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Guide to COVID-19 Coverage

HPI is monitoring the coronavirus (COVID-19) outbreak and what it means for our members, clients, business partners and communities.

The Centers for Disease Control and Prevention (CDC) website is the best source for up-to-date information. The outbreak is evolving quickly, and the CDC and health departments in each state are working on public health policies to help prevent the spread of the illness.

Stay safe. If you need to see a doctor, call first. Many providers that you have always seen in person are now offering appointments over the phone. If your doctor or urgent care facility doesn’t offer phone or video visits, you have access to telemedicine through other providers.

Try the CDC’s symptom checker to help you make decisions about seeking appropriate care.

HPI has implemented the following coverage for medically necessary COVID-19-related services at in-network doctor’s offices, urgent care centers, telemedicine providers or emergency rooms:

  • Testing*: covered in full, no member cost-sharing
  • Treatment: covered in accordance with member's plan and applicable member cost-sharing
  • Telehealth services: covered in full, no member cost-sharing
  • Prior authorizations: not required for COVID-19 testing
  • Vaccine**: covered in full, no member cost-sharing

*Cost-sharing for testing received from out-of-network providers also will be waived should the urgent services be unavailable from in-network providers.

**A vaccine will be covered after it has received an A or B recommendation from the United States Preventive Services Task Force (USPSTF) or a recommendation from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention.

HPI will continue to review coverage and cost-sharing policies to ensure that members can receive the appropriate COVID-19 testing and treatment without difficulties.

 

HPI Case Management is here to help

Assistance is available to eligible members who are having difficulty managing their current medical needs during this pandemic. Case Managers can help to obtain currently approved medications, medical equipment or accessing and coordinating needed medical care. Please contact your case manager directly or send an email to casemanagement@healthplansinc.com. Please include your name, contact information and best day/time, and our case manager will attempt to contact you.

If you have health concerns, check in with your health care provider to see if they offer virtual visits from home (via smartphone, tablet or computer). If your provider doesn't offer virtual visits, providers such as Doctor On Demand are covered under all plans. Members can also receive outpatient behavioral health care through virtual visits.

PDF icon Download instructions for registering for Doctor On Demand

Telehealth visits may help limit the spread of the disease and provide crucial behavioral health care to those in need. It may also be an option for individuals in self-imposed quarantine to check in with a health care provider.

HPI is taking steps to ensure all plans provide coverage for telehealth services as follows:

  • All plans, including Qualified High Deductible Health Plans (QHDHPs), will cover COVID-19-related testing, treatment and counseling via telemedicine providers with no member cost-share.
  • All plans, excluding QHDHPs, will cover all other services received via telehealth providers with no member cost-share*.
  • All QHDHPs will continue to cover non-COVID-19 related telehealth services with applicable member cost-sharing, as the IRS has not changed the regulations governing these plans to date.

*This may vary by client. Please refer to the client’s Plan Document to confirm how these services are covered.

United Behavioral Health/Optum offers a Public Crisis Line for those needing emotional support. Open 24/7, this help line is free of charge and available to anyone.
Call (866) 342-6892

SAMHSA’s Disaster Distress Helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters, and infectious disease outbreaks.
Call (800) 985-5990

Living Well at Home with Virtual Wellness Classes

Well-being programs here for you when you need them the most.

Whether you are looking to shake it up, stretch it out, or get centered, we’ve got you covered with Zumba®, yoga, guided mindfulness, and wellness sessions. All are available at no cost to you and will be easy to access via Zoom.

Note: You will be able to access these webinars immediately if you have Zoom downloaded on your device. If you have not downloaded Zoom, the links will take you to Zoom’s home page to download the tool. Once you’ve downloaded and launched Zoom on your device, you will be prompted to enter your name and email in order to join the webinar, but you are not required to enter your real name or email. Please know that HPI is not responsible for the availability, privacy or security of the Zoom platform. We recommend that you use caution when sharing any personal or identifying information with online meeting applications, including any interactive features.

 

Strength Classes

These live classes involve full body workouts that can help you increase strength, mobility and flexibility. Try something new or enjoy a form of exercise you already love.

Stretches for Running - October 7, 2021, 1-1:30 p.m. ET
Even a slight jog is a workout for your muscles, and stretching keeps the muscles in the body flexible. Learn the best way to warm up and stretch before and after your run to help you avoid injury and improve performance.
» To access these sessions, visit https://us02web.zoom.us/j/88213176780

Resilience Boosters - October 14, 2021, 1-1:30 p.m. ET
What is resilience, and how can we cultivate it during this time of uncertainty and upheaval? In this session, you will learn evidence-based strategies to cope with the crisis at hand, relieve stress, practice self-care and develop habits that promote optimal well-being and strengthen your resiliency!
» To access these sessions, visit https://us02web.zoom.us/j/88213176780

Nutrition for Running - October 21, 2021, 1-1:30 p.m. ET
Eating a good diet can help provide the energy you need to finish a race or just enjoy a casual run. You’re more likely to be tired and perform poorly during a run when you don’t get enough:

  • Calories
  • Carbohydrates
  • Fluids
  • Iron, vitamins and other minerals
  • Protein

Learn how to meet your nutritional needs to enhance your performance.
» To access these sessions, visit https://us02web.zoom.us/j/88213176780

Tips on “Running the Right Way” … It’s Not Just About Jogging - October 28, 2021, 1-1:30 p.m. ET
In this webinar, we’ll explore the best approaches to running to accomplish any fitness goal and how to make the most of your valuable time.
» To access these sessions, visit https://us02web.zoom.us/j/88213176780

 

Yoga Classes

Yoga – Mondays and Wednesdays at 5:15pm to 6:15pm (ET)
Breathe in, breathe out and stretch it out with a relaxing yoga practice. These live yoga sessions are accessible to all fitness levels and are the perfect way to whine down after a long day.
» To access these sessions, visit https://zoom.us/j/528276681

 

Zumba® Classes

Zumba® – Tuesdays and Thursdays at 5:15pm to 6:15pm (ET)
Dance like nobody’s watching! Our Zumba® classes will be the most fun you’ve ever had working out. Enjoy upbeat music and moves anyone can try!
» To access these sessions, visit https://zoom.us/j/959837402

 

Cardio Dance

Join in for 30 minutes of cardio dance! There are high- and low-impact options, and movements are easy to follow along with. Music will feature hip hop and Top-40 hits! This class will leave you sweating and smiling!

September 23, 2021, 1-1:30 p.m. ET

September 30, 2021, 1-1:30 p.m. ET

» To access these sessions, visit https://us02web.zoom.us/j/88213176780

 

Guided Mindfulness Sessions

Mind the Moment – Tuesdays and Thursdays from 8:30am to 9:00am (ET) 
Mindfulness can help us feel connected and get centered. Experiment with short bursts of mindfulness instruction, followed by mini meditations, led by a team of expert instructors.

Tuesdays from 8:30 to 9 a.m. ET
» To access these sessions, visit https://zoom.us/j/946535238

Thursdays from 8:30 to 9 a.m. ET
» To access these sessions, visit https://zoom.us/j/580279161

Access past mindfulness sessions at any time by visiting the Mind the Moment YouTube Channel.

  

Health and Wellness Webinars

This series of classes takes a holistic look at health to help you stay physically and mentally resilient.

An Apple a Day … A Delicious Way to Keep the Doctor Away - September 22, 2021, 1-1:30 p.m. ET
Learn about the health benefits of including apples in your diet as we prepare some delicious apple treats.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Calming Drinks - September 29, 2021, 1-1:30 p.m. ET
There are many healthy calming drink options to grab when your stress is high, and no, we’re not talking about the after-work glass of wine! In this session, we go over many different kinds of beverages that will help you slow down and feel less stressed.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Making Lasting Connections - October 6, 2021, 1-1:30 p.m. ET
Learn how to share yourself in a way that helps build solid relationships. This session will look at types of behaviors, communication styles and personality types to help guide you to creating better connections.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Managing Stress Eating and “Procrastineating” - October 13, 2021, 1-1:30 p.m. ET
Many of us feel worried, anxious and stressed, and one of the ways we cope with our stress is by eating, especially high-sugar, high-fat, processed food. While comforting in the short term, it’s unhealthy in the long term. This webinar will teach participants techniques and tips on how to manage stress eating as well as “procrastineating” (eating to procrastinate!). Don’t miss this informative, useful and fun session.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Forming Healthy Habits - October 20, 2021, 1-1:30 p.m. ET
We all know what we should be doing to be healthy, so why aren’t we doing it? In this session, you’ll learn how habits are created, tips and tools to create better habits, and daily habits that impact health and happiness.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Healthy Halloween Treats - October 27, 2021, 1-1:30 p.m. ET
Learn about the health benefits of pumpkin and how to use it to make delicious and healthy Halloween treats.
» To access these sessions, visit https://us02web.zoom.us/j/996948529

Access past health and wellness webinars at any time by visiting the well-being webinar playlist on YouTube.

The federal rule issued on May 4, 2020, entitled Extension of Certain Timeframes for Employee Benefit Plans, Participants and Beneficiaries Affected by the COVID-19 Outbreak, provides participants in certain employee benefit plans* additional time to:

  • Elect COBRA coverage
  • Make COBRA premium payments
  • Notify the Plan of second qualifying events under COBRA
  • File medical, dental, vision, Medical Care Reimbursement Account (MCRA )(aka health FSA), and disability claims for covered benefits/eligible expenses
  • Appeal denials of medical, dental, MCRA and disability claims
  • Make a Special Enrollment Request under HIPAA rules for medical or dental coverage

The deadlines for taking any of the actions described above that would ordinarily have been due on or after March 1, 2020, are extended to the earlier of the following dates:

  • One year from original due date shown in your Explanation of Benefits, COBRA Election Notice or response to your request for an appeal, or
  • At least 60 days after the end of the pandemic National Emergency, (the pandemic National Emergency was declared by the President to begin on March 1, 2020, and will continue until the current President ends it).

 

This message will be updated when the pandemic National Emergency has ended.

 

What’s not affected

The new rule does not apply to the deadlines related to:

  • Active employees initially enrolling in a plan
  • Change in status events, except a change in status that also qualifies under the HIPAA Special Enrollment rules (see your Plan Document for information about HIPAA Special Enrollment)

*Plans sponsored by government entities or churches are not required to extend these deadlines. If you are covered by a government or church-sponsored plan, please call the member service number on your Plan Identification Card to find out if the deadline extension applies to your plan.

*Medical, dental, vision and Medical Care Reimbursement Account plans only

Benefits and coverage questions:
Contact the phone number listed on the back of your Member ID Card, or call:

800-532-7575
Monday through Friday, 8am to 5pm (ET)

 

COVID-19 -specific questions:
877-213-5225
Monday through Friday, 8am to 5pm (ET)

If you are not feeling well, please contact your primary care provider to discuss active symptoms.

© 2021 Health Plans, Inc.

Health Plans, Inc. is a Harvard Pilgrim company

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