COVID-19

COVID-19 Public Health Emergency is Ending May 11, 2023

PreferredOne has provided coverage with no member cost-sharing for COVID-19 related services and treatment for the duration of the Public Health Emergency. Effective May 12, 2023, all coverage relating to COVID-19 will return to normal plan benefits**.

Prevention of Illness

The best way to prevent illness is to avoid exposure through simple precautions

Prevention

The best way to prevent the illness is to avoid exposure through simple precautions. Prevention steps include:

• Wear a mask over your nose and mouth if you are experiencing symptoms.
• Wash your hands frequently with soap and warm water for at least 20 seconds, especially after using the bathroom, before eating, and after blowing your nose, coughing, or sneezing.
• Use alcohol-based (60%+) hand sanitizer if soap and water are not available.
• Clean and disinfect frequently touched surfaces using a household cleaning spray or wipe
• Avoid close contact with people who are sick.
• If you’re feeling sick stay home.

COVID-19 FAQ

COVID-19 EMPLOYER, BROKER, MEMBER FAQ

Upon the ending of the Federal COVID-19 Public Health Emergency on May 11, 2023, coverage for COVID-19 is subject to normal plan benefits effective May 12, 2023**. If you have additional questions or need further assistance, please contact your PreferredOne representative.

COVID-19 TREATMENT & TESTING

Q: What is the coverage for COVID-19 treatment?

A: Effective October 1, 2021, coverage for inpatient/outpatient treatment for COVID-19 is subject to normal plan benefits**. PreferredOne members have access to virtual care, which is a convenient option that saves money. Learn more about online care or use the provider directory to locate providers in your network.

Q: What is the coverage for COVID-19 testing?

A: During the Public Health Emergency, PreferredOne waives cost sharing for COVID-19 lab testing ordered by a provider, including related telehealth, office, urgent care, and emergency room visits for all members. Effective May 12, 2023, coverage for COVID-19 testing and related services will be subject to normal plan benefits**.

Q: What is the coverage for COVID-19 at-home over the counter (OTC) test kits

FDA authorized COVID-19 OTC at-home test kits are covered without cost-sharing for the duration of the federal public health emergency. Effective May 12, 2023, coverage for over-the-counter FDA authorized COVID-19 at-home test kits will end**. OTC kits can still be purchased using HSA and FSA funds and kits may still be available through the federal government.

PreferredOne Members with ClearScript Pharmacy Benefit Services who purchased eligible kits on or before May 11, 2023, can submit receipts for reimbursement up to 8 tests per member every 30 days and up to $12 per test. PreferredOne Members with other pharmacy benefit services can contact their pharmacy benefit manager or PreferredOne customer service.

Q: How do I know if the test kit is authorized by the FDA?

A: Refer to the FDA authorized tests on this site: FDA Antigen Diagnostic Tests for SARS-CoV-2

Q: Is antibody testing for COVID-19 covered under our plan?

A: When ordered by your provider for diagnostic purposes, antibody testing is subject to your normal plan benefits

Q: I have additional questions about my benefits. Who can I call for more information?

A: Please contact PreferredOne Customer Service at the phone number on the back of your member ID card.

VACCINES & BOOSTERS

Q: What is the coverage for the COVID-19 Vaccine and COVID-19 booster?

A: During the Federal COVID-19 Public Health Emergency, PreferredOne provides coverage with no member cost-sharing for the administration of FDA approved or emergency use authorized COVID-19 vaccines. Effective May 12, 2023, PreferredOne will provide coverage of COVID-19 vaccines and boosters as defined by the Affordable Care Act, in conjunction with the Advisory Committee on Immunization Practices (ACIP) of the CDC.

Q: I am fully vaccinated and I’m wondering when I should get the COVID-19 vaccine booster

A: Talk to your healthcare provider to determine when you are eligible for a booster.

Q: Are online care visits eligible for reimbursement?

A: Yes. Online Care visits may be done via computer or phone and do not require video. We encourage online care for non-emergent service, including mental health. Online care is part of the normal plan benefits.

Q: Can members go to any provider to get testing or treatment for COVID-19?

A: Yes, however, your benefits may be greater when you see an in-network provider. Members should use the provider look-up tool on their MyAccount or contact customer service to locate an in-network provider. We encourage members to use Online Care as their first resource.

Q: Does PreferredOne require prior authorization for COVID-19 testing or treatment?

A: No, PreferredOne does not require prior authorization for COVID-19 testing or treatment.

Q: Are prevention items such as gloves, masks, and disinfecting supplies covered under the plan benefits?

A: No, charges for the above items are not covered under the plan benefits.

**This applies to Fully Insured and Level Funded groups only. Self-funded group coverage may differ. Please contact Customer Service with questions.