Health Plans and COVID-19

April 14, 2020

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.

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.

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)

In an effort to reduce potential exposure, the carriers and the Centers for Disease Control and Prevention (CDC) are recommending the use of Telemedicine services. You may access Penn Medicine’s Virtual Care Telemedicine Practice Connecting Penn Medicine employees and University employees with Penn Medicine providers, 24/7/365. The highlights of eligibility are below:

  • Open to the public, any patient with any insurance plan, normally a $49 fee-for-service. This fee will be waived under Penn Medicine’s COVID-19 community health initiative for anyone who works on Penn Medicine campuses, regardless of their insurance plan, including University faculty and staff. This applies to all Penn Plans, PennCare PPO, Aetna POS II, Keystone/AmeriHealth Health Plan, Aetna HDHP and Aetna POS Standard.
  • Patients 14 years or older who are located in PA, NJ, DE, MD. For patients under 14, parents or guardians are urged to contact the child’s healthcare provider. 
  • Practice is staffed by full-time CRNPs
  • Provides medical advice, short-term care prescriptions, and scheduling collaboration with Penn Medicine primary care teams
  • Connect via PennChart’s audio-video “facetime” technology using the MyPennMedicine (MPM) app, downloaded from the Apple or Google store
  • Self-schedule 20-minute virtual appointments via MPM or call us for help downloading the MPM app
  • Visit us at 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.

Encourage Members to Refill Maintenance Medications

We know that access to needed medication is important to you and your family members during the uncertainty caused by COVID-19. We strongly recommend you take action and refill any needed medications for yourself or a family member, who have long-term maintenance medications with a 90-day supply, or up to your plan’s maximum quantity.  Contact your pharmacist with how to obtain a 90 day supply if desired. Under the Penn plans you may obtain a 90-day prescription refill benefit for maintenance medications and the option of home delivery from CVS Caremark Mail Service pharmacy or from a local CVS store.

Relaxing Refill Restrictions

CVS Caremark is waiving early refill limits on 30-day prescriptions for maintenance medications at any in-network pharmacy. Relaxing refill-too-soon limitations allows members to fill maintenance medication prescriptions ahead of their normal fill schedule to ensure members are able to maintain an adequate supply of medication on hand.

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)

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.