e-Alert – Coronavirus Update for Tufts Health Plan Commercial and Direct Members

Background

Tufts Health Plan is committed to providing their members with accurate, reliable information about access to health care services in response to the COVID-19, also known as the Coronavirus outbreak.

Summary

Waiving Member Costs for Coronavirus Testing and Related Telemedicine
Effectively immediately and until further directed, and in accordance with guidance from our state regulators and the CDC, Tufts Health Plan will provide Tufts Health Plan Commercial and Direct Members with access to the following:

• No out of pocket costs for medically necessary Coronavirus testing, counseling and vaccinations. This coverage applies at in-network providers, urgent care centers, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.
• No copayments for medically necessary Coronavirus treatment. This coverage applies at in-network providers, urgent care center, emergency rooms and other facilities, and at out of network providers in the event a member cannot easily find an in-network provider to provide timely services.

This will also be applicable to members of their self-funded groups that have not opted out.

Telehealth Can Help Members Avoid Contact with the Coronavirus in Medical Offices
People who are experiencing mild symptoms should contact their health care provider before going to a health care facility.

• Many providers offer telehealth services. Ask your primary care provider if they do. All out of- pocket costs for telehealth visits related to Coronavirus will be waived for the duration of this COVID-19 situation for Commercial members. Telehealth enables members to make inquiries regarding symptoms or treatment for the Coronavirus in order to reduce the need for members to go to medical offices where the risk of coming in contact with the Coronavirus may be higher. This will also apply to members of our self-funded groups that have not opted-out.
• Tufts Health Plan Commercial members (not including Direct) can also use our telehealth solution powered by Teladoc*. With telehealth from Teladoc, members can access U.S.- based, board-certified providers for general medical needs and diagnoses from anywhere in the world and for plans issued or renewed in 2020 at $0 copay. Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about Coronavirus. For the duration of this crisis, there will be no member cost for this service to our employer-sponsored groups, including self-funded groups that have this benefit and have not opted out.
• Tufts Health Plan also offers access to our Nurse 24 telephonic service to all Tufts Health Plan Commercial and Direct members at no cost, through which you can speak to a registered nurse 24/7 to receive medical advice on appropriate care. Tufts Health Plan Commercial members should call 866.201.7919; Direct members should call 888.697.6546.

What should you do if you think you have been exposed to the virus?
People with COVID-19 or with other experiencing other symptoms should stay home and follow all quarantine procedures provided here by the Tufts Health Plan. Anyone who has been in close contact is advised to stay home. If your symptoms worsen, please contact your health care provider, urgent care or the emergency room.

Prescription Refills
Tufts Health Plan is permitting members a one-time refill of their prescriptions prior to the expiration date in order to have an adequate supply of medication should they need it.

Tufts Health Plan is also waiving the refill limitation fee, for one 30 day prescription of a maintenance medication to a 90-day duration.

If a member has multiple maintenance medications, each drug will only be waived once.

Contacting Member Services
If you have any questions or concerns about the Coronavirus, please call (866)201-7919 (Massachusetts Commercial members) or (888)697-6546 (Direct members) to speak to a registered nurse.

Where can Individuals find additional information and updates about Coronavirus?
To find out more information, please visit the CDC website at www.cdc.gov and click on “Coronavirus Disease 2019.”

Other important sources of information are listed below:

The Massachusetts Department of Health
The Rhode Island Department of Public Health
The New Hampshire Department of Health and Human Services

Tufts Health Plan has a policy is in place, in case the company needs to close down due a pandemic.

Employers Next Steps

• HR Knowledge encourages all employers to stay informed by visiting the CDC website.
• If you are a Full-Service or Virtual HR client and have any questions at this time, please email us.

The People Simplifying HR

For almost twenty years, HR Knowledge has made it our mission to demystify the complex and daunting process of HR management. We do more than just provide the level of service and technology you’d expect from an industry leader.

We combine an unparalleled passion for service with our decades of HR, payroll, and benefits experience to provide our clients with personalized and actionable advice that is second—to—none.

From managed payroll to employee benefits to HR support, we can help your organization thrive, grow, and reduce operating costs — no matter what industry you serve. Whether you’re interested in our Full-Service solution or just need your employee handbook written, HR Knowledge can help you minimize risk while staying on top of compliance regulations.

The bottom line? We’re not just another cloud-based technology company that also does HR, #WeAreHR.

This content is provided with the understanding that HR Knowledge is not rendering legal advice. While every effort is made to provide current information, the law changes regularly and laws may vary depending on the state or municipality. The material is made available for informational purposes only and is not a substitute for legal advice or your professional judgment. You should review applicable laws in your jurisdiction and consult experienced counsel for legal advice. If you have any questions regarding this content, please contact HR Knowledge at 508.339.1300 or email us.