Medicare Member FAQ

We Answer Your COVID-19 Questions (5/22/2020)

BlueCross is here for you during this unusual time. It doesn’t feel good, but together we’ll get through this.

Our members are our priority, and we’re here to answer your questions. We’ve heard from many across Tennessee and across the country, and we’re sharing these topics to help all of our members.

If we haven’t answered one of your questions here, please sign in to your bcbst.com account and chat with us, or call the Member Service number on the back of your member ID card. We’re here for you.

 

Your Health Plan

Q. I’m concerned about going into a doctor’s office. Can I have an appointment on the phone or video chat instead?

Yes, if your provider offers this service. We’ll cover telehealth visits with providers in our networks who offer this service until at least June 30, 2020. This includes visits with your primary care physician, specialists, behavioral health providers, ABA providers, and physical, speech and occupational therapists. This visit will cost the same as a face-to-face visit with your provider, so any copay or cost-share you would normally have will still apply.

 

Q. How do I find a doctor who does telehealth?

We recommend calling your regular provider to see if they offer this service. Many are offering telehealth to help keep their patients at home as much as possible.

 

Q. Should I delay my ongoing care like wellness visits or behavioral health appointments?

No. These are important health appointments that you should still schedule. Your provider’s office may have different safety steps for you to take. To make it easier for you to get the care you need during this time, starting May 19, we’re waiving your out-of-pocket cost for primary care providers and behavioral health providers in our network through Sept. 30, 2020. This applies to both in-office and telehealth visits.

 

Q. Will my plan cover the COVID-19 test?

Yes. We’ll cover and waive member costs for the FDA-approved test, as well as those currently pending FDA approval, if your doctor recommends it. We’re also waiving member copays and deductibles for the visit to your provider, urgent care center or emergency room related to the test, as long as the provider is in your network. We’ll still cover the testing and visit if you see a provider out of your network, but they may bill you for the difference in their visit charge and our payment to them.

 

Q. Will my plan cover COVID-19 antibody tests?

We’ll cover FDA-approved COVID-19 antibody tests that a network provider orders during an appointment, including during a telehealth appointment. Many of the antibody tests marketed have proved ineffective, so we’ll cover just those the FDA has cleared, approved or given emergency use authorization for. If a network provider doesn’t order this test, you may have out-of-pocket costs.

 

Q. Will my plan cover COVID-19 at-home tests that diagnose a current infection?

We’ll cover at-home tests that diagnose a current infection if authorized by a licensed physician. Many at-home tests marketed have proved ineffective, so we’ll cover just those the FDA has cleared, approved or given emergency use authorization for. If you pay for a test up front without having approval from a licensed physician, you may have out-of-pocket costs.

 

Q. Will my plan cover other tests, like flu or strep, that my doctor does before a COVID-19 test?

Yes. We’ll cover testing for flu and strep under your usual benefit and cost-share. Many providers are performing these tests prior to COVID-19 testing.

 

Q. Once a COVID-19 vaccine is available, will my health plan cover it?

Yes. We’ll cover vaccines developed and approved to treat COVID-19 when they’re available. The cost for our members will be based on their plan.

 

Q. Will my health plan cover treatment of COVID-19?

Yes. If you’re diagnosed with COVID-19, we’ll cover any relevant provider treatment. We’ll also waive your costs for COVID-19 treatment at in-network facilities and with in-network providers through May 31, 2020. That means you won’t pay anything for treatment from providers in our network. This applies to our members in fully insured group, individual, Medicare and BlueCare Tennessee plans. If your employer pays your claims, also called a self-funded group, they’ve been extended the option to waive cost-sharing for their members. If you use a provider who’s not in our network, we’ll cover treatment under your usual benefits. That means those providers may bill you for the balance owed.

 

Q. My provider gave me a prescription and recommended over-the-counter drugs to help with my symptoms outside of the hospital. Will I still have my copay or cost-share for them?

Yes. If your provider gives you treatments in the hospital or while at their office, we’ll cover those at no cost to you. Any prescriptions or over-the-counter drugs your doctor recommends for at-home symptom treatment will have your normal copay or cost-share.

 

Q. Will I have to get a preauthorization for testing or treatment of COVID-19?

No. Providers have certain claims codes for testing and treatment related to COVID-19.

 

Q. Will my health plan cover medical supplies such as masks, gloves and disinfectant?

No. We don’t cover these supplies under your health plan.

 

Q. My plan includes PhysicianNow. Can I use it to get care while avoiding possible transmission from the doctor’s office?

Yes. We encourage you to use your PhysicianNow Powered by MDLive® telehealth benefit to stay home as much as possible. Many of our members who have this service can use it and not have a copay from now through at least June 30, for any of the conditions they normally help with. PhysicianNow currently has more demand than usual, so we recommend scheduling an appointment for a time that works best for you. They’ll call you back at your scheduled time for your appointment.

 

Q. Will you allow for early refills so I don’t have to make multiple trips to the pharmacy and risk exposure?

Yes. If your pharmacy benefits are covered through BlueCross, we’re allowing early refills on most medications, and we’re encouraging 90-day fills for chronic medications. Your plan may also have mail-order benefits if you don’t want to go out to a pharmacy to get your medications.

Some medications such as controlled substances and certain specialty drugs aren’t included in this.

 

Your Health

Q. I’m not sure which symptoms to look for. Where can I find them?

The CDC has a coronavirus self-checker on its website that helps you quickly understand which symptoms to watch out for and how to get help. The virus has a wide range of symptoms that include fever, cough, shortness of breath or trouble breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell.

 

Q. I’m experiencing COVID-19 symptoms and fear I’ve been exposed. What do I do?

The first step is to stay home and separate yourself from other people or animals as much as possible. That’ll help keep germs from spreading until you can get advice from a doctor.

Next, call your provider’s office and tell them your symptoms. If they think you need to be tested, they can give you instructions for where to go and what to do. That’ll help keep down the risk of others’ getting sick. If you don’t have a regular doctor, you can call your local health department.

 

Q. I’ve been exposed to someone with COVID-19 but don’t have any symptoms. What should I do?

Since you’re not having symptoms but you think you’ve been exposed, please stay home and call your doctor about next steps. If they think you need to be tested, they can give you instructions on where to go and what to do.

 

Q. I have COVID-19 symptoms but don’t know if I’ve been exposed. What should I do?

The first step is to stay home and separate yourself from other people or animals as much as possible. That’ll help keep germs from spreading until you can get advice from a doctor.

We recommend you call your provider’s office and tell them your symptoms. If they think you need to be tested, they can give you instructions on where to go and what to do. That’ll help keep down the risk of others’ getting sick. If you don’t have a regular doctor, you can call your local health department.

 

Q. Where can I get tested for COVID-19?

Right now, testing varies in every community. Some testing requires a physician referral. And some walk-up and drive-through testing sites don’t need a referral. It’s best to call your local health department to find out how to best access testing.

 

Q. Can I get tested, even if I don’t have symptoms, if I think I might have been exposed?

Your provider is your best source for advice on whether you should be tested. The Tennessee Department of Health, the Centers for Disease Control and Prevention, and the World Health Organization have recommendations on their websites; but they may change as more news becomes available.

 

Q. I had symptoms, but they’ve gone away. When is it safe to leave my isolation room at home?

A good rule to follow from the CDC is once your fever has been gone for 72 hours, your other symptoms have improved and it’s been a minimum of seven days since you started feeling sick. However, you’ll still want to isolate at home for at least two weeks.

 

Q. Now that shelter-at-home orders are lifting, is it OK for me to go for preventive appointments, dentist visits or eye exams?

Yes. Many providers are slowly reopening their practices to see our members in person. They’ll be following some safety social distancing guidelines, so be sure to call their office before your appointment to know what extra safety steps they’ll want you to follow when you get there. You also should take some personal safety measures, including wearing a cloth mask while in public and making sure you don’t have a fever or any signs of COVID-19 before going in person.

If you have health issues that put you at higher risk of COVID-19 complications or simply don’t feel comfortable going out in person, many providers are still offering telehealth appointments.

 

Protecting Yourself and Others

Q. What can I do to protect myself and family?

Social distancing is the best way to protect yourself. That means staying home other than for necessary groceries or medicine.

Wash your hands with soap and water frequently, especially if you’re out of your home. Hand sanitizer can help when soap and water are unavailable.

Clean all frequently touched surfaces in your home, car and workspace, if you’re still going in to work.

Cover your coughs and sneezes, and immediately throw away the used tissues.

If someone in your house is sick or has symptoms, have them self-isolate away from others in the house. Call their provider for instructions on what to do next.

 

COVID-19 and Fraud

Unfortunately, some people are using the threat of coronavirus to defraud others, especially our senior population.

Q. I’ve gotten a phone call asking for my BlueCross subscriber ID and bank account information for medicine to prevent or cure COVID-19. Is this a scam?

Yes. We will never call you to ask for your subscriber ID. Additionally, most financial companies will not ask you for your account numbers. The only way to potentially prevent coronavirus and COVID-19 is social distancing. There’s no medicine to prevent or cure it.

 

Q. Someone came to my door to sell testing and preventive medicine for coronavirus. Is this a scam?

Yes. This is a scammer trying to take advantage of people. Testing is done at approved sites with doctor’s orders, and there’s no medicine to prevent or cure the virus and illness currently.

 

Q. I got an email offering testing and a cure for COVID-19. Is this a scam?

Yes. This is a scam where someone is trying to take advantage of people. These emails could have links that download malware to infect your computer when clicked on. Please do not click on any links, respond to or forward these emails.

 

Q. I’ve seen ads for wellness products that say they can fight coronavirus. Are these a scam?

Yes. There are currently no treatments to prevent or cure coronavirus or COVID-19. Any wellness products you see advertised for these purposes are fraudulent.

 

Q. I’ve seen people selling at-home or self-test COVID-19 testing kits. Are these a scam?

Yes. The FDA has not approved any COVID-19 test that’s available for purchase for testing yourself at home. Only tests available at designated testing sites are approved for COVID-19 testing.

 

BlueCross Working for You

Q. Will BlueCross shut down with government requests for closures?

No. We’re considered essential, so we’ll remain open. However, we have taken steps in the last month to help keep our employees well while ensuring our members see no lapse in service. Weeks ago, we transitioned many of our customer service, claims and billing employees to work from home. Since March 16, 2020, the majority of our workforce has been working full time from their homes to allow them to practice social distancing. We’ve not experience any reduction in service to you, nor do we expect any.

 

Q. Have you done anything for people in the state who might not have BlueCross?

Yes. Our Foundation donated $3.25 million to food banks throughout Tennessee to help local organizations fight hunger. As this pandemic continues, more people are facing uncertainty about providing food for their families. This donation is our way of helping local organizations meet this need. These organizations can provide up to four meals for every dollar received.