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Coronavirus (COVID-19)

Last updated: September 29, 2020

It’s normal to have questions about Coronavirus (COVID-19) and protecting yourself and the people you care about. After all, there’s a lot of information out there right now. This page will have the latest updates about your benefits and resources to help you stay healthy, so check back often. 

The Centers for Disease Control and Prevention (CDC) is asking everyone to help reduce the risk of spreading the infection. Check the CDC website for up-to-date information.
 

 

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FAQs

Is Simply Healthcare Plans covering my costs related to COVID-19?

Yes, for Medicare Advantage members we are waiving any cost-sharing for:
 

  • the treatment of COVID-19 from April 1 through December 31, 2020.
     
  • COVID-19 diagnostic tests.
     
  • visits to get the COVID-19 diagnostic test, regardless of where the test is administered.
     
  • virtual care from other providers until December 31, 2020. (We always cover LiveHealth Online visits for Medicare Advantage members.)
     

Will Simply Healthcare Plans waive cost-shares for COVID-19 treatments delivered by out-of-network providers?

Yes, we will waive cost shares for out-of-network providers but we will reimburse out-of-network providers at in-network rates or Medicare rates, as applicable.

What is COVID-19?

An airway and lung infection, similar to a cold or the flu. COVID-19 is a disease caused by a novel coronavirus that hasn’t been seen in humans before. 

What are the symptoms?

Similar to a cold or the flu. Mild to severe fever, cough and shortness of breath. Symptoms may appear 2-14 days after being exposed to the virus.

How can I help protect myself?

The best way to prevent infection is to avoid being exposed to the virus. Check the CDC website for up-to-date information.

Good health habits can also help prevent and fight COVID-19. Here are some tips:

  • Washing your hands is the best way to avoid getting sick:
     
    • Wash often with soap and water for at least 20 seconds.
       
    • If you can’t use soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol.
       
  • Clean and disinfect items and surfaces you touch often with regular household cleaning spray or a wipe.

  • Cover your cough or sneeze with a tissue, and throw away the tissue.

  • Stay home when you are sick.

  • Avoid touching your face.

  • Avoid close contact with people who are sick.

Are certain people at greater risk than others for getting COVID-19?

Older adults, people with disabilities, and people with diabetes or who have severe chronic medical conditions like heart, lung or kidney disease seem to be at higher risk for more serious COVID-19 illness. We will support you and help you get the care you need.

What can I do to protect someone I am caring for?

If you’re caring for someone who does not have COVID-19:

Take steps to avoid causing any extra risk to you or them.

  • Stay home if possible.
  • Keep hand sanitizer nearby or wash your hands when you come into their house or room.
  • Wash your hands thoroughly and use hand sanitizer before and after touching or feeding someone, or touching any mobility devices or equipment.
  • Every day, wipe down the surfaces of mobility devices, like a cane or walker or other frequently used equipment, with household cleaner.
  • Check the CDC website or call their doctor to find out if the person you care for is at a higher risk of getting COVID-19. If so, find out what steps you can take to minimize their risk.

If you’re caring for someone who has COVID-19:

  • Many people who have COVID-19 can recover at home, but it is important to keep an eye on them.
  • Keep their doctor’s contact information where you can find it easily.
  • If their symptoms get worse, call their doctor.
  • If they have any emergency warning signs like trouble breathing, pain or pressure in the chest that won’t go away, confusion, a bluish color in the lips or face or you can’t wake them up, call 911 right away. Make sure you tell the dispatcher they have COVID-19 or if they have symptoms of it.

How to stop the spread while caring for someone with COVID-19:

  • As always, wash your hands often with soap and water, especially after being around them. If you can’t use soap and water, use hand sanitizer.
  • If possible, have the person who is sick stay in a separate room and have them use a separate bathroom, away from you and anyone else in the house.
  • Make sure you both wear a cloth covering, like a mask, which covers the nose, mouth and chin when you’re in the same room. That includes in the car if they have to go to the doctor and while at the doctor’s office.
  • If they can’t wear a cloth face covering, make sure to wear one when you’re around them. Wear gloves if you have them.
  • Clean surfaces you touch often every day. That includes things like countertops, doorknobs, light switches, faucets and more.

Check the CDC website for more information.

Do I need to wear a facemask?

It’s best to follow the CDC’s recommendations for using a facemask. CDC information for household members and caregivers can be found here.

What if I have symptoms? Should I see my doctor?

Call your doctor right away if you’ve been around someone who has or may have COVID-19 and you have a fever, cough or hard time breathing. Before visiting your doctor, we suggest that you call ahead. This will help the doctor’s office take steps to keep other people from getting infected or exposed. 

What is telehealth, and should I use it?

Telehealth is live video chatting with a doctor. Using telehealth, like LiveHealth Online, can keep you from getting the virus from others at an emergency room or doctor’s office. It can also help keep you from spreading the virus to others.

If you are a Medicare Advantage member, you may also consider these options if you are concerned about your health:
 

  • Medicare Advantage members can talk with a doctor over phone or via video chat at no cost, using LiveHealth Online. In addition, we are waiving cost shares between March 17 and December 30, 2020 for telehealth visits from other providers.
     
  • Telehealth can also be used for behavioral health visits and physical, occupational and speech therapies, when no equipment and/or direct physical hands-on interaction is needed.
     
  • A Coronavirus Assessment is available on the Sydney Care mobile app, which you can download at no cost. The Coronavirus Assessment is designed based on guidelines from the Centers for Disease Control and Prevention and National Institutes of Health. It may help you quickly and safely evaluate your symptoms and assess your risk of having COVID-19. Sydney Care is available to download now on Android or iOS. 
Google Play - Download Sydney Care App Apple iTunes - Download Sydney Care App  
  • If your plan includes the 24-Hour Nurse HelpLine you can call 24 hours a day, 7 days a week at the number on your member ID card. This is also at no cost to you.

What if I need to see a doctor who is not in my plan?

You should try to see doctors in your plan. If your doctor offers telehealth visits, your plan will pay for those, too. We will pay for care you get from doctors outside your plan (called “out of network”) as long as the services are medically needed.

Do I have to get preapproval (prior authorization) for a COVID-19 test?

No, prior authorization is not required for COVID-19 testing.

Are there limits to the care or services I can get during an epidemic?

No. If you have a Medicare Advantage or Medicaid from us, your plan covers sick visits and tests.

I’m worried about running out of my medication. What can I do?

Does your plan with us include prescription drug coverage?

We are relaxing early prescription refill limits for members who wish to receive a 30-day supply of most maintenance medications, where permissible. Members filling 90-day prescriptions can obtain their medications through our home delivery pharmacy and, in some circumstances, select retail pharmacies. Call the Pharmacy Member Services number on your ID card to find out about your coverage options, including whether you can get 90-day supplies.

Your health is important. Don’t stop taking your medicines as prescribed, and get your refills on time.

 

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