Care and coverage for coronavirus (COVID-19)

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Care and coverage for coronavirus (COVID-19)

We want to help our members understand their coverage during the coronavirus (COVID-19) outbreak and use it to help stay healthy.

Important information for our members

If you feel sick…
Call your primary care provider (PCP) if you are concerned about exposure or risk of the disease. You will not pay any costs toward diagnostic lab tests for coronavirus or visits – to a doctor’s office, urgent care center, or emergency room – where the test is performed or ordered. No preauthorization or referrals are needed.

This benefit is available until the end of the federal public health emergency, which has been extended through Jan. 21, 2021.


If you are treated for COVID-19…

Your plan’s deductible, copays, and/or coinsurance apply.*


You can use telehealth to help stay well

We all must continue to take precautions to prevent the spread of COVID-19. You can use telehealth, or virtual visits, to see in-network medical and mental health care providers for services covered by your plan. Your plan’s deductible, copay, or coinsurance for office visits will apply to telehealth visits.

Talk to your doctors to see if they can arrange for telehealth visits.  

Many plans also include telemedicine through MDLIVE® or Teladoc®. If yours does, sign into our member website for directions to your plan’s telemedicine provider. Note: Telemedicine doctors cannot order lab tests — diagnostic or antibody tests — for COVID-19.

Telehealth is not clinically appropriate for all covered services. Telemedicine services are available to members with telemedicine benefits in their plans. Some plans may have different coverage. Your benefits administrator can answer any questions you have.


Mental health support is available
To find mental health clinicians, visit liveandworkwell.com and sign in (you can register for an account with your ConnectiCare membership). You’ll be able to search for mental health professionals in your plan’s network. You can also make appointments for virtual visits. Your plan’s deductible, copay, or coinsurance for office visits will apply to telehealth visits.

You can also, for no charge, call the Optum support line 24 hours a day, seven days a week, at 1-866-342-6892 for help getting connected to caring professionals.


Passage plan members, note:

Please ask your PCP for referrals to visit certain specialists as outlined in your plan documents. The temporary waiver of your plan’s referral requirements ended Sept. 9, 2020.


Have medicine supplies on hand without leaving home
All ConnectiCare members can have many prescriptions delivered at home by Express Scripts. Express Scripts will fill 90-day supplies of most maintenance medicines with a doctor’s prescription.**

To start using Express Scripts, visit the website or call 1-877-866-5798. Have your prescription number(s) ready.

Temporary programs, announced in March, allowed members to get prescriptions delivered at home from CVS and Walgreens without a delivery charge and to fill prescriptions early. Those programs ended Sept. 9, 2020.

Check your plan’s benefits for the costs of prescription drugs.

 

Programs announced in March after declaration of a state of emergency in Connecticut and Massachusetts temporarily waived deductibles, copays, and coinsurance for telehealth visits with PCPs, specialists, and mental health clinicians in the member’s plan network as well as with MDLIVE® or Teladoc® telemedicine visits, when covered by a member’s plan. 


*Members of plans underwritten by ConnectiCare of Massachusetts, Inc. may have different end dates of cost share waivers for in-network COVID-19-related telehealth and treatment.


**Most specialty drugs are not available through Express Scripts home delivery and do not qualify for a 90-day supply. For more information about specialty medications, visit our specialty drug page.

If you feel sick…
Call your primary care provider (PCP) if you are concerned about exposure or risk of the disease. Visits, including telehealth visits, by Medicare Advantage members for a COVID-19 test continue to have no cost share for both in-network and out-of-network health care providers through the declared national public health emergency. Members also have no cost share for the lab test during the public health emergency.

You can visit a PCP or mental health counselor at no charge
Medicare Advantage members can visit in-network primary care providers (PCPs) and in-network behavioral health clinicians for covered services in person or using telehealth from Aug. 1, 2020 through Dec. 31, 2020 at no cost to them.* This means that you will not have copays, deductibles, or coinsurance for services covered by your plan.   

Members whose plan benefits include Teladoc® telemedicine visits will also have no cost share for Teladoc services through Dec. 31, 2020.

This policy does not cover facility-based, behavioral health in-patient or partial hospitalization services

Visits to medical specialists
Medicare Advantage members can continue telehealth visits with medical specialists for covered services. However, members will be responsible for cost shares for medical specialist visits that take place by telehealth.* The temporary waiver of your plan’s cost shares for specialist telehealth visits ended Sept. 9, 2020.

How to have a virtual visit

  • Contact your doctor’s or mental health counselor’s offices. The office staff will arrange appointments and instruct you on how to connect with the health care professional. Professionals must be in your plan’s ConnectiCare network for the visit to be free.  OR
  • Use Teladoc® to consult with a board-certified doctor.** To arrange a visit, go to teladoc.com/connecticare, download and activate the Teladoc mobile app, or call 1-800-835-2362 (TTY: 711). You will first have to register, if you already haven’t.

Check your plan’s benefits to see if they include Teladoc.** Note: Teladoc doctors cannot order lab tests —  diagnostic or antibody tests — for COVID-19.  

Please consult your health care providers to see if they can arrange for telehealth visits (not all may be able to). Telehealth is not clinically appropriate for all covered services.

Mental health support is available
Go to liveandworkwell.com and sign in (you can register for an account with your ConnectiCare membership). You’ll be able to find local mental health professionals or make appointments for virtual visits.

You can also, for no charge, call the Optum support line 24 hours a day, seven days a week, at 1-866-342-6892 for help getting connected to caring professionals.

Have medicine supplies on hand without leaving home
All members can have prescriptions delivered at home by Express Scripts. Express Scripts will fill 90-day supplies of most maintenance medicines with a doctor’s prescription.***

To start using Express Scripts, Medicare Advantage members can visit the website or call 1-877-866-5828. Have your prescription number(s) ready.


Temporary programs, announced in March, allowed members to get prescriptions delivered at home from CVS and Walgreens without a delivery charge and to fill prescriptions early. Those programs ended Sept. 9, 2020.

Check your plan’s benefits for the costs of prescription drugs.

*This assumes the Centers for Medicare & Medicaid Services (CMS) 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.

**Teladoc is not available to members of the Choice Dual (HMO D-SNP) plan. Those members can contact the ConnectiCare Nurseline at 1-877-489-0963 (TTY: 711) with non-emergency questions. Please check your plan documents for more information. Registration with Teladoc is required but free for qualifying members.

***Note: Most specialty drugs are not available through Express Scripts home delivery and do not qualify for a 90-day supply. For more information about specialty medications, visit our specialty drug page.

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Losing insurance from an employer, parent, or spouse?

You may be able to buy an individual or family plan. 

Find more information on plans, financial help, and numbers to call.

 

 

Last updated on 10/07/2020


 


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.

 

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We’re in this together.

We can answer questions about your health plan and where to turn for help.

In an emergency, call 911 or go to an emergency room.