Highmark: Preparing for the Coronavirus

Highmark: Preparing for the Coronavirus

Dear ACSHIC Members:

We recognize how important it is to help those affected by Covid-19, so effective immediately temporary program changes are in place. Under this program, cost-sharing associated with physician-ordered diagnostic testing for coronavirus will be waived.

ACSHIC will cover Coronavirus, or COVID-19, testing at 100% when recommended by a medical professional. Once again, in a situation where a member goes to a specialist, urgent care, or retail (as we promote safer visits)  Highmark is also waiving those copays as long as the claim is coded correctly as testing for the Coronavirus:

Please call the Concierge at 877-258-3123 if you have questions or need additional information.  Please be sure to provide your ID and Group Number.

What we do know

  • The new Coronavirus, or COVID-19*, was identified in December 2019 and
  • It originated in Wuhan, China and is spreading in the US and internationally
  • It is more contagious than the seasonal flu
  • It produces flu-like symptoms–fever, cough, shortness of breath
  • In about 15% of cases, it can lead to severe respiratory illness, such as pneumonia
  • There is no vaccine and no antiviral treatment
  • The virus is fatal in about 2% of reported cases–more than the seasonal flu, but less than previous coronavirus outbreaks SARS and MERS


*The World Health Organization has named the disease caused by the virus COVID-19: “CO” stands for corona, “VI” for virus, “D” stands for disease, and “19” for the year it emerged.

“Everyday preventive actions to help avert the spread of respiratory diseases like the coronavirus are key. While it sounds quite simple, washing your hands with soap and water, avoiding touching your eyes, nose, and mouth, and staying home when you are sick are fundamental to avoiding and stopping the spread of illness. If you feel sick, always seek medical advice and call your doctor.”   –Charles DeShazer, M.D., Chief Medical Officer, Highmark


How to protect yourself

  • People who are sneezing, wheezing, coughing–just avoid them
  • Wash your hands often with soap and water for at least 20 seconds (it’s longer than you think–try singing either “Happy Birthday” or recite the Pledge of Allegiance twice).
  • Use an alcohol-based hand sanitizer (at least 60% alcohol) if soap and water are not available
  • Apply the “not above the shoulders” rule–avoid touching your eyes, nose, and mouth with unwashed hands
  • Commonly used surfaces–clean them, often
  • You are at greater risk of getting the seasonal flu than this new virus–so get a flu shot


Where to go for help

  • For answers on Coronavirus, the flu, or any health-related questions, call your doctor
  • If you don’t have a doctor, visit our online Find A Doctor service for help in locating one nearby
  • If you are in a medical emergency, call 911 immediately


Official sites with information you may find important


Frequently Asked Questions – check back often for our latest updates

  • What are the symptoms of the Coronavirus, or COVID-19?
    Symptoms appear 2-14 days after exposure and include fever, cough, shortness of breath.
  • When should I see my doctor?
    Anyone who thinks they may have been exposed to COVID-19, or if you are experiencing fever, cough, or shortness of breath, should contact their primary care physician or health care provider immediately.
  • How do I get tested?
    Contact your doctor, health care provider, or local county health department. They will use CDC guidelines to determine if testing is warranted. There are a few ways that a lab may get a sample for testing.

    1. Swab test. A health care provider will use a special swab to take a sample from your nose or throat.
    2. Nasal aspirate. A health care provider will inject a saline solution into your nose, then remove the sample with gentle suction.
    3. Tracheal aspirate. A health care provider will put a thin, lighted tube called a bronchoscope down your mouth and into your lungs, where a sample will be collected.
    4. Sputum test. Sputum is a thick mucus that is coughed up from the lungs. You may be asked to cough up sputum into a special cup, or a special swab may be used to take a sample from your nose.
    5. Blood. A health care professional will take a blood sample from a vein in your arm.
  • Where can I get tested?
    Contact your primary care physician for testing options. Testing is completed at the State Department of Health (DOH) and will be brought into facilities once tests are available. Test results are made available within 24 hours of the State DOH receiving the test kit.
  • Is Coronavirus testing covered by my plan and what will it cost me? Highmark will cover Coronavirus, or COVID-19, testing at 100% when recommended by a medical professional. This means copays, deductibles, and coinsurance do not apply for this testing. When will a vaccine be available?
    Estimates range between 6-18 months. No vaccine is currently available.
  • Is there a treatment?
    There is no antiviral treatment for COVID-19. People with COVID-19 should seek medical care to help relieve symptoms, such as receiving a fever reducer.
  • Who is most susceptible to COVID-19?
    The CDC has not yet identified any factors that would increase an individual’s risk of acquiring COVID-19. However, the very young and elderly, pregnant woman, or people with compromised immunity (i.e. Recent surgeries, cancer, etc.) are at higher risk of complications if infected with COVID-19.
  • How do I schedule an appointment to get tested?
    Contact your primary care physician. He or she will complete a travel and exposure screening to help best determine if further testing is required.  Also, consider calling Teladoc.
  • What kind of doctor do I see to get tested?
    Your primary care physician will be able to help you. If you don’t have a doctor, visit your member website or call Member Services at the number on the back of your insurance card to identify an in-network doctor.
  • I’m sick – should I quarantine myself?
    Yes, stay at home when you are sick. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Clean and disinfect frequently touched objects and surfaces.
  • Can I go directly to an ER? Do I call first?
    In case of emergency contact 911. It is recommended to call the ER or Urgent care facility so they can prepare for your arrival. Mild cases of COVID-19 are often treated symptomatically from home or through outpatient services instead of a visit to an acute care facility.
  • Do I have a virtual care benefit?
    Virtual care, or video visit, is a great way to avoid leaving home when you are ill and still receive medical assistance.  This service is available through your Teladoc benefit.
  • How can I get extra prescriptions filled during the spread of the Coronavirus?
    Many plans do allow 90 day fills for certain medications; however, others limit to a 30- or 34-day supply. Medication quantity limits may also apply. If you are interested in receiving a 90-day supply of medication, check your benefits and then have a conversation with your primary care physician to determine if a 90-day supply is appropriate.
  • I am pregnant; should I still travel?
    CDC recommends avoiding all non-critical travel.
  • I travel for work, when should I cancel it?
    CDC recommends avoiding all non-critical travel.
  • Do I need to purchase face masks?
    No, Follow CDC’s recommendations for using a facemask. CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19. However, the use of facemasks is crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
  • Does my insurance cover me if I get sick when I travel?
    Yes, see coverage options at your member website or your plan app or call Highmark Concierge at the number on the back of your insurance card 888-258-.
  • Who can I contact at Highmark with questions about my benefits or insurance coverage?
    Call the telephone number on the back of your insurance card for Highmark concierge 877-258-3123. This number is specific to your plan and benefits, and it helps you receive the right answers faster.

 

To keep up to date on COVID-19, and to find out what members are asking https://faqs.discoverhighmark.com/

 

The recommendations above are based on the information currently provided by Highmark in conjunction with the advice of the CDC and the Pennsylvania Department of Health and may be updated as more information becomes known.

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