Health Plans and COVID-19

July 13, 2021

Your Health Insurance and COVID-19

Penn’s insurance carriers, Independence (Blue Cross), Aetna, CVS Caremark, Keystone (IBC), and Penn Medicine’s Connected Health Virtual Care Telemedicine Practice are all closely monitoring the situation with the respiratory illness caused by the  COVID-19 virus (Coronavirus). They are committed to making sure that our participants can receive appropriate testing and treatment for this virus if needed. Below are enhancements they are making to our plans to improve access for members.

Testing will be covered under Penn Plans

During this public health crisis, Independence and Aetna will cover as a preventive service and waive cost sharing (such as co pays and coinsurance) for the COVID-19 test when performed at a hospital or an approved laboratory. This applies to all Penn Plans, PennCare PPO, Aetna POS II, Keystone/AmeriHealth Health Plan, Aetna HDHP and Aetna POS Standard.

Independence Blue Cross: Penn Care PPO and Keystone/Amerihealth

  • Currently covered at 100% with no copayment required by the participant. COVID-19 testing is not considered a “preventive” service, this means that, medical necessity would need to be established for each Penn employee or student, usually due to symptomatology or exposure. This includes an order for the COVID test by an eligible health care provider.
  • Independence will cover testing for asymptomatic individuals with exposure for whom testing has been prescribed by a health care provider.
  • Independence does not cover tests and screenings as a condition of employment, school (i.e., surveillance testing) or for travel. Broad-based public health testing used as a requirement for individuals to return to work or school is not covered under Independence group health plans.

Aetna: Aetna POSII, Aetna HDHP and Aetna POSII (ACA)

  • Under the Aetna Plans COVID testing is currently covered at 100% for provider visits in and out of network. This includes the testing only not necessarily the Physician visit. The cost-sharing waiver applies to testing performed or ordered by in-network or out-of-network providers. The policy aligns with Families First legislation and regulations requiring all health plans to provide coverage of COVID-19 testing without cost share.
  • Aetna will cover, without cost share, diagnostic (molecular PCR or antigen) tests to determine the need for member treatment. This applies to direct-to-consumer/home-based diagnostic or antigen tests.
  • Aetna’s health plans generally do not cover a test performed at the direction of a member’s employer in order to obtain or maintain employment or to perform the member’s normal work functions or for return to school or recreational activities, except as required by applicable law.
  • An order from an authorized health care professional is required for covered COVID-19 tests for Aetna plans. An order can often take place as part of being tested at a COVID-19 drive-through test site or purchasing a direct-to-consumer/home-based test.

CVS Pharmacy Drive-Thru

  • Starting September 14, 2020, you can schedule an appointment at a drive thru CVS Pharmacy in Pennsylvania. There are no New Jersey locations currently.
  • You do not need a doctor’s note, or to be symptomatic to obtain testing at one of these sites.
  • This is a University of Penn sponsored program. Appointments can be scheduled up to 72 hours in advance and must be made via this link, Please do not share this link. You will be asked to provide your Penn ID.
  • Additional days/times for appointments open each day at midnight in your time zone. Please check back if you need an alternate day/time.
  • After your appointment has been scheduled, a trained CVS Health colleague may reach out to you to confirm the details of your visit, including pre-registering you for an account on MyChart. MyChart is an online platform where you will receive your test results in days. Majority of results are available within 2 to 3 days, though results may be delayed based on lab performance particularly in times of peak demand.
  • Please arrive no more than five minutes before your appointment. Upon arrival, please stay in your car and follow the posted instructions at the site.
  • After you complete your test, if you have not already signed up for a MyChart account, you will receive reminder information about registering to check your results.

How to schedule a CVS testing appointment

  1. Visit the CVS scheduling website
  2. Enter your zip code in the “Home Zip Code” field
  3. Enter your birthday in the “Date of Birth” field in MM/DD/YYYY format
  4. Select your gender
  5. Enter your Penn ID in the “Employee ID or Student ID” field
  6. Click “Get Started”
  7. Choose a location and appointment date
  8. Choose an appointment time
    Complete visit information
  9. Click “Submit”.You will receive a confirmation email with a confirmation code.

Treatment will be covered

At this time, there is no specific antiviral treatment or vaccine for COVID-19. Members should receive care from their doctor to help relieve symptoms as they would other viral respiratory infections. Independence and Aetna will continue to cover medically necessary health care costs to treat infectious diseases, including COVID-19, based on the terms of the member’s insurance plan.

Telemedicine is available. OnDemand (215-615-2222)

The University has partnered with Penn Medicine to offer a virtual care telemedicine practice called Penn Medicine OnDemand. Penn Medicine OnDemand provides urgent primary care services by providers in the Penn Center for Connected Care. 

Penn Medicine OnDemand providers address your immediate care needs such as sore throats, rashes, earaches, muscle or joint pain, and other minor injuries. The telemedicine practice is available 24 hours a day, 7 days a week, 365 days a year by Penn Medicine providers who deliver fast and speedy care using video visits. When an in-person, office-based appointment with a Penn Medicine provider is recommended, the Penn Medicine OnDemand team will help you schedule it at a time and location that is convenient for you.  For answers to frequently asked questions and to schedule a Penn Medicine OnDemand appointment, please visit www.PennMedicine.org/OnDemand

CVS/Caremark

CVS Health is taking steps to address the outbreak and protect member access to medication. The latest steps we are taking will help ensure patients of all ages have every option available to them when it comes to filling prescriptions. As long as COVID-19 continues to pose a threat, CVS will maintain a relentless focus on how best to serve you and your family members.

Free Home Delivery from CVS Pharmacy

Beginning immediately, CVS Pharmacy will waive charges for home delivery of all prescription medications. With the CDC 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. This includes mail order and home delivery via your local CVS pharmacy.

Quest Behavioral Health (PennCare/Personal Choice PPO Provider)

July 2021 Update: During the Covid-19 state of emergency, the federal government issued the “Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency,” (https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html) which temporarily changed the way Quest Behavioral Health covered telehealth claims. The state of emergency is being lifted on September 30, 2021.  Quest Behavioral Health’s Telehealth coverage plan beginning October 1, 2021 is as follows:

  • Telehealth sessions will continue to be covered, as long as providers use a HIPAA-compliant audio-visual platform and have an approved Telehealth Attestation on file.  
  • Once the COVID-19 state of emergency has been lifted, providers may only treat patients through face-to-face appointments or, if approved by Quest, through a HIPAA-compliant telehealth platform. Providers are required to have an approved Telehealth Attestation on file with Quest as of September 30, 2021 in order to continue telehealth services and ensure reimbursement. A copy of the Telehealth Attestation document may be obtained on the Quest website at Telehealth | Quest Behavioral Health and EAP Services.

In light of the pandemic and the federal government’s “Notification of Enforcement Discretion for telehealth remote communications during the COVID-19 nationwide public health emergency,” (https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html) the Quest Behavioral Health plan is as follows:

  • During the coronavirus state of emergency, providers are to use a HIPAA-compliant telemental health platform to the extent they are able to do so.
  • IF they or their clients are unable to access such a platform, Quest will temporarily allow phone sessions, effective immediately and ending once the state of emergency has been lifted by the governor.
  • Providers are to use their best judgment and discretion in safe guarding their clients’ privacy. This includes informing clients that privacy cannot be guaranteed over cell phones and social media platforms, such as FaceTime, Duo, and Skype.
  • Providers are NOT to use Facebook, Twitch, TikTok, or other public facing applications.
  • Once the COVID-19 state of emergency has been lifted, providers may only treat patients through face-to-face appointments or, if approved by Quest, through a HIPAA-compliant telemental health platform.
  • Quest will make every attempt to meet the patients' needs while social distancing is required, however keeping the confidentiality of the provider-patient relationship is of paramount importance to Quest. 

Flexible Spending Account (FSA) and Health Spending Account (FSA) Provisions

  • HSA-qualified health plans can now cover telehealth and other remote care service expenses below the HDHP statutory deductible limit, or at no or low-cost sharing, without affecting an account holder’s ability to continue contributing to their HSA. This provision will last until December 31, 2021.
  • Over-the-counter drugs and medicines can be paid for or reimbursed through an FSA, HRA or HSA without a doctor’s prescription. 
  • Feminine care products are now considered a qualified medical expense and are eligible for payment or reimbursement through an FSA, HRA or HSA. All expenses incurred after December 31, 2019 qualify and the provision has no expiration date.