Important Health Plan Benefit Updates from BCBS

March 17, 2020

Important health plan benefit updates regarding coronavirus (COVID-19) and virtual visit coverage

Last week, we communicated to our members and groups about benefit updates regarding coronavirus (COVID-19) and this week we have an important update.

Effective March 16, 2020, all Wellmark members will have access to virtual health care visits with no cost-share. To avoid the spread of COVID-19, we encourage our members to take advantage of virtual visits with their current primary care physician, if they have this capability. For those who don’t currently have a primary care physician, please use an in-network provider or Doctor on Demand^®. The cost-share for such visits, including those for mental health reasons, are waived for the next 90 days. At that time, we will reassess. This update applies to all fully-insured and self-funded plans.

The other updates we communicated previously still apply to Wellmark’s fully-insured members. Self-funded (employer- or other entity sponsored plans) may have some variation. Wellmark is currently working with our self-funded groups on how they wish to implement these or similar updates to their benefit plans with respect to COVID-19.

• Waiving prior authorization processes. Wellmark will waive prior authorization processes for covered services related to COVID-19 to ensure patients receive the right care at the right time and location.

• Covering diagnostic tests for COVID-19. Members will have no cost-share for appropriate testing to establish the diagnosis of COVID-19.

• Increasing access to prescription medications. Wellmark prescription drug benefit plans allow for early refill (up to 30 days of medication) and we encourage the use of your 90-day retail and mail order benefits for maintenance drugs. We also will ensure formulary flexibility if there are medication shortages or other access issues. Members will not be liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.

• 24/7 support. Members also have access to Wellmark’s BeWell 24/7^SM service that connects them to real people who can help with a variety of health-related concerns 24/7.

Wellmark Medicare Supplement members, should visit Medicare.gov to learn what is covered related to COVID-19 health care needs. As a supplemental carrier, Wellmark will continue to pay for out-of-pocket expenses related to Medicare covered services, such as deductibles, copays and coinsurance. Visit our prescription drug plan’s websites (YourMedicareSolutions.com/Covid-19 or JourneyRxMedicare.com/Covid-19) to see specific information about drug coverage related to coronavirus.

Frequently asked questions

1. Does Wellmark cover COVID-19 testing?

   Wellmark covers COVID-19 diagnostic tests. Members will not be responsible for the cost of appropriate diagnostic testing, meaning there will be no out-of-pocket costs, including no copays, no deductibles, and no coinsurance. We will also ensure patient testing and any subsequent testing needed are done in close coordination with federal, state and public health authorities.

2. Am I allowed to get my prescriptions early or receive a larger supply?

   Wellmark will waive early refill limits on 30-day prescription maintenance medications (consistent with members’ benefit plans). We also will ensure formulary flexibility if there are medication shortages or other access issues. Members will not be liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.

3. Does Wellmark cover any quarantine-related expenses?

   Wellmark does not cover quarantine-costs for COVID-19. However, medical-related expenses will be covered if needed during quarantine.

The most up-to-date information
Wellmark continues to use the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), Iowa Department of Public Health (IDPH), and South Dakota Health Department as our official sources of information. For the latest U.S. impacts of COVID-19, please see the data reported by the CDC.