.

Accessibility for telehealth is also expanded. High-deductible health plans with HSAs may now allow pre-deductible coverage for telehealth and other remote services, as well as allowing the use of HSAs for the purchase of over-the-counter medications without a prescription.

Very limited action was also taken to address surprise medical bills. Under the CARES Act, all health insurance plans would reimburse a COVID-19 test provider at the in-network rate put in place prior to the pandemic. If the provider is out of network, the health plan is to fully reimburse the provider based on the provider’s own “cash price,” which must be made publically available while the public health emergency is still declared. Providers that do not post their test price publically could be fined up to $300 a day.

This action taken by Congress follows the passage of the Families First Coronavirus Response Act and several pieces of emergency guidance released by the Trump Administration. We are expecting more action from Congress and the Administration to address other aspects of the coronavirus pandemic. Be sure to regularly check your email, NAHU’s social media channels and website for any updates. Should either the CDC or WHO guidance change, NAHU will act accordingly and immediately update you.

NAHU Conference

“Due to the closing of the Atlantic City casinos and current bans against gathering, The New Jersey Association of Health Underwriters Annual Conference will not take place April 27-29, 2020, at Harrah’s, as scheduled. We are developing an alternative plan and will keep you updated. Thank you.”

Small Business Administration

“Here’s a link to guidance from the SBA to help do your part in keeping your clients and the community healthy.”

SBA Offers Daily Disaster Loan Training Webinars for Small Business

The U.S. Small Business Administration Eastern Pennsylvania District Office and the Chester Delaware Counties SCORE Chapter will hold webinar training on the SBA Economic Injury Disaster Loan (EIDL) Program for small businesses and private non-profits due to COVID-19.

The webinar will provide you with answers and help you understand: 1) who is eligible for an SBA Disaster (EIDL) loan, 2) what you need to have in hand before filing your application, and 3) Q&A time devoted to answer your specific questions.

Due to the high volume of questions we are receiving, the webinar will be held daily. If the session is full, please join a session at another day.

  • Schedule begins Tuesday, March 24, and continues daily through Friday, April 3. Webinars are offered Monday through Friday.
  • Each webinar starts at 12PM and concludes at 1:30PM.
  • Log in information: https://score.zoom.us/j/723846010
  • Call our SBA District Office at 610-382-3062 with any questions about the training.”

Medicare.gov & CMS.gov

“Protect yourself from fraud.

Scammers may use COVID-19 as an opportunity to steal your identity and commit Medicare fraud. In some cases, they might tell you they’ll send you a Coronavirus test, masks, or other items in exchange for your Medicare number or personal information. Be wary of unsolicited requests for your Medicare number or other personal information.

It’s important to always guard your Medicare card like a credit card and check your Medicare claims summary forms for errors. Only give your Medicare number to participating Medicare pharmacists, primary and specialty care doctors or people you trust to work with Medicare on your behalf. Remember, Medicare will never call you to ask for or check your Medicare number.”

Trump Administration Acts to Ensure U.S. Healthcare Facilities Can Maximize Frontline Workforces to Confront COVID-19 Crisis

CMS temporarily suspended a number of rules so that hospitals, clinics, and other healthcare facilities can boost their frontline medical staffs as they fight to save lives during the COVID-19 pandemic. These changes affect doctors, nurses, and other clinicians nationwide, and focus on reducing supervision and certification requirements so that practitioners can be hired quickly and perform work to the fullest extent of their licenses. The changes will ensure that healthcare facilities across the nation can expand their staffs and organize them in the most efficient way possible to handle the incoming surge of COVID-19 patients.

Press Release

Fact Sheet

Trump Administration Announces Expanded Coverage for Essential Diagnostic Services Amid COVID-19 Public Health Emergency

CMS, together with the Departments of Labor and the Treasury, issued guidance to ensure Americans with private health insurance have coverage of COVID-19 diagnostic testing and certain other related services, including antibody testing, at no cost. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test. As part of the effort to slow the spread of the virus, this guidance is another action the Trump Administration is taking to remove financial barriers for Americans to receive necessary COVID-19 tests and health services, as well as encourage the use of antibody testing that may help to enable health care workers and other Americans to get back to work more quickly.

Press Release

Guidance

Removal of Non-Invasive Ventilator Product Category from DMEPOS Competitive Bidding Program

CMS is removing the non-invasive ventilator (NIV) product category from Round 2021 of the DMEPOS Competitive Bidding Program due to the novel COVID-19 pandemic, the President’s exercise of the Defense Production Act, public concern regarding access to ventilators, and the NIV product category being new to the DMEPOS Competitive Bidding Program.

DME Competitive Bidding Program

Applicability of Diagnoses from Telehealth Services for Risk Adjustment in Medicare Advantage

The COVID-19 pandemic has created an urgency to expand the use of virtual care to reduce the risk of spreading the virus. CMS is stating that Medicare Advantage Organizations and other organizations that submit diagnoses for risk adjusted payment are able to submit diagnoses for risk adjustment that are from telehealth visits when those visits meet all criteria for risk adjustment eligibility. It is important for enrollees in Medicare Advantage to be able to receive clinically appropriate services via telehealth, and CMS appreciates all the necessary steps Medicare Advantage Organizations are taking to help providers and members cope with the pandemic.

Memo

CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS approved its 50th COVID-19 Medicaid emergency waiver to Utah delivering urgent regulatory relief to ensure the State can quickly and effectively care for their most vulnerable citizens.  CMS also approved a COVID-19 related Medicaid Disaster Amendment that brings relief to Arizona.  These approvals help to ensure that states have the tools they need to combat COVID-19 through a wide variety of state plan flexibilities. CMS continues to authorize amendments to ensure emergency flexibilities in programs that care for the elderly and people with disabilities, including most recently in Georgia. These approved flexibilities support President Trump’s commitment to a COVID-19 response that is locally executed, state managed, and federally supported.

All told, CMS has approved 50 emergency waivers, 27 state amendments, 8 COVID-related Medicaid Disaster Amendments and one CHIP COVID-related Disaster Amendment in record time. States are using a toolkit CMS developed to expedite the application and approval of Medicaid state waivers and State Plan Amendments.

Medicaid State Plan Amendments

Section 1135 Waivers

CHIP State Plan Amendments

Social Security

“I want you to hear directly from me how the COVID-19 pandemic is affecting our services. The first thing you should know is that we continue to pay benefits. Be aware that scammers may try and trick you into thinking the pandemic is stopping your Social Security payments but that is not true. Don’t be fooled.

For more information, please visit ssa.gov/news/press/releases

Medicare & Telehealth Benefits

“I want you to hear directly from me how the COVID-19 pandemic is affecting our services. The first thing you should know is that we continue to pay benefits. Be aware that scammers may try and trick you into thinking the pandemic is stopping your Social Security payments but that is not true. Don’t be fooled.

For more information, please visit ssa.gov/news/press/releases”

Regulations by State

Check here for the most up-to-date rules and regulations of conducting business by state during the pandemic.

Alabama

Insurance sales are deemed essential. May remain open if following all business protocols, using telework when available. Read more 

Alaska

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Arizona

Insurance sales are deemed essential. May stay open with additional sanitization precautions as recommended for businesses.

Arkansas

No information at this time.

California

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Colorado

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Connecticut

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible.

Delaware

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

District of Columbia

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible.

Florida

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible.

Georgia

Insurance sales are not on list given of businesses that must close. Can continue to stay open if chosen, however safety protocols must be followed. Read more 

Hawaii

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Idaho

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Illinois

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Indiana

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Iowa

No information at this time.

Kansas

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible. Read more 

Kentucky

Insurance sales are deemed essential, so businesses do not have to close. Should try to work from home if possible.

Louisiana

Insurance sales are not mentioned specifically, but agents can continue operations with essential employees using proper protocols. Read more 

Maine

Insurance sales are considered essential, however use of telesales or remote work should be used whenever possible. Read more 

Maryland

Insurance sales are deemed essential, so businesses do not have to close. Should try to work from home if possible and no door-to-door sales.

Massachusetts

Insurance agents/brokers are not mentioned on the essential list, so only telesales/remote work is accepted. Read more 

Michigan

Insurance sales are considered essential only if their work cannot be done by a telephone or remotely. Read more 

Minnesota

Insurance sales are considered essential but with note: Executive Order 20-20 requires all employees who can work from home to do so, even if they are eligible for a Critical Sector worker exemption. Read more 

Mississippi

Essential businesses can remain open, following safety protocols. Read more 

Missouri

The stay at home ban does not require businesses to close whether they are deemed essential or not, only that they follow social distancing and sanitation requirements. Read more 

Montana

Insurance sales are deemed essential, but businesses are required to follow all distancing protocols while open and use telesales as much as possible. Read more 

Nebraska

No information at this time.

Nevada

Insurance sales are deemed essential, but expected to provide services through telework opportunities. Read more 

New Hampshire

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible.

New Jersey

Insurance sales are deemed essential. Urged to follow social distancing protocols. Read more 

New Mexico

Insurance sales are deemed essential. May remain open is following all business protocols, using telework when available. Read more 

New York

Insurance sales are considered essential. Businesses are urged to follow all safety protocols and keep in-person interaction as minimal as possible. Read more 

North Carolina

Insurance sales are deemed essential and are exempted from closing. Should limit contact with public and use telesales when possible.

North Dakota

No information at this time.

Ohio

Insurance sales are considered essential. Telework highly recommended. Read more 

Oklahoma

Insurance sales are listed as essential. Business can remain open as normal while following social distancing guidelines. Read more 

Oregon

Insurance sales are not on the list of businesses that have to close, but telesales are highly recommended.

Pennsylvania

Even though insurance is considered a life-sustaining business, in-person sales are not designated as such and could hinder the safety and well-being of others. Therefore, any Pennsylvania agents who continue to sell insurance in-person, will run the risk of losing their licenses.

Per the Pennsylvania Department of Labor & Industry, “the Coronavirus Aid, Relief, and Economic Security (CARES) Act creates a new temporary federal program called Pandemic Unemployment Assistance (PUA).

In general, PUA provides up to 39 weeks of unemployment benefits to individuals not eligible for regular unemployment compensation or extended benefits, including those who have exhausted all rights to such benefits.”

As an independent insurance agent, you would be considered self-employed and should file for PUA assistance rather than filing for regular unemployment compensation.

You can refer to these FAQs from the Pennsylvania Department of Labor & Industry for more clarification.

Rhode Island

The state has not placed essential listings. However, the order does not close service-based businesses. Telesales recommended if possible.

South Carolina

Insurance sales not on the list of businesses that have to close. Read more 

South Dakota

No information at this time.

Tennessee

Insurance sales are deemed essential, so agents do not have to work from home, though recommended if possible. Read more 

Texas

Insurance sales are considered essential. Can remain open but should use telesales whenever possible. Read more 

Utah

No information at this time.

Vermont

Insurance companies, agencies and professionals that can conduct business functions remotely can continue to operate those parts of their business. Businesses in this industry that cannot transition functions to remote operations shall suspend those functions unless deemed necessary.

Virginia

Insurance businesses can remain open. May have no more than 10 patrons in a business at a time. Highly recommended to use telesales whenever possible. Failure to follow distancing requirements could result in a class 1 misdemeanor. Read more 

Washington

Insurance sales are considered essential. Can remain open but should use telesales whenever possible.

West Virginia

Deemed Essential, face-to-face sales are prohibited except under certain circumstances including use of protective equipment. Telesales functions are recommended in possible. Read more 

Wisconsin

Insurance sales are deemed essential, however, businesses may not engage in door-to-door solicitation, regardless of its purpose or status as an essential business or operation. Encouraged to remain open using telework tools. Read more 

Wyoming

No information at this time.

Questions? Call us at 855-888-8326.

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