Preparing for Coronavirus

The health of your employees is our priority

March 06, 2020  

U.S. health officials have advised that Americans should be prepared for significant disruption due to the novel coronavirus (COVID-19) outbreak. Tufts Health Plan is carefully monitoring the situation and supporting efforts by the Centers for Disease Control and Prevention (CDC) and health experts to mitigate the risks and keep people safe.

We are also working closely with the Massachusetts Division of Insurance to take the necessary steps to enable our members to obtain medically necessary and appropriate testing and treatment that will help fight the spread of this disease.

Below are answers to common questions about this rapidly evolving situation:

Where should individuals go if they think they are sick?
People with mild, flu-like symptoms should call their health care provider before going to a health care facility. If their provider offers telehealth services, they should call them first. There may be a cost share associated with the visit. They can also use our telehealth solution powered by Teladoc®. With telehealth, our commercial members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world for $0 copay.1 Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about coronavirus.  

Teladoc’s doctors can answer questions about the disease and evaluate an individual’s risk. They are prepared to follow the appropriate and most recent process in place for coronavirus. For more information, members should visit teladoc.com/coronavirus.

People with COVID-19 or with other flu-like symptoms should stay home and follow all quarantine procedures. Their close contacts may also be advised to stay home. If someone has more significant symptoms, they should go to their health care provider, urgent care or the emergency room. But they are advised to call in advance and follow any protocols that the facility has in place.

Where can individuals find additional information about coronavirus and situation updates?
They should visit the CDC website at www.cdc.gov and click on “Coronavirus Disease 2019.”

Is the screening test for coronavirus more expensive than the test for the flu? 
We are in conversations with the major national labs and the state labs regarding the cost of the coronavirus test. We do not yet have pricing.

At this time, we have not yet seen claims for any of the codes that would be used for the coronavirus test. Currently more general codes are being used; specific codes for the coronavirus test and for diagnosis of the disease will be implemented on April 1.

Will Tufts Health Plan know if a member gets tested for coronavirus?  Are labs in Massachusetts doing any coronavirus testing yet or is it all going to the CDC?
Yes, if a claim is submitted using the codes for the coronavirus test, we are tracking it. The CDC has provided kits to state labs and local testing is starting. Major national lab chains also are developing their own test kits.

If a member is diagnosed with coronavirus, what associated costs are expected and how much care will be required?  Or will it be treated like any flu case?
Approximately 80% of individuals who contract coronavirus will have mild symptoms. They will be quarantined at home with treatment that is similar to that for a cold or the flu.

Those with significant symptoms may need hospitalization. This may include stays in the Intensive Care Unit with ventilator support. Because there are no specific treatments for COVID-19, it is likely the claims will closely resemble the costs associated with other significant respiratory illnesses, such as severe flu cases in individuals with other medical conditions.

What is Tufts Health Plan doing about potential drug shortages related to the closure of Chinese factories or to coronavirus outbreaks?
Our pharmacy team works closely with our pharmacy benefit manager, CVS Health, and with our specialty pharmacies to monitor for drug shortages. At this time, there is no specific concern about shortages.

The pharmacy team is also part of our Pandemic Preparedness plan. They will watch for any need to alter usual processes in response to changing needs. For instance, if generic drugs are not available, there are policies to provide brand-name substitutes.

Where can I find out more?

For more information about Coronavirus, you can visit the following sites:
The Centers for Disease Control and Prevention
The Massachusetts Department of Health
The Rhode Island Department of Public Health
The New Hampshire Department of Health and Human Services

  1. Tufts Health Plan Commercial members (not including Tufts Health 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.

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