As COVID-19 vaccine distribution rolls out nationally, we have developed MANY resources to help our clients and members navigate the myriad of questions they may have at this time. Overview fliers, educational videos, and other resources have been created to address vaccine hesitancy, encourage vaccination appointment scheduling, and guide members to other sources for vaccine information.
Click here to view a table of resources that you may find helpful for yourself as well as your members. The links to the resources can be found in the Where column.
A group health plan must provide coverage without any cost-sharing requirements, such as deductibles, co-payments and co-insurance, or prior authorization or other medical management requirements, for:
- The costs of a test to detect or diagnose the virus that causes COVID-19; or
- Health care provider visits, including telehealth visits, urgent care and emergency room visits, that result in an order for or administration of a test to detect or diagnose the virus that causes COVID-19.
What are the costs associated with COVID-19 testing and treatment?
Where will I be covered for Coronavirus testing for if I think I have symptoms?
The Test Location tool will show test locations within a certain mile radius of the desired zip code. Most test locations will ask for a script from a provider.
Here are the links to the tools:
Use this online symptom checker to assess your risk for COVID-19 and get treatment options.
Use our online tool to find a COVID-19 testing location in your area.
Last updated: 4/15/2020
Will my benefits waiting period be waived when I come back to work?
What will happen to my voluntary benefits with MetLife if I am terminated or furloughed?
Portability options will then be available for Critical Illness, Hospital, Accident and Metlife Legal to continue the coverage on a direct bill basis.
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- Life portability will be provided once coverage is terminated.
- LTD and STD will terminate at the end of the month in which employment terminates and claims in process will not be affected.
How long can I stay active on my benefits if I am laid off?
Will my HealthEquity benefits be terminated?
Fulfillment for upcoming commuter benefits will go forward as usual. With this in mind:
- Regular established pass return and refund policies remain in effect, so we recommend that your employees reach out to the agency associated with their election if they have questions about returns or refunds.
- If your employees need to make changes to their benefit, they should log in to their account at www.healthequity.com/wageworks and update appropriately.
What if I need to go to the Doctor before I enroll on COBRA?
If we want to continue to provide medical coverage during a furlough, can we just continue to treat the furloughed employees as active employees, or must we offer COBRA? Some of our employees will have hours and pay reduced.
- Keep the furloughed employees on the medical plan as active employees for up to 20 weeks. After the 20 weeks, if the employee has not returned to work, COBRA would need to be offered.
- Treat the furlough as a COBRA qualifying event (i.e., a loss of coverage due to a reduction in hours). Employees with active coverage will be offered COBRA beginning the first of the month following the date of the furlough.
Must I pay for a terminated (or reduced hours) employee’s COBRA coverage?
Can an employee elect COBRA if the employee was not enrolled in our medical plan at the time of termination of employment?
What happens if our company goes out of business? Who offers COBRA?
Where can I send my employees for emotional support?
American Well®, also known as AmWell, is available for Oxford members to schedule online doctor visits. Members can sign into the Oxford Health member website to access a code for an online doctor visit with an Amwell provider. There is no charge for online visits.
Members can find this code after signing into the member website in the COVID-19 section. Click here for instructions on how to access AmWell for Oxford members.
2) Optum’s Emotional-Support Help Line
Professionally trained mental health staff are available to provide support to people who may be suffering from fear or stress as a result of COIVD-19. The service is free of charge and available to anyone. A public toll-free emotional-support helpline is available (866) 342-6892.
3) Optum’s COVID-19 Resources for Employee Wellbeing
The Optum COVID-19 site has frequently updated facts and resources as well as tips for keeping employees educated, healthy, and engaged. You’ll also find educational videos with subject matter experts.
The content is appropriate for audiences worldwide and sourced from the World Health Organization and the U.S. CDC. Click here to go to the Optum COVID-19 site.
4) NEW! Sanvello On-demand Support
Employees may find the Sanvello mobile app to be a helpful resource for those needing support in coping with the mental health impacts of COVID-19. Sanvello is an app that offers clinical techniques to help dial down the symptoms of stress, anxiety, and depression.
UnitedHealth Group, in response to the COVID-19 situation, is extending free premium access to the Sanvello app for its members. Please see press release for more details.
Additional resources for those who may be experiencing stress, anxiety, or depression during the COVID-19 crisis:
Are masks FSA-eligible?
Are surgical gloves FSA-eligible?
Is hand sanitizer FSA-eligible?
Other products such as rubbing alcohol and hydrogen peroxide are may also be FSA-eligible, but could also require a prescription to be reimbursed through an FSA.
Are COVID-19 vaccinations covered under my insurance?
Coverage will be provided on both an in- and out-of-network basis – even if a member does not have out-of-network benefits.
If members receive the vaccine at an out-of-network provider, they may need to pay out-of-pocket and submit a claim for reimbursement.
Once the vaccines are more widely distributed, Oxford/UHC will be covering the vaccine through our pharmacy partners, as well as through medical providers.
Last updated: 1/26/2021
Are at home COVID-19 tests covered?
Among the FDA authorized at-home COVID-19 tests that are available, our vendor LabCorp does provide them and will bill Oxford and UHC directly. For more information, you may contact LabCorp at Pixel by LabCorp.
Last updated: 1/26/2021
Does UHC/Oxford Health have an online symptom checker for COVID-19?
The symptom checker assesses members based on their response and triages them into one of five levels:
- Self-isolation;
- Physician evaluation;
- Same day care;
- Emergency care;
- Call 911.
Last updated: 4/15/2020
Is there any help I can get through my health plan if I suspect I have symptoms associated with COVID-19 and where can I find test locations in my area?
UHC/Oxford Health also provides a test location tool which will provide test locations available to members within a certain mile radius of their zip code. Here are the links to these invaluable tools:
- Use this online symptom checker to assess your risk for COVID-19 and get treatment options, or
- Use our online tool to find a COVID-19 testing location in your area
Will Oxford suspend or change premiums?
What are the available resources and services for Oxford/UnitedHealthcare members?
- All COVID-19 testing and treatment is covered without the need to meet a deductible or make co-pays.
- Telehealth and Virtual visits are available for Oxford and UHC members for COVID-19 screenings.
What if I need early refills of my prescriptions? UnitedHealthcare has removed the refill too soon policy.
- This applies to both UnitedHeathcare and Oxford members.
- The change allows members with active eligibility to obtain an early refill of their prescription medications if they have refills remaining on file at a participating retail, specialty or mail-order pharmacy. Contact your doctor immediately if you see that you need refills.
- The refill obtained will stay consistent with the standard days’ supply previously filled by the member as allowed by their plan (e.g., 30- or 90-day supply).
- Your pharmacist can contact the Pharmacy Manager at Oxford.
- Members should call the number on the back of their ID card if they need assistance.
- Delivery is available at select pharmacies. Walgreens and CVS deliver and have suspended charging.
Will diagnostic testing be covered under our benefit plans?
- However, at the present time there is no specific treatment plan or vaccine available for 2019-nCoV. So, it would be premature for carriers to render any decision pertaining to the IRS recommendation.
- The COVID-19 situation continues to evolve and change, so we will continue to provide you with additional details as we receive them.
Where can I send my employees for emotional support?
American Well®, also known as AmWell, is available for Oxford members to schedule online doctor visits. Members can sign into the Oxford Health member website to access a code for an online doctor visit with an Amwell provider. There is no charge for online visits.
Members can find this code after signing into the member website in the COVID-19 section. Click here for instructions on how to access AmWell for Oxford members.
Additional resources for those who may be experiencing stress, anxiety, or depression during the COVID-19 crisis:
How long can I stay active on my benefits if I am active with reduced hours?
- If employment is considered furloughed with reduced hours then you can remain on benefits (medical, dental, vision) until April 30, 2021, or for up to 20 weeks, whichever is later, providing premiums are paid in full.
- If employment is not considered furloughed and hours are reduced below the threshold to be eligible for benefits, then benefits will terminate on the last day of the month and Cobra notification will be provided. Portability and direct pay options will be offered for MetLife plans.
What are the available resources and services for EmblemHealth members?
All members can call our 24-Hour Nurse Hotline at any time free of charge to speak to a nurse about health concerns. Experienced, licensed nurses can provide confidential, one-on-one health counseling and accurate information to help you make informed health care decision.
Call at 877-444-7988.
ACPNY Virtual Visits with Zoom
For AdvantageCare Physicians (ACPNY) and BronxDocs patients experiencing symptoms of COVID-19 including a fever over 100.4 and shortness of breath—you can speak with one of the practice’s medical providers through Zoom, a leader in video conferencing. When you call to schedule your appointment, you will be asked a few questions so the team can assess your symptoms, risk, and need for a virtual visit.
Contact ACPNY at 646-680-4227.
Contact BronxDocs at 646-680-5200.
Teladoc
For members with a plan that includes Teladoc, you have 24/7 access to board-certified, state-licensed doctors by phone or video, every day of the week. They can send a prescription to your local pharmacy. Services are available in English, Spanish, and Chinese. Call 800-835-2362 to get started.
Telehealth
Connect with your in-network health care professional, virtually. These virtual visits are $0 during the outbreak, whether or not the visit includes testing for COVID-19. Contact your doctor directly about their specific offerings.
Aflac Hospital and Disability Coverage for Current Participants:
For policyholders with concerns about coverage for disabilities or hospitalizations due to COVID19 infections, rest assured, the answer is yes, you are covered. No policy language would cause these policies not to pay. These policies will pay full benefits directly to the member regardless of any other insurance and regardless of the pandemic.
Plans are portable and pay cash directly to the member for a hospitalization (Hospital Plans) or because the member could not work due to a diagnosis of COVID19 (Disability).
If anyone is interested in hearing about the plans or have questions about coverage should call Alvaro Montenegro at 201-628-4924.
IRS Relaxes Some Rules:
Over the counter drugs, menstrual care products that are not normally covered or that require a prescription are retroactive to 1/1/20, are now considered eligible expenses. These may be reimbursed through a Health Savings Account, Health Reimbursement Account, and a Flexible Savings Account.
To learn more about our PEO medical plans click this link or contact us to learn more.