Frequently asked questions about the coronavirus (COVID-19)
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Frequently asked questions about the coronavirus (COVID-19)
There are many questions about seeking care for coronavirus (COVID-19), your benefits as a ConnectiCare member, and more. Find many of the answers here.
Coronavirus symptoms and testing
Call your primary care provider (PCP) and describe your symptoms. Unless it’s an emergency, stay home. Do not go to public places and avoid public transportation. Your PCP will evaluate your symptoms and give you directions on what to do next. If your PCP thinks you should be tested, he or she will arrange for it and direct you where to go.
Times like these point out the importance of having a PCP. If you don’t, make it a priority to find one and establish your relationship. Start your search using “Find a doctor” on connecticare.com.
As always, if you are experiencing severe symptoms, call 911 or go to your local emergency department. Severe symptoms include very high or very low body temperature, shortness of breath, confusion, or feeling like you may pass out. If you decide to go to the emergency department, try to call ahead and let them know you are coming. This will let them safely prepare for your arrival. Additional information is available from the CDC.
There’s a lot in the news about testing and its importance in the future in restoring activities like schools and businesses. At this time, however, you still need an order for testing from a medical professional who is following guidance from the Centers for Disease Control and Prevention (CDC) and state department of health.
If you are concerned about anything associated with the coronavirus, it’s important to remember the steps you can take to stay safe. For tips to protect you and your family, visit our dedicated coronavirus webpage, which is frequently updated.
We know that you may need to see your doctor again to be diagnosed with COVID-19. If you need to see your doctor about COVID-19 and be tested again, your visit and test will be covered by your plan. This includes any doctors outside of our network. There will be no cost-sharing, including copays, coinsurance, or deductibles. This policy is in effect during the public emergency.
Health plans are not required under federal law to cover testing that employers choose to require of employees before they can return to or continue to work. ConnectiCare does not cover testing conducted to screen for general workplace health and safety (such as employee “return to work” programs), for public health surveillance for COVID-19 (SARS-CoV-2), or for any other purpose other than individual diagnosis or treatment of COVID-19.
If individuals seek testing on their own, they should be aware that providers of diagnostic testing for COVID-19 are required by law to list the cash prices for testing on their websites.
As stated above, during the public health emergency ConnectiCare will cover COVID-19 diagnostic testing without cost share when:
- A licensed medical professional decides the test is medically necessary for a member under the professional’s care, and
- Orders a test in order to diagnose and, if necessary, treat a member.
Testing providers may not bill members for any balance over their health plan’s reimbursement for the test.
No, not at this time. You may have read that the Food and Drug Administration (FDA) has granted emergency clearance to one in-home test, produced by LabCorp. The first tests are to be made available to health care and emergency workers who may have been exposed to the virus or have symptoms. And a doctor must still evaluate a patient’s symptoms and decide if the patient should be tested. Please be aware that there are unauthorized fraudulent COVID-19 tests for sale.
If your doctor or licensed health care professional sends you to get your antibodies checked for COVID-19 because it is clinically indicated, your visit and FDA-authorized test will be covered. There will be no cost-sharing, including copays, coinsurance, or deductibles. Given the high demand for testing and antibody testing reliability, we encourage our members to use Quest Diagnostics for their testing. Quest is ConnectiCare’s in-network, preferred lab and testing provider. This policy is subject to change as we learn more about antibody testing during this rapidly evolving situation.
ConnectiCare coverage
We have safe and convenient options for members.
ConnectiCare members under age 65 or with group health plans can, temporarily, visit their own in-network doctors using telehealth for covered medical and mental health services. There are no copays, deductibles, or coinsurance. Visits are no-cost for any illness or injury – not just COVID-19 – through Sept. 9, 2020. Your doctor’s office can tell you if it’s able to offer you telehealth.
Medicare Advantage members can visit in-network primary care providers (PCPs) and in-network behavioral health clinicians in person or using telehealth from Aug. 1, 2020 through Dec. 31, 2020 for covered services at no cost to them.* They will be responsible for cost shares for medical specialist visits – in person or by telehealth – after Sept. 9, 2020. Medicare Advantage members will not have copays, deductibles, or coinsurance for covered services during that time.
Members whose plan benefits include Teladoc® telemedicine visits will also have no cost share for Teledoc® services through Dec. 31, 2020.
This policy does not cover facility-based, behavioral health in-patient or partial hospitalization services.
Medicare Advantage members can continue telehealth visits with medical specialists for covered services without a cost share through Sept. 9, 2020. After that date, members will be responsible for cost shares for medical specialist visits that take place by telehealth.* As a reminder, members continue to be responsible for cost shares for in-person visits to medical specialists.
Learn more about covered medical and mental health services on our dedicated COVID-19 care and coverage webpage, which is frequently updated.
We also offer telemedicine services 24/7 for members of many group and individual plans, including plans sold through Access Health CT, and most Medicare Advantage plans. Sign into your member website (Medicare Advantage plans | all other plans) for directions to your plan’s telemedicine provider.
ConnectiCare Medicare members with Choice Dual (HMO D-SNP) plans can call the 24-hour Nurseline at 1-877-489-0963 (TTY: 711).
NOTE: Telemedicine doctors cannot order lab — diagnostic, or antibody tests — for COVID-19.
*This assumes the Centers for Medicare & Medicaid Services will continue to allow health plans to adjust benefits mid-year during the public health emergency. As a result, the end date of the waiver is subject to change.
We are alerting the primary care providers (PCPs) in our Medicare Advantage network as well as the clinicians in the behavioral health network managed by Optum for ConnectiCare members. If a doctor’s office staff asks for a copay, please ask them to check our provider website for details.
Please visit our care and coverage page to see what costs will be covered for ConnectiCare members.
Members under 65 or with plans through their employers - Yes. If you visit an in-network doctor using telehealth for something not related to COVID-19, the visit will be covered at no cost to you through Sept. 9, 2020. There will be no copays, coinsurance, or deductibles. Virtual visits include video and/or phone visits and they must be for a service covered by your plan.
If you use an out-of-network telehealth service or have a virtual visit with an out-of-network doctor – for whatever reason – this may NOT be covered by your plan or may be covered under your out-of-network level of benefits if your plan has them. Unless a plan exception applies, all normal coverage restrictions and cost-sharing charges will apply for care or treatment from out-of-network providers.
Medicare Advantage members – please see our care and coverage page for more on your coverage.
Pharmacy
Yes, the recent CARES Act passed by Congress repealed the prohibition on using health account dollars to pay or reimburse yourself for over-the-counter medicines, such as pain relievers, cold and flu medicines, and more. And the act added menstrual supplies to the list of items that can be reimbursed from a tax-qualified health account. This was effective Jan. 1, 2020. Check your account administrator’s website (for many ConnectiCare members, that’s HealthEquity) for more information.
ConnectiCare covers 90-day supplies of long-term medications (or maintenance drugs) through Express Scripts mail order. Members can get their medications delivered right to their home if they’re quarantined or concerned about visiting pharmacies during the outbreak. Express Scripts also gives members access to pharmacists 24 hours a day, seven days a week, in case they have questions about their medications.
Sign up online – Visit express-scripts.com and sign in. If you don’t have an account, you can create one in just a few minutes. Have your ConnectiCare member identification (ID) card handy. After you sign in, click “Home” in the Express Scripts window and you will see a list of available prescription refills. Select the items you want to order and follow the instructions to complete your request.
By phone – To start using Express Scripts by phone, have your prescription number ready and call:
- Medicare – 1-877-866-5828
- All other plans – 1-877-866-5798
Mobile app – Download the app on your mobile device from the App Store, Google Play, or Amazon apps.
By fax: Have your doctor call 1-888-327-9791 for faxing instructions. (Faxes can only be accepted from a doctor’s office.)
If you want an early refill for your prescription due to the COVID-19 outbreak, it will help to tell your pharmacist to enter the Submission Clarification Code (SCC) 13. By entering SCC 13, the pharmacist is overriding your standard prescription fill in their system. It will make the process go smoother. Some pharmacies are not as familiar with this new code; that’s why we are telling you about it. If your early refill is rejected even after entering this code, please ask your pharmacist to contact the Express Scripts Pharmacy Help Desk at 1-800-922-1557.
Additional questions
Talk to your doctor’s office about the safety measures they are taking and your situation. You should also talk to your doctor about any immunizations – such as the flu shot – and preventive care screenings that you may be due for and how to get them. Your doctor can help you decide the best options for your care.
Both Connecticut and Massachusetts currently require people to wear a mask or cloth face covering over their nose and mouth when out in public and unable to maintain a safe distance (at least six feet). There are some exceptions for age and health restrictions. But people who can wear a face covering should do so.
A face covering should fit snuggly on your face, be held by ties or ear loops, let you breathe comfortably, and be washable or disposable. A cloth face covering with multiple layers of fabric will help prevent an infected person without symptoms from spreading the disease. The cloth face coverings recommended are not surgical masks or N95 masks. Those are needed by health care workers and first responders.
After each use, carefully remove the mask and wash your hands. You can clean a cloth mask in your washing machine for the next time you need it. Visit the CDC webpage for some ideas on homemade masks. Remember to continue practicing social distancing and washing your hands often to prevent catching or spreading COVID-19.
We are allowing Passage plan members to see specialists without first getting a Passage PCP’s referral through Sept. 9, 2020. This applies to members of group plans and individual plans, those purchased through Access Health CT and SOLO plans. Referrals are not required for members of Medicare Advantage Passage Plan 1 (HMO).
The annual flu vaccine does not protect against the coronavirus. We do encourage members to always get their annual flu vaccine because it is the single best thing you can do to protect yourself and your family from various strains of the flu.
It is best for you to check directly with the office of the doctor who is going to perform your surgery or procedure. The staff will also be able to tell you about any testing needed in advance and the safety procedures at the hospital or ambulatory surgery center.
While we believe the information in this communication is accurate as of the date published, it is subject to correction or change during the rapidly evolving response to the COVID-19 outbreak.
Last update 08/07/2020
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