Vaccine coverage. COVID-19 vaccines are an important step in slowing the spread of the virus. As vaccines are approved, your Group Health Plan will cover the cost of administering them with no cost share (such as co-pays, deductibles, coinsurance) for members as per their ACA Preventive Care benefit. View our COVID-19 FAQs for more details.
Vaccine approval. The vaccines are approved by the Food and Drug Administration (FDA) for Emergency Use Authorization, though widespread availability of a vaccine likely will not occur for months. Distribution of the vaccine is controlled by the federal government, and they collaborate with local and state governments and Departments of Health on distribution. Independence Administrators does not control the availability or distribution of any vaccines.
Wear a mask. COVID-19 cases are on the rise, locally and nationally. Public officials and health experts are urging us to use face coverings whenever we go out. The virus mainly spreads from droplets released into the air when we cough, sneeze, or talk. Whether you show signs of illness or not, masks prevent these droplets from reaching others and reduce their risk of getting sick.
Practice social distancing. Limit close contact with anyone outside of your household. Even if you’re wearing a mask, it’s still recommended you stay at least six feet from others when in public, or at least two arms’ length apart.
Wash your hands regularly. The virus can also spread from touching recently contaminated surfaces and then touching your face. Washing your hands with soap and water is one of the most importance defenses against the spread of COVID-19 and other illnesses. Keep hand sanitizer on you for when you don’t have access to soap and water.
Check your symptoms. If you think you’ve been exposed to COVID-19 and develop a fever, cough, or have trouble breathing, call your doctor. Visit the Centers for Disease Control and Prevention (CDC) for more details on symptoms.
Testing is covered. Your Group Health Plan will cover the cost for medically appropriate diagnostic and antibody testing in accordance with all federal mandates through June 30, 2021². First, contact your doctor or state health department. They will screen you based on CDC guidelines. Independence does not cover tests that are needed for return to work, return to school, for travel, or for visiting with relatives. Learn more about the differences between diagnostic and antibody tests in this infographic. Please review the terms of your health benefits plan for additional information.
Talk to a doctor from anywhere¹. Telemedicine services for a COVID-19 related diagnosis from your primary care doctor are covered at no cost through June 30, 2021². Telemedicine services from your doctor for a non-COVID diagnosis are available for same cost as an office visit, based on your health plan. You can also schedule a same-day appointment with a doctor 24/7 with MDLIVE¹ at no cost, depending on your plan. MDLIVE doctors can assess your symptoms and help with next steps. Register or login at mdlive.com/ibxtpa.
Specialists are available. The CDC recommends that the best way to prevent illness is to avoid being exposed to the virus that causes COVID-19. Ask your specialist if your visit can be done over the phone or video. If so, office visit cost-sharing will apply, based on your health plan. This also includes urgent care, nutritionists, and therapists (occupational, physical, speech). Physical and occupational therapy must be conducted via video.
Treatment is covered¹. Your Group Health Plan may waive plan members’ cost for in- network, acute in-patient treatment of COVID-19 through the public health emergency². Cost sharing will be applied to post-acute care (e.g. skilled nursing, rehabilitation and long term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out of network care.
Pre-authorizations temporarily waived. Pre-authorization is currently not required for any acute, in-patient admissions from an in-network Emergency Department for a COVID-19 diagnosis through April 30, 2021. Facilities are still required to notify Independence Administrators.
Coverage for pulse oximeters¹. Pulse oximeters are small, portable devices that monitor oxygen levels in the blood and pulse rate. To help monitor members who have a COVID 19 diagnosis or are recovering from COVID 19, your Group Health Plan may cover consumer grade pulse oximeters that are prescribed by an in-network doctor and purchased through an in-network supplier. If applicable, member cost sharing will be waived through the public health emergency².
Navigate COVID-19 with Quil. To help you navigate some of the challenges you may be facing during the COVID-19 outbreak, Quil Health — the digital health joint venture between Independence Health Group and Comcast — has developed a comprehensive COVID-19 Preparedness Tool that members can access for free. Get access now.
Keep your health on track. As doctors’ offices re-open, talk with your doctor if you delayed an elective procedure and need to reschedule. Be sure to make an appointment with your doctor if it’s time for your annual check-up or preventive health screenings too.
Check your medications. Check to make sure you have enough medications. Call your doctor if you need refills.
Virtual visits for mental health¹. If you have mental health benefits through your Group Health Plan, you can talk to an in-network mental health counselor online or on the phone. The cost will be the same as a mental health specialist visit. Call the number on the back of your ID card or visit myibxtpabenefits.com to find a provider.
Login at myibxtpabenefits.com to find a doctor.
1 Please note: For employers who are self-insured, coverages may vary. If you have coverage through your employer, please check with them about how these programs apply.
2 The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act mandate that member cost sharing (deductible, co-pays and coinsurance) is waived both in and out-of-network for the testing and diagnosis of COVID-19 through the public health emergency. For High Deductible Health Plans, in-network cost sharing waivers detailed above will remain in effect through the public health emergency unless prohibited by law.
MDLive is an independent company.