Florida Blue Increasing Access to Health Care Services for Members to Aid in Coronavirus Treatment (Updated 3.18.20)

Florida Blue Increasing Access to Health Care Services for Members to Aid in Coronavirus Treatment

March 19, 2020

General

Message from Florida Blue below:

Summary 

Florida Blue is making several adjustments to make it easier for members to get tested and treated for COVID-19, while also increasing access to other health care services. This article has been updated with information about in network primary care providers, behavioral health providers and specialists offering virtual visits and Teladoc’s $0 cost share for IU65, Medicare Advantage and fully insured group members. 

Where Members Can Get the Latest Information 

We are regularly updating our blog to make sure members are getting the latest news about the coronavirus, policy changes and other ways we’re making it easier to get care. To find the blog, they need to click on the coronavirus link at the top of floridablue.com, floridablue.com/medicare or our mobile app. 

If members have questions about the coronavirus, have symptoms and need help finding a doctor to do a COVID-19 test, or any other concern, they are encouraged to call Florida Blue at the customer service number on the back of their member ID card. 

We prepared FAQs to help you with member questions. Click here to view the FAQs. 

Details About Changes to Benefits for IU65, Fully Insured Groups and Medicare Advantage Members 

To help our fully insured and Medicare Advantage members get needed care and treatment, Florida Blue is: 

  • Waiving copays and deductibles related to the medical test for the virus. This waiver also applies to short-term plans. Members should call their primary care doctor if they’re experiencing symptoms linked to the coronavirus, such as mild to severe respiratory symptoms, like a cough and difficulty breathing, and a fever. If their doctor feels they need to be tested, the lab test itself is at no cost to the member. However, there may be a charge for the office visit or other tests (like for the flu) if they’re performed. 

o Note: A doctor’s order is required for the COVID-19 test. Remember, a visit to a value choice provider for IU65 members or small group members has no doctor visit cost. Sanitas patients can also use mySanitas virtual chat for no cost. 

  • Late today we learned that the U.S. Senate’s COVID-19 bill includes a provision that allows a $0 copay for Medicare Advantage members who need an office visit to determine if COVID-19 testing is needed. More details to come on this breaking development. 
  • Increasing access to necessary medications. We’re waiving early medication refill limits on 30-day prescription medications for Medicare members and 30-day prescription maintenance medications for commercial members. We’re also encouraging members to use their 90-day mail order benefit. If they need help with mail order, please ask them to call us at the customer service number on the back of their member ID card. They should say Pharmacy when they call. 
  • Offering counseling for members feeling stress related to the coronavirus. In partnership with New Directions Behavioral Health, members can talk to specially trained behavioral health counselors at no cost. They can speak with a counselor 24/7 about stress they may be feeling by calling the toll-free helpline at 833-848-1762. The counselors will not be able to assist with questions about COVID-19 testing or treatment, so members should call us at the number on the back of their member ID card for help with those questions. 
  • Strongly encouraging members to take advantage of virtual visits for less serious medical issues. Members have two options for virtual care: Teledoc and virtual visits with Florida Blue network providers. 

o OPTION 1: TELADOC 

Effective March 17, IU65 and fully insured group members with Teladoc coverage can have Teladoc virtual visits at $0 cost share while the coronavirus is a health concern. Effective March 18, Medicare Advantage members have this same benefit and $0 cost share. Until things get back to normal, members can help protect their health and avoid a crowded doctor’s office for non-emergency illnesses by using virtual visits and taking advantage of 24/7 Teladoc services. Members should consider a virtual visit for a sinus infection, sore throat, rash, allergies, upset stomach or other non-emergency situations. And medications, except controlled substances, can be prescribed. A virtual visit lets members get the care they need, when they need it, plus keeps them out of the waiting room. Note: Members cannot get the COVID-19 test through Teladoc. These tests must be completed in person. If members need help finding a doctor for a COVID- 19 test or any other concern, encourage them to call Florida Blue at the customer service number on the back of their member ID card. 

For fastest Teladoc support, we encourage members to contact Teladoc online or through their mobile app. They can download the app from Apple App or Google Play stores. Before their first virtual visit, members will need to set up a Teladoc account, including sharing their medical history. Completing this step ahead of time accelerates visit requests. 

o OPTION 2: VIRTUAL VISITS WITH FLORIDA BLUE NETWORK PROVIDERS 

Effective March 15, IU65, Medicare Advantage and members of fully insured groups can also use Florida Blue network providers, if the doctor has virtual visit capabilities. This option enables members to receive virtual care from primary care providers, behavioral health providers and specialists to help protect the member’s health and avoid a crowded doctor’s office. Members should call their doctor to see if they offer virtual visits. 

Virtual visits will be at the regular office visit cost share for routine office services. Network provider virtual visits will be in effect for the next 90 days. Florida Blue will assess any potential extensions. Note: Members cannot get the COVID-19 test through a virtual visit. These tests must be completed in person. If members need help finding a doctor for a COVID-19 test or any other concern, encourage them to call Florida Blue at the customer service number on the back of their member ID card. 

Support for ASO and MPP Groups 

Florida Blue is also working with our Self-Funded and MPP groups to be able to modify their benefits, if they choose, in light of this situation to support and encourage their members to get needed care and treatment. 

The following applies to groups administered by any of our four TPA partners (South Carolina, Highmark, Alabama and WebTPA) and the Florida Platform. 

  • Effective March 17, copays and deductibles related to the medical test for the virus will be waived unless the ASO/MPP group wants to opt out. ASO/MPP groups who choose to waive the cost share for their members should understand that they are agreeing to pay that difference and the full cost of the test will come through their medical claims. Sales should work with their respective account management teams at SC/HM/AL/Web as appropriate if the group does not want to waive the copays and deductibles for their group. For Groups on the FL platform, FB is developing on a quicker way to implement these group changes. More detailed information will follow shortly. Sales has until March 27 to submit any ASO/MPP changes if requested. 
  • We are encouraging our ASO/MPP Groups to also encourage their employees to use virtual visits, if it is part of their coverage, for less serious medical issues to avoid a crowded doctor’s office for non-emergency illnesses. Members should consider a virtual visit for a sinus infection, sore throat, rash, allergies, upset stomach or other non-emergency situations. Medications can be prescribed except for controlled substances. ASO/MPP members may have two options for virtual care Teladoc and virtual visits with Florida Blue network providers: 

o OPTION 1: TELADOC: 

For ASO/MPP groups that offer Teladoc, virtual visits will continue to process at the ASO/MPP group’s current member cost share unless the Group decides to modify the benefit to be $0 or something other than their current benefit. ASO/MPP groups who choose to waive the cost share for their members (or reduce the amount) should understand that they are agreeing to pay that difference and the full cost of the test will come through their medical claims. Sales should work with their respective account management teams at SC/HM/AL/Web if a group wants to waive the cost share or modify the current benefit. SC will be able to implement a change within two weeks from notice. For Groups on the FL platform, FB is developing a quicker way to implement these group changes. More detailed information will follow shortly. 

All platforms can add Teladoc coverage for any ASO/MPP group that does not have it today but would like to add it in light of this situation. ­ For HM/AL/Web, Sales should work with their applicable Account Management 

team to add this coverage for groups on those platforms ­ For Groups on the SC platform, SC has developed a Rapid Start Implementation 

process and will be able to set up a new Teledoc group within two weeks. Sales should work with their Account Management team for any group who wants to add Teledoc coverage ­ For Groups on the Florida Platform, Sales should use the SPR process to add 

Teledoc coverage for groups who want to add this coverage. Work is in flight to accelerate this process. 

ASO/MPP groups can opt in to cover Teladoc visits at $0. ASO/MPP groups who choose to waive the cost share for their members (or reduce the amount) should understand that they are agreeing to pay that difference and the full cost of the test will come through their medical claims. ASO/MPP members should check their benefits to determine if virtual visits via Teladoc are part of their Florida Blue health plan. Sales should work with their respective account management teams at SC/HM/AL/Web if a group wants to waive the cost share. SC will be able to implement a change within two weeks from notice. For Groups on the FL platform, 

FB is developing on a quicker way to implement these group changes. More detailed information will follow shortly. 

If your ASO/MPP group has a different vendor for virtual visits, Sales should work with their respective account management teams at the partner plan, as well as with the vendor, as appropriate, if a group wants to waive the cost share or modify the current benefit. 

­ Teladoc is experiencing higher call volume so for fastest support, we 

encourage members to contact Teladoc online or through their mobile app. Members can download the Teladoc app from the Apple App or Google Play stores. Before a member’s first virtual visit, they’ll need to set up a Teladoc account, including sharing their medical history. Completing this step ahead of time accelerates visit requests. Share this flier with your customers. 

o OPTION 2: VIRTUAL VISITS WITH FLORIDA BLUE NETWORK PROVIDERS 

ASO/MPP group members can also use Florida Blue network providers, if the doctor has virtual visit capabilities. This option enables members to receive virtual care from primary care providers, behavioral health providers and specialists to help protect the member’s health and avoid a crowded doctor’s office. Members should call their doctor to see if they offer virtual visits. Note: Members cannot get the COVID-19 test through a virtual visit with a network provider These tests must be completed in person. 

Effective March 15, virtual visits will be at the regular office visit cost share for routine office services. ASO groups must opt out if they don’t want this to apply or if they want a different cost share. ASO/MPP groups who choose to waive the cost share for their members (or reduce the amount) should understand that they are agreeing to pay that difference and the full cost of the test will come through their medical claims. Network provider virtual visits will be in effect for the next 90 days. Florida Blue will assess any potential extensions 

What You Should Know About the Virus 

What is the Risk of Contracting COVID-19? The risk of contracting COVID-19 in Florida is low. Most of the people who contract COVID-19 recover in a matter of days, oftentimes at home, according to health officials. Symptoms can be more serious for older adults and people with underlying health conditions. 

What Are the Symptoms? Patients typically have mild to severe respiratory symptoms, such as a cough and difficulty breathing, as well as a fever. As with other viruses, people who are elderly and/or have underlying health conditions are more at risk. Symptoms may appear two to 14 days after exposure. 

How is the Virus Spread? According to the CDC, the virus is mainly spread person-to-person, particularly when they are within six feet of each other. The primary way is when an infected person sneezes or coughs and their droplets land on a nearby person’s mouth or nose or are inhaled into their lungs. Another way is when a person touches a surface where the virus is, then touching his or her own mouth, nose or eyes. Click here for more information on how the virus can be spread.

How Can You Protect Yourself and Your Family? There is no vaccine to prevent infection for COVID-19. The best way to protect yourself is to avoid being exposed to the virus. Here are some prevention tips: 

  • Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating and after blowing your nose, coughing or sneezing. Also, wash your hands when you touch things in public like elevator buttons, door knobs and office telephones. 
  • Avoid touching your eyes, nose and mouth with unwashed hands 
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash. 
  • Avoid contact with people who are sick and stay home when you are sick. 
  • Surgical masks should be reserved for caregivers, health care personnel and people with symptoms and under suspicion for COVID-19. As of now, masks are not covered by Florida Blue health plans. 
  • Make sure you have enough nonperishable food for a week or so in case you get sick, just as you would if you had the flu. 
  • Follow government travel restrictions. 

Where Do Providers Get Updated Information? 

The CDC takes the lead with providers. All providers are aware of the protocol when dealing with infectious diseases. They work directly with the CDC and local health officials. Florida Blue has no active role in that process. If there are any ordered quarantines or other actions required by Florida Blue, we take that direction from the CDC and local health officials. 

Resources 

Here are several websites that can be used to find the latest details: 


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