Fully Insured Business Updates on COVID-19 as of 3/19/2020
Special Enrollment Period:
UHC will be providing Fully Insured Small Group and Key Account customers a Special Enrollment opportunity to enroll employees who previously didn’t enroll in UHC coverage. Limited to those employees who did not elect coverage prior. March 23rd through April 3rd, 2020for fully insured small group business and key account customers. State eligibility guidelines will still apply. In the next few days notices will go out to groups directly notifying them of the details to provide employees this opportunity to enroll.
Pharmacy:
All UHC members who need an early prescription refill may request an early refill through their current pharmacy. Delivery options are available through Optum home delivery. We recommend only those who are not at risk avoid an early refill to mitigate undue stress on the overall supply chain. However we do want to reassure members that our manufactures indicated that all 300 top utilized prescriptions currently have over a 60 day supply.
Virtual Visits:
For the next 90 days UHC will be waiving all copays for Virtual Visit providers for FI business.
National VV providers include Teladoc, Amwell and DR.On Demand and all have developed protocols for members who think that they may have been infected or exposed to COVID-19.
Telehealth:
Effective immediately UHC has expanded our policies around telehealth services for all lines of business. For the next 90 days all eligible INN medical providers who have the ability and want to connect with their patients through virtual care such as live video conferencing can do so. We will waive member cost sharing for COVID-19 related visits and if not a COVID-19 related visit member cost sharing will still apply for traditional services.
Example: Member has seen Dr. Smith for years but Dr. Smith is currently only seeing patients in the office for COVID-19 only visits but Dr. Smith can see you via virtual visit for your service need non-related to COVID-19. The visit takes place virtually with Dr. Smith, perhaps a prescription is prescribed for a separate condition and end the call. Dr. Smith is able to bill UHC and the member is able to pay their standard cost share just as they would if they were in the office.
UHC already announced UHC is waiving all member cost sharing including copays, coinsurance and deductibles for COVID-19 testing.
The Federal Legislation approved this past Wednesday night goes further and requires all group health plans to cover all COVID-19 Testing and testing related items or services without any member cost sharing - without any prior authorization and without any medical management requirements. That above coverage includes the items and services provided in an office visit including a telehealth visit, an urgent care visit, an emergency room visit and any other testing related services. That rule also applies for in network and out of network. We do expect the legislation to apply retroactively.
Behavioral Health:
An emotional support help line is available to anyone including non-members. Anyone experiencing anxiety or stress related to COVID-19 this is a free services that provides access to specialty trained mental health specialist available 24 hours a day, 7 days a week by calling 1- 866-342-6892
This is in addition to member’s EAP benefits which provide critical incident response services.
Federal Legislation Update on Services Related to COVID-19 and COVID-19 Testing:
UHC already announced UHC is waiving all member cost sharing including copays, coinsurance and deductibles for COVID-19 testing.
This past Wednesday night 3/18 Federal Legislation was approved that goes further and requires all group health plans to cover all COVID-19 testing and testing related items or services without any member cost sharing - without any prior authorization and without any medical management requirements. That above coverage includes the items and services provided in an office visit including a telehealth visit, an urgent care visit, an emergency room visit and any other testing related services. That rule also applies for in network and out of network. We do expect the legislation to apply retroactively.
Member Communication:
We strongly encourage members to register on our member website myuhc.com and mobile app Health4Me so that we have their email address to distribute information to members so we can update them.
Pending:
We are still looking into the questions around grace periods being extended; coverage being continued for EE’s who’s hours have dropped below min. requirements and/or put on furlough and a few more. If you sent it to me, it’s with upper leadership and on our radar! Keep the questions coming though. Remember to continuously check the link at the bottom as updates are coming in constantly.
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