Helping Tufts Health Unify Members During the Coronavirus (COVID-19) Pandemic

If you believe you have COVID-19 or another flu-like illness, stay home. People with COVID-19 have had a wide range of symptoms. This may include: a cough, shortness of breath, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. This list is not a full list. Follow the CDC’s guidance for separating yourself from others. Your close contacts should stay home too.

If your symptoms get worse, call your health care provider before you visit them or go to urgent care. Follow any rules that a health care facility has in place. This will reduce your chances of exposing others to COVID-19.

In an emergency, call 911. Or go to an emergency room right away.

If you have questions about COVID-19 or any health issue, call your care manager directly. For calls after business hours, call us at 855-393-3154. 

If you are experiencing COVID-19 symptoms or have been exposed to someone that has, you should call your health care provider. You do not need a referral or prior approval (authorization) to get medically necessary testing or treatment related to COVID-19. Based on where you live, you can find a location near you to get tested for COVID-19. Just click one of the links below to search for a location.

Please call ahead to check the rules for each location before you seek a test. For help understanding any symptoms you may be having, you can also check your symptoms online.

Testing locations:

• Current list of Massachusetts testing sites –Department of Public Health
• CVS MinuteClinics taking appointments
• Nationwide search
• Prueba COVID-19

In addition to your provider’s office and locations listed above, the state has also set up testing sites around the state. Check Stop the Spread for locations and instructions.

• Members do not need a referral or prior authorization to get medically necessary testing or treatment related to COVID-19 in-network or out-of-network. A referral or prior authorization is required for any out-of-network service that is not related to COVID-19.
• Tufts Health Unify members are covered for antibody testing when testing is determined by a primary care provider (PCP) or another provider to be medically necessary. Please contact your PCP or other provider to find out whether this testing is appropriate for you.

Testing for COVID-19 is only covered for reasons that are medically necessary. Tufts Health Unify will not cover testing for COVID-19 for reasons solely related to travel, work or school.

The U.S. Food and Drug Administration (FDA) has approved several COVID-19 vaccines. A vaccine will be available to all individuals free of charge (as required by the CARES Act). The federal government has pre-purchased hundreds of millions of doses.

• Early supplies of the vaccine are limited.
• Teams of public health officials are creating priority groups.
• We are hopeful that over the next few months, most high-risk groups will have had an opportunity to be vaccinated.

The first vaccines approved require two doses. You will need to take both doses for the vaccine to be fully effective.

COVID vaccine distribution for residents of the Commonwealth is being led at the state level in a phased in approach. 

The general public (those not falling into one of the higher risk categories) is not expected to be offered the vaccine until later in 2021. For more detailed information and the most up to date information on vaccine distribution, please visit www.mass.gov/covid-19-vaccine-in-massachusetts.

When the vaccine is made available to the general public, there will be no cost share for our members.

Be aware of vaccine scams

As COVID-19 vaccine distribution begins, be aware that scams are starting to emerge. It’s important to know what signs to watch for, including:

• You are asked to pay out-of-pocket to get the vaccine.
• You are asked to pay to put your name on a vaccine waiting list or to get early access.
• Marketers offer to sell or ship doses of the vaccine for payment.

Learn more about how to protect yourself and report potential COVID-19 fraud here.

Until further notice:

• As new treatments are approved for emergency use authorization, they will be subject to the same guidelines as our other COVID-19 treatments.
• COVID-19 vaccines that are FDA-approved and available are covered in full. There will be no cost to members.
• Tufts Health Unify members are fully covered to receive telehealth services from network providers. Telehealth is the term for checking in or receiving health care from a provider by phone or another technology virtually. Contact your provider to see if this option is available.

Tufts Health Unify members are fully covered to receive medically necessary testing and in-person treatment for COVID-19 from any health care provider within our provider network and with out-of-network providers if a member has trouble accessing such services in-network. However, we strongly encourage members to continue receiving services from their current providers and stay within our network if possible.

Referrals or prior authorizations are required for any out-of-network service that is not related to COVID-19.

Call member services at 855-393-3154 (TTY: 711) if you have questions about out-of-network coverage.

Members can get an early refill of their prescriptions prior to the expiration date so they have a supply of their maintenance medications should they need it.

We will waive the refill limitation for maintenance medications to permit refills of up to a 90-day supply. Early refills are not allowed for controlled substance drugs.

Call 855-393-3154 (TTY: 711) to speak with a registered nurse 24/7.

Your provider may offer check-ins by phone or video chat. Contact your provider to see if this option is available. Virtual check-ins are covered in full under Tufts Health Unify.

Virtual check-ins and telehealth enable members to make inquiries regarding symptoms or treatment for COVID-19 or other health issues without going to medical offices where the risk of coming in contact with COVID-19 may be higher.

If you don’t have reliable phone or internet service or you’re having trouble paying for the services you have, you may qualify for help through the federal Lifeline program. Learn more.