In response to the Office of the Insurance Commissioner's emergency order regarding the outbreak of the coronavirus disease 2019 (COVID-19) in the United States and in Washington state, all fully-insured health carriers are ordered to provide certain coverage related to COVID-19. This order does not apply to self-insured plans, which the AWC Trust plans are. However, the AWC Trust has worked with Regence BlueShield, Asuris Northwest Health, and Kaiser Permanente to follow the guidance and requirements of this order.
COVID-19 and AWC Trust medical plan coverage
For all AWC Trust Kaiser Permanente plans, the following will apply:
• Cost sharing (deductibles, copayments, and coinsurance) will be reduced to zero dollars ($0.00) for medically necessary screening and testing for COVID-19. The cost sharing reduction will apply to all Kaiser Permanente and other plan (participating) providers. Plan coverage provisions apply for all other services.
• Early prescription refills will be allowed in Washington and Oregon. Unless there is a clinical concern, early refill requests for non-controlled substances will be allowed when the patient has a current supply of 30 days or less.
• Kaiser provides many ways to get care without leaving your home, including phone appointments and email.
• Additional information can be found on their website which is being updated regularly.
For all AWC Trust Regence BlueShield/Asuris Northwest Health plans, the following will apply:
• Cost sharing (deductibles, copayments, and coinsurance) will be reduced to zero dollars ($0.00) for medically necessary screening and testing for COVID-19. The cost sharing reduction applies to in-network and out-of-network COVID-19 testing and visits associated with the testing. Plan coverage provisions apply for all other services.
• Early prescription refills are allowed, except for opioid medications. For certain medications that treat chronic conditions, members may request a 90-day refill.
• Case managers are making proactive outreach to high-risk members.
• MDLive will continue to have a $10 copay on all plans except the High Deductible Health Plan (HDHP) where members pay $42 until their deductible is met, after which coverage is at 100%.
• Additional information can be found on the Regence website which is being updated regularly.
A special note about HDHP's and expenses related to COVID-19
The Internal Revenue Service, responding to the COVID-19 public health emergency, has approved payment of medical expenses by high deductible health plans for COVID-19 testing and treatment without regard to satisfaction of the HDHP deductible. This is outlined in IRS Notice 2020-15. The AWC Trust has implemented this guidance into our Regence/Asuris and Kaiser HDHP's, meaning that screening and testing for COVID-19 will not be subject to deductible or other cost sharing on the HDHP's, just like all other Trust medical plans.
Access to COVID-19 testing
There is a high level of public interest in COVID-19 testing. Below is some basic information that may be helpful for you and your employees:
• Only patients who have a doctor's order based on medical necessity for testing will be tested.
• Testing is not available to the public on an elective basis, unless the patient has exhibited specific symptoms and a doctor has prescribed the test.
• The number of available tests is currently limited, thus the CDC is encouraging physicians to minimize unnecessary testing and consider a patient's exposure risks before ordering tests.
• If a provider believes testing is needed, there is no pre-authorization required.
• Prior to February 29, the CDC was the only place approved by the FDA to develop, produce, and process tests, however more testing sites are becoming available each day.
• Test results generally take 24–72 hours.
• A COVID-19 billing code (U0002) has been announced which allows laboratories to bill for non-CDC laboratory tests.
• ComPsych Employee Assistance Program Coronavirus resources – includes information on how your EAP can help during these stressful times. Call 1-800-570-9315 to access counseling services, financial assistance, legal assistance, and work-life assistance.
• ComPsych is providing the following webinars:
o Coping with uncertainty about the Coronavirus (March 17, 8–9 am) or watch the recorded webinar
o Navigating your work from home transition due to the Coronavirus (March 19, 2–3 pm)
• Centers for Disease Control and Prevention – includes what you need to know; resources for the community and latest updates
Washington State Department of Health – includes information on systems and testing, resources and recommendations