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Your PPO Coverage for COVID-19

This information is current as of April 9, 2020.

As you are aware, the novel coronavirus (COVID-19) continues to be a rapidly developing situation. COVID-19 is an illness that affects your breathing and lungs and can spread between people in close contact (6 feet) or by touching an infected surface or object. Officials report that in most cases, symptoms are mild to moderate and similar to the flu—fever and cough.

Screening and Testing Guidelines and Coverage Treatment Options and Costs Telehealth and Virtual Care Pharmacy Benefits Emotional and Social Support General COVID-19 Guidance and Information

Screening and Testing Guidelines and Coverage

COVID-19 screening and testing guidelines. Get the latest information:

Get tested, if necessary. There is no cost to you for the COVID-19 screening, test or associated services (e.g., the doctor office visit to receive the test). If you are diagnosed with COVID-19, you will need to pay the applicable copay or coinsurance for care related to treatment of the illness.

COVID-19 test facility finder. Anthem and Castlight have partnered to provide a nationwide directory of COVID-19 testing facilities: COVID-19 Test Facility Finder. This page can also be found via Anthem.com/coronavirus.

The search feature within the Engage platform has been enhanced so members can search using the words “COVID”, “COVID-19” or “coronavirus” to find results about the virus and their care options.

Note: Member cost-share information on the UC Vita/Engage platform has not been changed to capture the recently enhanced benefits.

Treatment Options and Costs

Options

If you start to feel sick, call your doctor before you go. If you develop symptoms of COVID-19, including fever, cough or shortness of breath, and believe you may have been exposed, call your health care provider or local health department before seeking care. Contacting them in advance will help ensure you can get the care you need without putting others at risk. Be sure to let the doctor know if you’ve been in close contact with someone diagnosed with COVID-19, or have recently been to an area where the virus has spread.

Telephonic-only care. Effective March 19, 2020 and until further notice, UC will cover telephonic-only visits with in-network providers. Out-of-network coverage will be provided if you are unable to connect with an in-network provider in a timely manner. This includes visits for behavioral health and substance misuse. Cost shares will be waived for in-network providers only, which means you can have a phone visit with an in-network provider at no cost to you during this time. If your provide has questions about this coverage or billing, they should call Anthem’s Provider Services team.

Note: This benefit does not include chiropractic services, physical, occupational and speech therapies. These services require face-to-face interaction and therefore are not appropriate for telephone-only consultations.

Costs

The COVID-19 test and associated services will be covered at no cost to you even if you. The costs below represent what you’ll pay for treatment if you test positive for COVID-19.

Anthem PPO

  • At a UC Medical Center: $15 copayment for doctor’s office visits and $250 copayment if you are hospitalized.
  • From an Anthem PPO network provider: $15 copayment for doctor’s office visits and 10% if you are hospitalized. The deductible will be waived.
  • Out-of-network: 30% after deductible

Telehealth and Virtual Care

By Telephone and Video Chat

Use telehealth and virtual care to connect with a doctor or nurse 24/7. Consider LiveHealth Online for an online visit with a board-certified doctor. Effective March 17, 2020 and until further notice, UC will waive member cost shares for telehealth visits, including visits for mental health or substance misuse. This means you can receive these services at no cost to you. Cost sharing will be waived for members using Anthem’s authorized telehealth service, LiveHealth Online, as well as care received from other providers delivering telehealth through internet video and audio services. If you attempt to use LiveHealth Online and have to pay out-of-pocket before obtaining a visit, you should call Anthem customer service so they can assist you. If your provider has questions about this coverage or billing, they should call Anthem’s Provider Services team. Note: This telehealth coverage does not include the use of facsimile or email.

You can also call Anthem 24/7 NurseLineSMat (800) 977-0027 to speak with a nurse about your symptoms and get recommendations for care. There is no cost to you for this service.

Pharmacy Benefits

Rest easy with more flexible pharmacy benefits. You can refill most prescriptions early. Anthem is relaxing prescription refill limits where permitted for members who wish to receive a 30-day supply of most maintenance medications early. Consider getting a 90-day supply by having your prescriptions mailed or delivered. Ask about your pharmacy’s mail or delivery options. Many large chains are currently offering this service at no cost. Or transfer prescriptions to the Anthem mail order service.

Emotional and Social Support

If you need someone to talk to. The Cigna Life Assistance Program is available during these trying times. You and members of your household can get three face-to-face sessions with a behavioral counselor at no cost. Call (800) 538-3543 to request a referral. Learn more.

Visit cignalap.com for a variety of articles and resources, including those about family, care giving, pet care, aging, grief, balancing, working smarter and more.

COVID-19 Mental health resource hub. We have joined with Psych Hub, a free digital hub to help our members with the stress resulting from COVID-19. This hub brings together a variety of resources to help members cope with social isolation, job loss and mental health issues.

Aunt Bertha social support services. During this time, we understand members may need help with food, housing, job training, transportation and other social support. We’re partnering with Aunt Bertha to connect individuals and families to social services in their communities. Members can access these services by visiting Aunt Bertha and entering their ZIP code.

Faculty and Staff Assistance Programs. Assistance programs offer free, confidential resources for emotional health, with several on-campus options. 

General COVID-19 Guidance and Information

Find additional guidance and information about COVID-19: