As we approach cold and flu season, the nation and the economy are still combating the affects of the COVID-19 pandemic. As with any public health issue, the insurance carriers work with and follow the guidance and protocols issued by the Centers for Disease Control and Prevention (CDC) as well as state and local public health departments in supporting the needs of members.
What to do if you have symptoms?
The CDC and health care providers ask that you call your doctor if you develop a fever, have a cough, or have difficulty breathing. Let them know if you’ve been in close contact with a person known to have COVID-19, or if you live in or have recently traveled to an area where the virus has spread. You can also check to see if your plan offers telehealth benefits to see a doctor online, many health plans include this service and some have waived the fee temporarily. If you think you are infected, using telehealth helps to prevent spreading a virus.
What will U.S. traditional medical insurance plans cover?
Your health plan will cover the care you get if you’re diagnosed as having COVID-19, based on your plan’s benefits. It may also cover testing for COVID-19. You should expect to pay any out-of-pocket expenses your plan requires, although many carriers are waiving some out-of-pocket expenses.
A health plan will not fail to be an HDHP under section 223(c)(2)(A) merely because the health plan provides health benefits associated with testing for and treatment of COVID-19 without a deductible. An individual covered by the HDHP will not be disqualified from being an eligible individual under section 223(c)(1) who may make tax-favored contributions to a health savings account (HSA).
Will my disability plan provide coverage should an employee be quarantined?
Disability carriers will pay valid claims in which an eligible member has a qualifying and documented medical event, including an event related to COVID-19 (Coronavirus). The elimination period will apply the same as for any illness. If a doctor orders a member to be quarantined without an official diagnosis, some carriers will approve coverage. However, many will not without a verified diagnosis.
What to consider?
Flu Shots – Promoting flu shots to your workforce to prevent the spread of the flu virus. Flu shots, when received by an in network provider are covered 100% by your health plan.
Rx compliance– Remind your employees of the importance of maintaining their underlying health conditions, now more than ever. This is a great time to think about changing from a 30-day supply to a 90-day supply of any prescription medicines you take on a regular basis. If you don’t have a prescription for a 90-day supply, talk to your doctor to see if a 90-day supply would work for you. You can even get them through home delivery pharmacy. If you have specific questions about the medicine you take, call the pharmacy services number on your member ID card.
Consider an EAP benefit– If you have an Employee Assistance Program (EAP), remind your employees of this valuable resource. Some medical, life or disability carriers include an EAP program as an Add-On benefit if you are already covered under one of their plans.
Business Benefits Insurance Solutions supports our clients and their employees with any coverage, claim questions or concerns.
Resources from the U.S. Chamber of Commerce
Resources from the CDC