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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.

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 24/7) or e-mail epiresource@isdh.in.gov.
  • 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. You can also email the Department of Public Health by using this site.
  • 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?

Symptoms include mild to severe respiratory illness with:

  • Fever
  • Cough
  • Trouble breathing or shortness of breath

Read more about the symptoms and complications 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 does not recommend the use of facemasks for people who are well and who are not in contact with sick individuals.

Facemasks should be worn by people who show symptoms of COVID-19, as well as by healthcare workers and others who are taking care of individuals who show symptoms of COVID-19 or other respiratory illnesses.

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.

Treatment

What is the recommended treatment for those with the virus?

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. 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 its members. Please see your member policy or contact the number on the back of your ID card for additional details specific to your policy’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.  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 differ from the text contained in this website, the official printed documents take precedence.

This coverage FAQ list is based upon the latest information from the Illinois Department of Insurance, issued on March 3, 2020.

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

For those with fully-insured policies:
At this time, the Centers for Disease Control and Prevention (CDC) continues to pay for the laboratory tests. For all group and individual fully-insured plans in all states, our Federal Employees Health Benefits (FEHB) Plan and all Medicare Advantage Plans, Health Alliance will cover, with no member cost share, the appropriate medically necessary diagnostic laboratory testing for COVID-19, where it is not covered as part of the Public Health Service response. We are also waiving cost sharing for COVID-19 testing related visits during this same time, whether the testing related visit is received in a healthcare provider’s office, an urgent care center, an emergency department or through telehealth. Call the number on the back of your member ID card if you have any questions about your coverage.

For those with self-funded employer group health plans:
Self-funded group health plans are required to provide benefits to pay for the test and testing related visits. Call the number on the back of your member ID card if you have questions about coverage.

*General note: At this time, the CDC continues to pay for the test. This might change in the future, however.

**Even though the CDC has broadened the COVID-19 testing criteria, many communities lack resources to complete the testing. Until commercial testing becomes more readily available, healthcare facilities may not be offering the testing or may prioritize testing of symptomatic patients or those considered most at risk.

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

Yes. As of March 17, 2020, the CDC continues to pay for the test. If this changes, your Health Alliance Northwest plan (or Health Alliance Northwest-administered plan) will cover all medically necessary diagnostic laboratory testing for COVID-19 with no member cost share. This will continue until at least May 4, 2020, consistent with guidance from the Washington Office of the Insurance Commissioner and the Washington Healthcare Authority. We are also waiving cost sharing for COVID-19 testing related visits during this same time, whether the testing related visit is received in a healthcare provider’s office, an urgent care center, an emergency department or through telehealth. Call the number on the back of your member ID card with any questions or for more details on coverage.

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 insurance cover 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.

There is currently no specific antiviral treatment for COVID-19. Individuals may receive care to help relieve symptoms as they would for other viral respiratory infections. 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 May 4, 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 insurance health plan cover 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 benefit.

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 May 4, 2020. Call the number on the back of your member ID card if you have any questions. Note: custodial care is not a covered benefit.

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.

Does my insurance cover any types 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. In addition to what is normally provided, Health Alliance is temporarily broadening our telehealth codes to cover additional services, including behavioral therapy, in response to the COVID-19 pandemic. 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. If you have specific questions about the types of telehealth services we will now temporarily cover, or any questions about possible cost sharing or in-network restrictions that might apply, call the number on the back of your member ID card.

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 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 March 1 and April 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. The extension is only applicable to fully insured Small Group Employer plans who have premiums due March 1 and April 1, 2020.

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

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 March 1 and April 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 March 1 and April 1, 2020.

For members on Individual plans who do NOT receive the Advanced Premium Tax Credit subsidy:
Individual members who do not receive Advanced Premium Tax Credit (APTC) subsidies will continue to benefit from a 31-day grace period and can have their coverage reinstated one time per plan year, at the member’s option following payment in full. This applies both to members who purchased their Individual plans through the Federally Facilitated Marketplace (but do not receive an APTC subsidy) and to those who purchased plans directly from Health Alliance.

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 due March 1 and April 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, and home-sewn masks do not prevent COVID-19. 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 masks that do prevent the spread of COVID-19 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®