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Health Alliance Northwest

Coronavirus (COVID-19) Information and Updates

With an increasing number of people in the United States diagnosed with COVID-19, the illness caused by the novel coronavirus, Health Alliance is working closely with local, state and federal health partners to keep you informed. Teams throughout our nation are taking preventive steps to limit the spread of the novel coronavirus and manage the treatment of COVID-19. We are here to help you understand the guidance that public health officials are providing, and to answer all questions about your plan’s coverage during this ongoing situation. In the FAQ section that follows, you’ll find information and resources regarding the illness, prevention, treatment and coverage.

With an increasing number of people in Washington and throughout the United States diagnosed with COVID-19, the illness caused by the novel coronavirus, Health Alliance Northwest is working closely with local, state and federal health partners to keep you informed. Teams throughout our nation are taking preventive steps to limit the spread of the novel coronavirus and manage the treatment of COVID-19. We are here to help you understand the guidance that public health officials are providing, and to answer all questions about your plan’s coverage during this ongoing situation. In the FAQ section that follows, you’ll find information and resources regarding the illness, prevention, treatment and coverage.

If you have questions that are not covered below, or if you want to learn more about the actions we’ve taken to respond to the COVID-19 pandemic, feel free to contact us:

Members: call the number on the back of your member ID card, or email CustomerService@HealthAlliance.org
Group Plan Administrators: call Client Support at (800) 851-3379, ext. 28151, or email ClientSupport@HealthAlliance.org
Providers: contact your provider relations specialist
Brokers: call Broker Services at (877) 917-8489 or email BrokerServices@HealthAlliance.org

All of our service areas have experienced confirmed cases of COVID-19. For the latest information regarding affected areas and number of cases, please visit the websites below:

This is a rapidly evolving situation, and public health officials in each state have set up ways to contact their departments for more information:

  • Illinois has established a COVID-19 hotline, which can be reached at (800) 889-3931 or by email at dph.sick@illinois.gov.
  • Indiana residents can call the state’s COVID-19 Call Center at (877) 826-0011 (available 8 a.m. to 8 p.m., seven days a week).
  • Iowa’s Department of Public Health has established a COVID-19 hotline for Iowans who have questions about the illness. The line is available 24/7 by calling 2-1-1. Healthcare providers with questions can call (800) 362-2736.
  • Ohio residents can call 1-833-4-ASK-ODH, staffed from 9 a.m. to 8 p.m. seven days a week.

This is a rapidly evolving situation, and Washington’s public health officials have set up ways to contact their department for more information:

  • If you have questions about what is happening in Washington and what to do if you have symptoms, call the Washington State Department of Health at (800) 525-0127. The hotline is available every day from 6:00 a.m. to 10:00 p.m. Please note that this hotline has been experiencing high traffic and may be temporarily unavailable.

Frequently Asked Questions

The following questions focus on COVID-19 and its prevention, how the novel coronavirus spreads and specifics about insurance coverage. For the most in-depth information about the virus and illness, visit the Centers for Disease Control and Prevention (CDC) website.

Symptoms and Basics

What is COVID-19?

It’s a respiratory illness – similar to SARS and MERS – that has sickened hundreds of thousands throughout the world. Since the virus that causes COVID-19 is a newly identified strain of coronavirus, we still don’t know everything about the illness, but Health Alliance is keeping track of the latest details and recommendations from health officials like those at the CDC and state and local public health agencies.

What are the symptoms?

The following information is directly from the CDC:

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus.

People with these symptoms or combinations of symptoms may have COVID-19:

  • Cough
  • Shortness of breath or difficulty breathing

Or at least two of these symptoms:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell

This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning to you.

Read more from the CDC here.

What should I do if I suspect I have been exposed to the virus that causes COVID-19?

If you think you’ve been exposed to the novel coronavirus or to someone with COVID-19, and develop a fever, cough or difficulty breathing, call your healthcare provider for medical advice. Additionally, many hospitals, clinics and other healthcare providers have set up online tools to help evaluate symptoms – check your healthcare provider’s website for these tools, which can help you figure out what actions to take. For more guidance on steps to take if you suspect you are sick, visit this webpage. As always, if you need emergency medical assistance, call 911.

How the Virus Spreads

How does the virus spread?

The first infections were linked to a live animal market in China, but the virus is now spreading from person-to-person. The virus seems to be spreading easily and sustainably among individuals in affected geographic areas in the United States and across the globe. These areas have shown “community spread” of the virus, which means that people in these locations have developed COVID-19, including some who are not sure how or where they became infected. For more information on how the virus spreads, visit the CDC website.  

Who is most at risk?

As the spread of the novel coronavirus and the public health response continue to change daily, so too does the assessment of who is most at risk and when. For this reason, we direct you to the CDC website for the latest information.

Can the virus be spread through food products or other items shipped from foreign countries?

In general, because of the poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packages that are shipped over a period of days or weeks at ambient, refrigerated or frozen temperatures.

Prevention

Is there a vaccine?

There is currently no vaccine available.

Do vaccines for the flu and/or pneumonia help protect against COVID-19?

No. Vaccines for pneumonia and the flu will not protect you from COVID-19.

What can I do to lower my risk of getting the virus?

The absolute best way to prevent illness is to avoid exposure to the virus. This means avoiding contact with individuals who have the virus and avoiding places where the virus has known to have spread.

Social distancing – which includes ending group gatherings, avoiding public places where people congregate and keeping personal contact minimal – has been recommended by numerous public health officials as a way to prevent contracting and spreading the virus. 

Additionally, everyday preventive actions can help prevent the spread of respiratory diseases. These include:

  • Wash your hands
  • Cover your cough
  • Stay home if you’re sick
  • Don’t touch mouth, nose or eyes
  • Avoid close contact with sick people*

For more information about how to protect yourself from respiratory illnesses like COVID-19, visit the CDC website.

* Virtual visits are a great way to avoid unnecessary travel to a doctor's office and are in line with the practice of social distancing. Your plan may offer a Virtual Visit with a doctor through your Hally™ mobile app or YourHealthAlliance.org account. Member cost sharing may apply. Additionally, your plan may also offer the services of our Anytime Nurse Line at (855) 802-4612 at no cost to you. Certain self-funded employer group plans may offer alternative platforms for virtual doctor visits and telephone help lines. For more information on telehealth services, please see the question below, “Does my insurance cover any types of telehealth and/or virtual doctor visits?” As always, please visit a hospital emergency department for all serious conditions and call 911 for all emergencies.

Should I – and my family – be wearing facemasks in public?

The CDC’s website states:

CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance. The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

For more information, visit the CDC’s webpage addressing face coverings. The CDC’s recommendations are subject to enhancement and/or change as more is learned about COVID-19, so please continue to check the CDC website for the most up-to-date information and recommendations.

Should I postpone or cancel my travel plans?

At this time, many public officials are recommending reduced travel, particularly to areas with multiple cases of COVID-19, or for older adults or those with significant chronic health conditions. Specific recommendations are constantly changing, so please check the CDC’s travel page for the latest information.

Should I avoid visiting my doctor or the hospital, or delay seeking other healthcare services, so as not to catch the virus?

If you have a serious or life-threatening condition, please continue to visit the hospital emergency department, and call 911 in all emergencies. In these cases, you should not stay home. Hospitals and healthcare providers are taking extra measures to ensure the safety of all their patients, so that vital and emergency procedures can continue.

If your condition isn’t serious or life-threatening, don’t delay, and call your healthcare provider to get his or her recommendation for what action is best in your situation. You may do the same for previously scheduled appointments for healthcare services that are not critical or timely. Your provider will help you determine your best course of action, whether that involves visiting a facility in person, receiving a service remotely (i.e. virtually) via telehealth, postponing a service or another option.

For more information on telehealth services, please see the question below, “Does my insurance cover any types of telehealth and/or virtual doctor visits?”

Treatment

If you think you’ve developed COVID-19, call your healthcare provider for medical advice. Older patients and individuals who have severe underlying medical conditions or are immunocompromised should contact their healthcare provider early, even if their illness is mild. If you have severe symptoms, such as persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face, contact your healthcare provider or emergency room and seek care immediately. Your healthcare provider will determine if you have the signs and symptoms of COVID-19 and whether you should be tested. As always, if you need immediate emergency help, call 911.

For those who test positive for COVID-19, your healthcare provider will seek the latest CDC advice regarding treatment. This may range from simple supportive care that lessens symptoms to care that aides vital organ functions.

Coverage

Please note that the content provided within this website is only intended as general summary information and does not constitute your policy of insurance or summary plan description. The information on this website does not guarantee coverage or verify eligibility for benefits. The information provided on this website is designed to support, not replace, the relationship between Health Alliance and the members of the plans it offers and administers. Please see your member materials or contact the number on the back of your ID card for additional details specific to your health plan’s coverage for diagnostic laboratory testing associated with COVID-19. Should a member require subsequent medically necessary treatment for COVID-19 related medical conditions, Health Alliance will cover such treatment pursuant to the terms and conditions associated with the member’s health plan for the plans that Health Alliance itself offers. For self-funded employer plans that Health Alliance acts solely as the administrator, the employer / plan sponsor has the responsibility to make such determinations regarding what benefits are provided for COVID-19 treatment (subject to applicable law). This website’s content is subject to change without notice to the Member. In any situation where the official printed publications of Health Alliance or a self-funded plan sponsor differ from the text contained in this website, the official printed documents take precedence. 

This coverage FAQ is based on the latest information from applicable resources which may include but are not limited to the Illinois Department of Insurance, federal law and CDC guidelines.

Please note that the content provided within this website is only intended as general summary information and does not constitute your policy of insurance or summary plan description. The information on this website does not guarantee coverage or verify eligibility for benefits. The information provided on this website is designed to support, not replace, the relationship between Health Alliance Northwest and the members of the plans it offers and administers. Please see your member materials or contact the number on the back of your ID card for additional details specific to your health plan’s coverage for diagnostic laboratory testing associated with COVID-19. Should a member require subsequent medically necessary treatment for COVID-19 related medical conditions, Health Alliance Northwest will cover such treatment pursuant to the terms and conditions associated with the member’s health plan for the plans that Health Alliance Northwest itself offers. For self-funded employer plans that Health Alliance Northwest acts solely as the administrator, the employer / plan sponsor has the responsibility to make such determinations regarding what benefits are provided for COVID-19 treatment (subject to applicable law). This website’s content is subject to change without notice to the Member. In any situation where the official printed publications of Health Alliance Northwest or a self-funded plan sponsor differ from the text contained in this website, the official printed documents take precedence.  

This coverage FAQ is based on the latest information from applicable resources which may include but are not limited to the Washington State Office of the Insurance Commissioner, federal law and CDC guidelines.

Health Alliance Northwest recently issued an insurance policy endorsement to our commercial health plan members explaining some changes to coverage pursuant to the Insurance Commissioner’s Emergency Orders and the Governor’s disaster proclamation. This does not apply to self-funded or Medicare Advantage plans.  To view this insurance policy endorsement click HERE.

If I get tested for COVID-19, will my health plan cover the test?*

Yes. Please note that not everyone needs to be tested for COVID-19, and your healthcare provider will determine if you have the signs and symptoms of COVID-19 and whether you should be tested. If you do get tested, your Health Alliance Northwest plan (or Health Alliance Northwest-administered plan) will cover, with no member cost share, the appropriate medically necessary diagnostic laboratory testing for COVID-19. This includes serological (antibody) tests for COVID-19. Also covered with no member cost share are tests for other causes of respiratory illness, when an individual’s attending provider determines that these tests (such as influenza and blood tests, among others) are needed to help diagnose whether or not an individual has COVID-19. Cost sharing is also waived for COVID-19 testing related visits, whether the testing related visit is received in a healthcare provider’s office, an urgent care center, an emergency department or through telehealth. All of these actions will continue for the duration of the applicable public health emergency. Call the number on the back of your member ID card if you have any questions about your coverage.

*Many communities still lack resources to complete testing on a widespread scale. Until testing becomes more universally available, healthcare facilities may not be offering the testing or may prioritize testing of symptomatic patients or those considered most at risk.

I have a High Deductible Health Plan with a Health Savings Account. Will my plan cover testing for COVID-19 even if I haven’t yet met my deductible? Will I lose my tax incentives if I get tested before meeting my deductible?

All fully-insured and self-funded High Deductible Health Plans will cover medically necessary diagnostic laboratory testing at no out-of-pocket cost to you, even if you haven’t yet met your deductible. Usually, your plan cannot cover medical services that are not classified as preventive care until you meet your deductible. However, the Internal Revenue Service (IRS) has allowed us to cover services related to COVID-19 without jeopardizing the tax benefits associated with your Health Savings Account (HSA), even if deductibles have not been met. Call the number on the back of your member ID card if you have any questions about your coverage.

Will my health plan provide benefits for treatment of COVID-19?

Your health plan will continue to provide benefits for medically necessary healthcare costs to treat infectious diseases, including COVID-19, based upon the terms of your specific health plan. Call the number on the back of your member ID card if you have any questions.

Your health plan will continue to provide benefits for medically necessary healthcare costs to treat infectious diseases, including COVID-19, based upon the terms of your specific health plan. Prior authorization requirements for any service ordered by a healthcare provider to treat COVID-19 will be waived until at least July 3, 2020, consistent with guidance from the Washington Office of the Insurance Commissioner and the Washington Healthcare Authority. Call the number on the back of your member ID card if you have any questions.

What if I get the virus and require emergency services – will my health plan provide benefits for these?

Many individuals who have contracted COVID-19 have not required any emergency services. However, in circumstances where emergency services are required, most health plans will provide benefits for these services at in-network levels regardless of which provider performs the services. Call the number on the back of your member ID card if you have any questions.

Will my health plan provide benefits for expenses incurred for medical supplies such as facemasks, gloves and disinfectants?

Most of these supplies are not covered by health plans. Call the number on the back of your member ID card if you have specific questions.

Will my health plan provide benefits for a hospital quarantine stay if I am diagnosed with COVID-19?

Your health plan will continue to provide benefits for medically necessary healthcare costs to treat infectious diseases, including COVID-19, based upon the terms of your specific health plan. Call the number on the back of your member ID card if you have any questions. Custodial care is not a covered expense.

Your health plan will continue to provide benefits for medically necessary healthcare costs to treat infectious diseases, including COVID-19, based upon the terms of your specific health plan. Treatment, including inpatient hospitalization, for COVID-19 is not subject to prior authorization requirements pursuant to the Emergency Order in place through July 3, 2020. Call the number on the back of your member ID card if you have any questions. Note: custodial care is not a covered expense.

Will my health plan allow early medication refills of prescription medications? I might want extra medication on hand if there is an outbreak of the virus in my community.

Yes, fully-insured plans and some self-funded group health plans do – with exceptions. You must have an active prescription available for refill. Please notify your prescriber if you do not have an active prescription on file with your pharmacy. Inform the pharmacy that you wish to have your medication filled to ensure you have 30 days’ worth of medication on hand in case of COVID-19. Exclusions include requests for most opioids and specialty medications, and instances where the member already has 30 or more days of medicine remaining. We recommend filling maintenance medications for 90-day supplies if possible. Call the number on the back of your member ID card if you have any questions.

Is it possible to have my prescription medications delivered by mail, in case my pharmacy closes or I don’t want to leave the house?  

Yes. You can enroll in our Prescription Benefit Manager (PBM) OptumRx’s mail-order program by calling (855) 209-1292 or by visiting YourHealthAlliance.org, selecting the “Plan & Benefits” tab, and choosing “Compare prices, find a pharmacy, look up drugs, and more” under the Pharmacy Benefits section. This will take you to the OptumRx website, where you can select “Home delivery” under the Member Tools section on the right-hand side of the page. You can select which medications you’d like to transfer to Home Delivery, and OptumRx will work with your provider to obtain a new prescription for mail-order.

You can learn more about the mail-order program by calling OptumRx at (855) 209-1292.

Please note: some self-funded groups may have a different Prescription Benefit Manager or might be unable to receive medication by mail. If your group has a different PBM, visit their website for information about whether they offer mail-order.

For our members in the Yakima County service area, Virginia Mason Memorial now offers home delivery of prescription medications through its Pharmacy at Creekside. Call (509) 573-3808 to get started.

Does my health plan cover any type of telehealth and/or virtual doctor visits?

Most Health Alliance Northwest and Health Alliance Northwest-administered plans provide benefits for telehealth and/or virtual doctor visits. For Health Alliance Northwest plans, we’re temporarily broadening our telehealth codes to cover additional services, including behavioral therapy, in response to the COVID-19 pandemic. With regard to the plans we administer, some of these self-funded employer plans have temporarily expanded telehealth codes in a similar manner. Call the number on the back of your ID card to validate if your plan has temporarily expanded telehealth benefits. Telehealth services are a great way to avoid unnecessary travel to a doctor's office and are in line with the practice of social distancing. Call the number on the back of your member ID card if you have specific questions about the types of telehealth services that are eligible, or questions about cost sharing or in-network restrictions that may apply.

Your plan may specifically offer Virtual Visits with a doctor through your Hally™ mobile app or YourHealthAlliance.org account. Member cost sharing may apply. Additionally, your plan may also offer the services of our Anytime Nurse Line at (855) 802-4612 at no cost to you. Certain self-funded employer group plans may offer alternative platforms for virtual doctor visits and telephone help lines.

As always, please visit a hospital emergency department for all serious conditions and call 911 for all emergencies.

Can my health insurance carrier – or my self-funded employer/plan sponsor – cancel my insurance policy or health plan, or refuse to renew it, if I am diagnosed with COVID-19 in connection to a preexisting respiratory illness?

No. Most insurance policies and self-funded group health plans cannot impose any pre-existing condition exclusions, including in connection with COVID-19. Health Alliance Northwest, in particular, will not deny an application for a short-term, limited-duration or excepted benefit plan based on a diagnosis of COVID-19.

Note: certain limited-duration health insurance coverage or excepted benefit policies offered by other insurance plans may exclude coverage for pre-existing conditions.

I’m an individual eligible for Medicare, but I was not able to make an election during a valid election period as a result of the COVID-19 pandemic. Is there a Special Enrollment Period for me to enroll in a Medicare plan?

Yes. The Centers for Medicare & Medicaid Services (CMS) announced that the existing Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster is applicable to, and available for, Medicare-eligible individuals who’ve been affected by the COVID-19 pandemic.

This SEP is available to residents of all states, tribes, territories and the District of Columbia as of March 1, 2020, for affected individuals who were unable to and did not make an election during another valid election period as a result of the COVID-19 emergency. This includes enrollment and disenrollment elections including the Medicare Advantage Open Enrollment Period (OEP) which had overlap March 1 – March 31, 2020.

This SEP is available from the start of the incident period of March 1, 2020, through June 30, 2020. Beneficiaries do not have to provide proof that they were affected by the pandemic-related emergency.

To see if you’re considered eligible for this SEP, or if you have any questions, please contact Health Alliance Northwest or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. For more information, click here to read the CMS announcement.

I am the administrator of my company’s Small Group plan. Can my company have an extension on paying our premiums?

Health Alliance Northwest will temporarily extend the grace period from 31 days to 60 days for all fully-insured Small Group Employers, as defined by the Department of Insurance, for all markets we serve, who have premiums due between (and including the dates of) March 1 and May 1, 2020.

The policy does not apply to any Large Group, Balance, self-funded Group, Individual or Medicare plans. The policy is also not permanent.

For any questions, please call Client Support at (217) 902-8151 or email ClientSupport@healthalliance.org.

If you’re an administrator of a Large Group Plan or on a Health Alliance Northwest Individual or Family plan, please call the number on the back of your ID card if you have concerns about your coverage or your premium payment.

I’m a member of Health Alliance on an Individual plan. Is any help offered if I can’t pay my premium this month?

For members who purchased their plans on the Federally Facilitated Marketplace AND receive an Advanced Premium Tax Credit to help pay premiums:
Following recent flexibility offered by the Federally Facilitated Marketplace (FFM), Health Alliance will provide an additional month of coverage, prior to placing them in grace, for our members who receive Advanced Premium Tax Credits (APTC) through the FFM and who have premiums due between (and including the dates of) March 1 and May 1, 2020. Normal grace period rules will apply once they enter the grace period, and their coverage will terminate back to the end of the first month of their grace period if they fail to pay. Health Alliance cannot reinstate these members’ coverage after termination, similar to those members whose grace period has expired earlier in 2020. Please note that this temporary policy only applies to those who receive the APTC subsidy, and to premiums due between (and including the dates of) March 1 and May 1, 2020.

To all of our valued members, if you have any questions or concerns about your coverage or your premium payments, please do not hesitate to call the number on the back of your member ID card.

I’m a member of Health Alliance Northwest on a fully-insured Individual plan. Can I have an extension on paying my premium?

Health Alliance Northwest will temporarily extend the grace period from 31 to 60 days for fully-insured Individual members in Washington State who have premiums between (and including the dates of) March 1 and May 1, 2020.

Assist America®

Will Assist America commit to transporting a member home if he or she is found to be infected with the virus overseas?

Assist America cannot commit to transporting a member infected with the coronavirus, as this decision may be outside of the company’s control. Currently, each case will be assessed on a case-by-case basis. Additionally, Assist America must follow all local government regulations pertaining to the situations existing in each country.

How Can I Help?

Are there specific ways to help my community during the COVID-19 situation?

Yes. There are many ways you can help address the COVID-19 situation, including staying home to prevent the virus’ spread, making donations to various health organizations and keeping yourself informed of the latest recommendations coming from public health officials. If you’re healthy, you can also donate blood.

Champaign and Vermilion County residents in Illinois can also make and donate non-clinical masks to Carle health system. To be clear, at this time Carle has a sufficient supply of surgical masks and other personal protective equipment (PPE) for their clinicians and patients. However, your home-sewn masks will help prevent the general spread of germs to those outside of patient care and will ensure that the more-limited supply of surgical masks can remain directed to Carle’s clinicians and patients in need. For information on how to make the masks and where to send them, visit this link.
Please note that other providers in our network may also accept home-sewn masks. Please check their websites for more information.

Frequently Asked Questions

How the Virus Spreads

Prevention

Treatment

Coverage

Assist America®