Member Coronavirus Information

COVID-19 is a respiratory disease that is caused by a new virus called a coronavirus, which has become a public health emergency. The number of cases continue to increase nationally and globally.

The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. COVID-19 can be contagious before a person begins showing symptoms.

Influenza (the flu), a contagious respiratory illness caused by the influenza viruses (Type A and Type B), has high activity in the United States in the Fall/Winter months. Everyone 6 months of age and older should get a flu vaccine annually.

If you have been exposed or begin showing symptoms of the virus or flu, contact your healthcare provider or health department immediately. 

Teladoc is a convenient way for Coordinated Care members to obtain telehealth services. Members receive 24-hour access to in-network healthcare providers for non-emergency medical issues. Get medical advice, a diagnosis or a prescription by video or phone. For more information about Coordinated Care services, please visit the Coordinated Care Telehealth page or call 1-877-644-4613 (TTY: 711).

We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:

• Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
• Use an alcohol-based hand sanitizing rub (must contain at least 60 percent alcohol).
• Wear a face covering/mask when in public and/or around others who do not live in your home if you are not fully vaccinated.
  
• Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
• Promptly dispose of tissues in a wastebasket after use.
• Clean public surfaces thoroughly.
• Stay home when you are sick.
• Avoid shaking hands.
• Avoid close contact with people who are sick.
• Get a flu vaccine annually.

On July 23, 2020, HHS Secretary Alex Azar renewed the COVID-19 Public Health Emergency (PHE). This extends flexibilities and funding tied to the PHE to continue for another 90 days. 

With this renewal the various testing, screening, billing, and telehealth coverages that were implemented in response to the COVID-19 PHE earlier this year will be extended to our members. This extension will go through late October, until the PHE is either terminated or extended again. This extension does not affect coverages that had already been made effective through December 31, 2020. 

Do you have any questions about this extension or the covered benefits impacted by it? Please contact Member Services.

Yes. When medically necessary diagnostic testing, medical screening services and/or treatment is ordered and/or referred by a licensed health care provider, we will cover the cost of medically necessary COVID-19 tests, screenings, associated physician’s visit(s) and/or treatment. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment.

No. We will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing, medical screening services, and/or treatment when medically necessary services are ordered and/or referred by a licensed health care provider.

Medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment and the associated physician’s visit will be covered when ordered, referred and/or performed in the following In-Network locations:

• Physician’s/Practitioner’s Office
• Independent Laboratory/Diagnostic Facility   
• Urgent Care Facility
• Emergency Department Facility

Are you unsure if you have been exposed to or at-risk of being infected with COVID-19? Schedule a virtual care visit with a provider. It is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. 

No. We will cover medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment at no charge to you, when such services are ordered and/or referred by a licensed health care provider. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment, along with the associated physician’s visit.

Any medically necessary treatment related to COVID-19 would be considered a covered benefit. We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

Yes, members will be able to refill prescriptions prior to the refill date.

There is now a vaccination available that will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future. The vaccine will have two doses a few weeks in between each shot. You will get a reminder card so you don’t forget your second shot. It is important to get both doses of the vaccine as instructed.

The vaccine is being administered to different populations in a tiered approach. When you are able to get the vaccine, call your doctor with any questions and ask when you can make an appointment with them or at your local pharmacy. Or, find out where to get your vaccine at cdc.gov/coronavirus/2019-ncov/vaccines or vaccinefinder.org. 

While it is not a requirement, getting your COVID-19 vaccine will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future.

Even if you have already had COVID-19, you should still get the vaccine. It may be possible to be infected more than once so getting the vaccine is a safe choice.

CDC recommends COVID-19 vaccines for everyone 6 months and older and boosters for everyone 5 years and older, if eligible.

Eligible for 1 booster:

• Everyone ages 5 years and older can get 1 booster after completing their COVID-19 vaccine primary series.

Eligible for 2 boosters:

• Adults ages 50 years and older 
• People ages 12 years and older who are moderately or severely immunocompromised
• People who got 2 doses (1 primary dose and 1 booster) of Johnson & Johnson’s Janssen vaccine

The CDC currently recommends the COVID-19 vaccine for pregnant women. If you have questions about getting the vaccine, it is recommended to discuss with your doctor to make an informed decision.

Fully vaccinated is considered two weeks past final dose, meaning the second dose of the Moderna or Pfizer mRNA vaccine, or two weeks past the single dose Johnson & Johnson vaccine.

To maximize protection from the COVID-19 and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial of high transmission.

Wearing a mask is most important if you have a weakened immune system or if, because of your age or an underlying medical condition, you are at increased risk for severe disease, or if someone in your household has a weakened immune system, is at increased risk for severe disease, or is unvaccinated. If this applies to you or your household, you might choose to wear a mask regardless of the level of transmission in your area.

Fully vaccinated people who have come into close contact with someone with suspected or confirmed COVID-19 to be tested 3-5 days after exposure, and to wear a mask in public indoor settings for 14 days or until they receive a negative test result.

A small percentage of people who are fully vaccinated will still get COVID-19 if they are exposed to the virus that causes it. These are called "vaccine breakthrough cases." This means that while people who have been vaccinated are much less likely to get sick, it will still happen in some cases. It’s also possible that some fully vaccinated people might have infections, but not have symptoms (asymptomatic infections). Experts continue to study how common these cases are.

If you get COVID-19 after vaccination, your symptoms might be less severe.

Fully vaccinated people are much less likely to be hospitalized or die than people with similar risk factors who are not vaccinated.

The safety of the COVID-19 vaccine is a top priority! The Food and Drug Administration (FDA) carefully reviews all safety data from clinical trials and authorizes emergency vaccine use only when the expected benefits outweigh potential risks. COVID-19 vaccines were tested in large clinical trials to make sure they meet safety standards.

You may run a fever after you get the vaccine. This is normal as your body builds immunity and fights off future COVID-19 exposures. You may feel sick after getting vaccinated. You could develop a fever, headache or body aches. This is your body reacting to the vaccine, which is a normal response. It is important to know that it is impossible to get COVID-19 from the vaccine. The vaccines currently in use and others being developed do not contain a live virus.

No. Both doses of the COVID-19 vaccine will be at no cost to you. You do not need to get a prior authorization for your vaccine.

Please call the administering facility/provider you received your first dose from to ask about your vaccine information and verify your second appointment/location.

The provider should have scheduled a second appointment with you at the same facility when you received the first dose. However, you can receive your second dose from another provider/facility and you should present your COVID-19 Vaccination Record Card.

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.

• Take care of your body. Take deep breaths, stretch or meditate.
• Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking.
• Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
• For more information, see the CDC’s suggestions for mental health and coping during COVID-19

Tip #1: Clean your phone right now

Drop what you’re doing! Clean your phone and case right now! You can use disinfecting wipes or sprays.

Why is this important?

It’s easy to say “I can always clean my phone later”. If you do it right now, you won’t forget! We’ve also told you how so you don’t have to figure that out on your own.

Tip #2: Use an alarm

Set a phone alarm called “clean phone.” Set an alarm on your phone called “clean phone” once per day. When it goes off, clean your phone right then and there!

Why is this important?

Even if you just cleaned your phone right now, you’re going to forget later! That’s why reminders are so important. You’ll have to clean.

For more information about cleaning and disinfecting visit the CDC Cleaning And Disinfecting Your Home page.

Protect yourself and those around you. Please consider the following before returning to adult day services.

• If you feel sick, stay home.
  • Avoid public places.
  • Contact your health care provider.
• Practice healthy habits.
  • Wash your hands after touching public surfaces.
  • Avoid touching your face.
  • Sneeze or cough into a tissue. You can also use the inside of your elbow.
  • Clean frequently used items and surfaces as much as possible.
  • Use a face mask while in public.
• Personal Protective Equipment (PPE) and frequent hand washing
  • Your provider may require a face covering and gloves during a visit. They may also require frequent hand washing.
  • Your service plan may be updated based on how you tolerate these changes.
• This has been a stressful time. If it’s affecting your mental health, you may need to speak to someone.

As a Coordinated Care member, you have access to health professionals 24/7. You can call the 24/7 Nurse Advice Line for non-emergencies. For more information about this service, call us at 1-877-644-4613.

It’s important to change how we use public spaces. Consider whether you need to touch certain objects and surfaces. Be sure to wipe public items before and after you touch them.

Things to be aware of while at your adult day center.

We have all had to make changes to reduce the spread of COVID-19. To reopen, we will need to continue these safe practices.

• Social distancing
  • Stay 6 feet away from others when going into a shared space.
• Wash your hands.
  • Wash hands with soap and water for at least 20 seconds.
  • Use sanitizer with at least 60% alcohol when soap and water are not available
• Wear a face covering.
• Avoid touching your eyes, nose, and mouth.
• Stay home when sick.
• Clean frequently touched items and surfaces.

It’s important to follow state and local guidance as we reopen. This will help you to change your plan as situations change.

Make sure your provider has a plan to maintain a safe environment.

When you return home from your adult day center.

We should think about our safety and the safety of others. The following can help reduce the spread of COVID-19.

• Disinfect “high touch” surfaces and items every day.
  • This includes personal devices and electronics.
  • Be sure to follow the cleaning product’s instructions.
• Consider changing your clothes before entering your home.

If you cannot return to your adult day center

As a Coordinated Care member, you may have respite hours available for your caregiver. These may be used if you cannot return to your day service program. For more information, call us at 1-877-644-4613.