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Five Questions to Ask your Health Plan During the COVID-19 Pandemic


In the midst of a public health crisis, like COVID-19, it is especially important to know and understand your health insurance plan’s coverage. With the threat looming that you and your dependents might contract the illness, it will bring you peace of mind to know exactly what tests and treatments your health plan will pay for, how much you will need to pay out-of-pocket and any restrictions that may or may not apply.

Here are five questions that you should ask your health insurance provider right now:

Does my plan cover testing and treatment for COVID-19?

At this time, there is no specific antiviral treatment or vaccine for COVID-19, but certain patients with severe symptoms might still require testing, hospitalization and treatment related to their symptoms. Some health plans, like AvMed, will cover the testing, including free antibody testing, and treatment with no cost-sharing at all. Ask your health plan if you will have any cost-sharing for testing, and check their terms for covering treatment of infectious diseases; as many health plans are following these same terms for the treatment of COVID-19 symptoms.

Is telehealth covered?

The medical community is expanding the use of telehealth services to help slow the spread of COVID-19. Most health plans are covering these virtual medical services at the same out-of-pocket costs that the patient would incur if they were receiving the services in-person. AvMed, for example, is offering its members and their qualified dependents the advantage of zero copays and cost share for any and all AvMed’s Virtual Visits, powered by MDLIVE, until May 15. Through AvMed’s Virtual Visits, members have access to a vast number of board-certified physicians conveniently from their computer or smartphone – anytime, anywhere  – 24/7/365.

Can I refill my prescriptions early?

The CDC recommends households have access to several weeks of medications and supplies

to prepare for unexpected events especially for those who might be at greater risk for serious complications. Due to this recommendation, the State of Florida has required health plans to allow early prescription refills.

Although waiving of refill limits is a requirement for all health plans, you should still contact them to ask how they are handling medication home delivery costs; especially if you are 65 and older or have a pre-existing condition that puts you at higher risk of contracting COVID-19 if you leave your house. For instance, AvMed, in partnership with CVS Health, is waiving charges for home delivery of all prescription medications.

Does my health plan cover mental health services to manage my stress and anxiety about the COVID-19 outbreak?

Mental health is as important as physical health, especially during a public health crisis with enforced quarantine orders. Check with your health plan to see if they cover mental health services. AvMed recommends its members tap into their plan’s behavioral health benefit through Magellan Health Services by calling 800-424-4810 or visiting magellanhealthcare.com/covid-19 for more information.

What if I can’t go to an in-network provider? 

The State of Florida requires health plans to cover services for an emergency medical condition at the in-network level, at no greater out-of-pocket costs, even if the provider is out-of-network.

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