COVID-19 Information | Ambetter from Arkansas Health & Wellness


What You Need to Know About Coronavirus



COVID-19 is a respiratory illness that is caused by a new virus called a coronavirus, which has become a public health emergency. Coronavirus illness 2019 (COVID-19) is an emerging illness. 

 

Your Ambetter Plan will cover the cost of medically necessary COVID-19 tests and the associated physician's visit


No prior authorization is required for these services

About Coronavirus

COVID-19 is a respiratory illness that is caused by a new virus called a coronavirus, which has become a public health emergency. Coronavirus illness 2019 (COVID-19) is an emerging illness. Many details about this disease are still unknown, such as treatment options, how the virus works, the total impact of the illness, and many other factors.  However, there are steps you can take to prevent the spread of coronavirus and stay healthy.

The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. COVID-19 can be contagious before a person begins showing symptoms.

Influenza (the flu), a contagious respiratory illness caused by the influenza viruses (Type A and Type B), has high activity in the United States at this time. Everyone 6 months of age and older should get a flu vaccine.

Prevention and Screening

We all have a role to play in protecting our communities and families from the spread of coronavirus. There are steps you can take to prevent the spread of coronavirus and stay healthy. If you have been exposed or begin showing symptoms of the coronavirus or flu, contact your healthcare provider or health department immediately.

Protect yourself and your community.

We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:

  • Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizing rub (must contain at least 60 percent alcohol).
  • Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
  • Promptly dispose of tissues in a wastebasket after use.
  • Clean public surfaces thoroughly.
  • Stay home when you are sick.
  • Avoid shaking hands.
  • Avoid close contact with people who are sick.
  • Get a flu vaccine.

If you are unsure if you have been exposed to or at-risk of being infected with COVID-19 (coronavirus), scheduling a virtual care visit with a provider is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. Due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times.

Medically necessary COVID-19 diagnostic testing and/or medical screening services and the associated physician’s visit will be covered when ordered, referred and/or performed in the following In-Network locations:

  • Physician’s/Practitioner’s Office
  • Independent Laboratory/Diagnostic Facility   
  • Urgent Care Facility
  • Emergency Department Facility

If you have been exposed or are showing symptoms of the coronavirus or flu, contact your healthcare provider or health department immediately. I would be happy to help you locate an in-network provider.

If you are unsure if you have been exposed to or at-risk of being infected with COVID-19 (coronavirus), scheduling a virtual care visit with a provider is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility.  However, due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times.

Yes, Ambetter members will be able to refill prescriptions prior to the refill date.

Yes, your plan utilizes Teladoc to provide telehealth services. All telehealth consults are now screened for COVID-19 symptoms and risk factors. Teladoc providers will evaluate your symptoms and contact history to assess your COVID-19 risk, and then help guide you through the next steps for care and testing, if needed. We are also encouraging members use telehealth visits for non-urgent health issues. If you haven’t used Teladoc before, you can visit their website or download the mobile App to get started. You can download the Teladoc app on the App Store or Google Play.

In addition to Teladoc, you may also be able to set up a telehealth consultation directly with your primary care provider. You can reach out to your primary care provider or their office to see what kind of virtual care options are available to you.  We are temporarily waiving prior authorization for in-network telehealth services. 

We encourage our members to use telehealth visits for non-urgent health issues or if you need to speak to a provider about your COVID-19 risk. However, due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times. Ambetter is committed to ensuring you have access to quality, affordable healthcare during this time, and are working closely with Teladoc to make sure members have access to virtual care when they need it.

To receive the fastest support, you can contact Teladoc by mobile App or through the web to request a virtual visit. You will also be able to see a wait time estimator to help you to anticipate when a provider will call you back. You can download the Teladoc app on the App Store or Google Play. You can also call Teladoc to request a virtual visit. If there is a wait, you can request a callback from a service representative to request a visit, so you don’t need to stay on hold.

If you haven’t used Teladoc before, you can set up an account and share your medical history before requesting a visit to make the process go quicker. You can set up your account on the Teladoc app or on their account set up page. If you need assistance setting up your account, you can call Teladoc for help.

Ambetter is working closely with Teladoc to ensure that there is enough provider capacity to address the high demand for virtual visits at this time. As the demand for virtual visits increases, Teladoc is continually working to make more providers available to meet the needs of our members. You may also be able to set up a telehealth consultation directly with your primary care provider. You can reach out to your primary care provider or their office to see what kind of virtual care options are available to you.

We encourage members to call the Nurse Advice Line with questions about symptoms of illness or other health-related issues. Registered nurses are available through the Nurse Advice Line 24 hours a day, 7 days a week, 365 days a year. However, due to a high demand at this time, please anticipate that there may be longer than usual wait times when you call the Nurse Advice Line. As a reminder, the Nurse Advice Line cannot answer general member services questions, providing plan benefits or making provider referrals, including questions related to COVID-19 coverage and benefits.  [For Ambetter members, you can find information on COVID-19 coverage and benefits on our dedicated coronavirus website: https://www.ambetterhealth.com/coronavirus.html.

Insurance & Costs

Ambetter is committed to the health of our members. Your Ambetter plan will cover the cost of medically necessary COVID-19 tests and the associated physician's visit. We do not require prior authorization for these services.

Yes. When medically necessary diagnostic testing or medical screening services are ordered and/or referred by a licensed health care provider, your Ambetter plan will cover the cost of medically necessary COVID-19 tests and the associated physician’s visit. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services.

No, our Ambetter plans will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing and medical screening services, when medically necessary services are ordered and/or referred by a licensed health care provider.

No, your Ambetter plan will cover medically necessary COVID-19 diagnostic testing and/or medical screening services at no charge to you, when such services are ordered and/or referred by a licensed health care provider. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services along with the associated physician’s visit.

Any medically necessary treatment related to COVID-19 would be considered a covered benefit, consistent with benefit coverage provisions of your policy for treatment of an illness. General plan cost-sharing requirements will apply for medically necessary treatment related services. We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law. 

Additional Information

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.

  • Take care of your body. Take deep breaths, stretch or meditate.
  • Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking.
  • Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
  • For more information, see the CDC’s suggestions for mental health and coping during COVID-19

 


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