1-800-477-2287

Coronavirus (COVID-19) Information

As a benefit administrator owned by a healthcare system, HealthFirst is monitoring COVID-19 developments very closely. We’ve been planning business contingencies for several weeks to ensure service to our broker clients, our clients and our plan members continues without operation. 

As expected, we have seen more coverage and developments concerning COVID-19.  We want to assure you that like you, our first concern is for the health and safety of our community, our clients, our partners and our staff. We also want to share the plan for our business continuity and our commitment to continual planning, focusing on proactive measures. We are constantly reviewing and reevaluating processes we have put into place to avoid any interruptions to our delivery of service and business operations.

What We All Can Do Now

  1. Know the symptoms - The most commonly reported symptoms include fever, dry cough and shortness of breath.
  2. Take these steps recommended by The Center for Disease Control
    1. Avoid close contact with people who are sick.
    2. Stay home when you are sick, except to get medical care.
    3. Wash your hands often with soap and water for at least 20 seconds. If water is not available, use a hand sanitizer that contains at least 60% alcohol.
    4. Clean and disinfect frequently touched surfaces daily.
    5. Practice good respiratory hygiene – cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash and immediately wash your hands or use sanitizer.
    6. Avoid touching face, nose, eyes with unwashed hands.

What our Members Need to Know if Medical Care is Needed

For members who develop symptoms or have been in close contact with a person known to have COVID-19:

  • Call your primary care provider or your local city or county health department first.  Be prepared to discuss your symptoms and answer screening questions. If you don’t have a physician, members should visit the member portal at www.hfbenefits.com/enrollment, enter the Web Group # shown on their member ID card, and under Inquiry, select Links, then search for a provider within the network.
  • If the members’ plan includes Teladoc, members can conduct a virtual visit with a physician, by phone at 1-800-TELADOC or through the Teladoc App.
  • If a member is referred for testing, The COVID-19 diagnostic tests are considered “essential” under the Affordable Care Act, which means they are covered by private insurers, Medicare and Medicaid and there is no cost for members.
  • If treatment is needed, health plan benefits coverage will apply. Your HR team can advise on your company’s plan.

What Information is Available for Screening?
According to our partners at UT Health East Texas, screening capacity is still limited in many areas. Individuals who feel they are experiencing symptoms are urged NOT to simply show up at a clinic or hospital, but instead to follow this protocol:

WITHIN EAST TEXAS, including Smith, Gregg, and surrounding counties:

  1. Call either 903-596-DOCS (903-596-3627), or your primary care provider. Individuals should be prepared to describe their symptoms (described below) and answer screening questions about whether they may have been exposed to the virus through travel or contact with an infected person.
  2. If the individual meets the criteria to be tested for the virus, they will be given additional directions. If the individual is referred to testing, they will be directed to a location to be tested. The facility will receive notification that an individual has been directed there. Upon arrival, someone from the facility will meet them at their car and obtain a sample.
  3. At this time, there is no fee associated with the test, but individuals may be responsible for clinical charges if they visit a clinic or ER.
  4. If the individual is experiencing severe shortness of breath or other life-threatening symptoms, they should call 911.

OUTSIDE EAST TEXAS:

  1. Call your primary care provider or your local city or county health department. Individuals should be prepared to describe their symptoms (described below) and answer screening questions about whether they may have been exposed to the virus through travel or contact with an infected person.
  2. If the individual meets criteria to be tested for the virus, they will be given additional instructions on how and where to be screened.
  3. If the individual is experiencing severe shortness of breath or other life threatening symptoms, they should call 911.

What HealthFirst is Doing

We are continually monitoring developments surrounding COVID-19 and have put into place measure to avoid interruptions to our clients and members. These measures include:

  • Internal education for our staff to make sure all safety guidelines are implemented
  • Positioning key staff to work remotely, if necessary
  • Moving to virtual meetings whenever possible
  • Establishing communication plans to ensure we can engage with internal and external stakeholders in an efficient and timely manner
  • Our HealthFirst executives and management are involved in business continuity planning to make adjustments as this situation changes.

Because of this planning and precautions, HealthFirst does not anticipate a disruption in our ability to provide the same service and support. We expect to continue handling calls and processing claims in a timely manner.

For updated information on COVID-19, we recommend these sites:
https://www.cdc.gov/coronavirus/2019-ncov/community/home/index.html
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/index.html
https://www.cdc.gov/coronavirus/2019-ncov/faq.html
https://uthealtheasttexas.com/

 

If you have a medical emergency, call 911 and tell the dispatcher about your symptoms and recent travel history.

Unless it is an emergency, stay home if you feel sick, even if your symptoms are mild. To reduce your risk of catching or spreading illness, do not go to work, school or public places, and avoid public transportation if possible.

If you feel like you need medical care, you are encouraged to call before you go to a doctor’s office or urgent care center and describe your symptoms over the phone. If symptoms are severe, you can also call 911.

Answer Questions to Determine Your Risk

When you call a health care provider, you will be asked about your risks for COVID-19. Risk factors include recent travel to certain countries or areas of the U.S., or exposure to an infected person.

You may be asked:
  • In the last 28 days, have you traveled outside of the continental United States?
  • Have you traveled to China, Japan, South Korea, Italy, Iran, Europe, United Kingdom, Ireland or a community with broad outbreaks (e.g. NY, NJ, WA, CA, MA, CO, and central and southern FL)?
  • Have you had close contact with someone diagnosed with COVID-19, the disease caused by the new coronavirus? (Close contact means having been within 6 feet of that person for an extended time, or being exposed to their cough or sneeze.)
  • Do you have a fever, a cough or difficulty breathing?
  • Has a public health officer said you were potentially exposed to COVID-19?
Follow Your Health Care Provider’s Instructions
Based on your answers to these questions, the care provider will provide instructions over the phone. You will be told if you need to be evaluated. Based on your risk for COVID-19, your health care provider may recommend that you:
  • Continue to monitor your health and call back if you develop a fever or respiratory symptoms.
  • Stay home and await further instructions.
  • Report to a medical care facility for evaluation. If possible, it’s best to go alone to your appointment. Do not bring children or other family members unless you require assistance.
  • Go to a clinic or emergency department, or call 911, if you have more severe symptoms, such as higher fever and severe shortness of breath.
Practice Hand Hygiene and Respiratory Etiquette
  • If you go to a care facility and you have COVID-19 symptoms, or have traveled to designated areas, you will be asked to wear a mask upon arrival. Masks are NOT recommended for healthy people in the general population.
  • Wash your hands thoroughly and frequently for at least 20 seconds with soap and hot water. Be mindful to wash your hands after sneezing, blowing your nose, coughing or using the bathroom, and before preparing or eating food.
  • If you cough or sneeze, do so into the bend of your elbow, not your hand, or use a tissue, and then immediately throw it away.
  • At home and work, clean often-touched surfaces such as doors and doorknobs, cabinet handles, bathroom hardware, tabletops, phones, tablets and keyboards regularly with disinfectant.
Stay Calm

The possibility of having a contagious illness is concerning but doctors, nurses and other caregivers are working together with national and international agencies to identify and provide care to patients while avoiding spread of the illness in the community.

Symptoms
  • Fever, cough, body aches, fatigue; sometimes vomiting and diarrhea
  • Can be mild or severe; fatal in rare cases
  • Can result in pneumonia
Transmission
  • COVID-19 may be spread by an infected person for several days before their symptoms appear, but we don’t know definitely.
  • COVID-19 might be spread through the airborne route, meaning that tiny droplets remaining in the air could cause disease in others, even after the ill person is no longer near.
Treatment
  • COVID-19 is not treatable with antibiotics, which only work on bacterial infections.
  • It may be treated by addressing symptoms, such as reducing fever. Severe cases may require hospitalization.
Prevention

COVID-19 may be prevented by frequent, thorough hand washing, coughing into a tissue or the crook of your elbow, staying home when sick and limiting contact with people who are infected.

Cause

COVID-19is caused by one virus, the novel 2019 coronavirus is now called severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

Antiviral Medications

Antiviral medications are currently being tested to see if they can address symptoms.

Vaccine

No vaccine is available at this time, though it is in progress.

A vaccine to cure COVID-19 is available. Answer: FALSE.

Currently there is no vaccine for the new coronavirus. Scientists have begun working on one, but developing a vaccine that is safe and effective may take months.

You can protect yourself from COVID-19 by taking acetic acid or steroids, or using essential oils, salt water, ethanol or other substances.
Answer: FALSE.
None of these recommendations protect you from getting COVID-19, and these practices may be dangerous. The best ways to protect yourself from this coronavirus, and other viruses, include:
  • Avoiding close contact with people who are sick, sneezing or coughing.
  • Practicing hand hygiene and respiratory etiquette
  • Wash your hands thoroughly and frequently for at least 20 seconds with soap and hot water. Be mindful to wash your hands after sneezing, blowing your nose, coughing or using the bathroom, and before preparing or eating food.
  • If you cough or sneeze, do so into the bend of your elbow, not your hand, or use a tissue, and then immediately throw it away.
  • At home and work, clean often-touched surfaces such as doors and doorknobs, cabinet handles, bathroom hardware, tabletops, phones, tablets and keyboards regularly with disinfectant. For a list of EPA-approved disinfectants, visit: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
A face mask will protect you from COVID-19.
Answer: FALSE.

Certain models of professional, tight-fitting respirators (such as the N95) can protect health care workers as they care for infected patients.

For the general public without respiratory illness, wearing lightweight disposable surgical masks is not recommended. Because they don’t fit tightly, they may allow tiny infected droplets to get into the nose, mouth or eyes. Also, people with the virus on their hands who touch their face under a mask might become infected.

People with a respiratory illness can wear these masks to lessen their chance of infecting others. Bear in mind that stocking up on masks makes fewer available for sick patients and health care workers who need them.

Coronaviruses are a type of virus. There are many different kinds and some cause disease. A newly identified type has caused a recent outbreak of respiratory illness now called COVID-19 that started in China.

Symptoms include cough, fever and shortness of breath. COVID-19 can be severe and some cases have caused death. This new coronavirus can be spread from person to person. It is diagnosed with a laboratory test.

There is no vaccine for coronavirus. Prevention involves frequent hand-washing with soap and water, coughing into a tissue (throw away immediately) or the bend of your elbow and staying home when you are sick.

Is our plan required to cover testing for COVID-19?
Yes. The Families First Coronavirus Response Act (H.R. 6201) requires that health plans cover as an Essential Benefit the medical expenses associated with testing and testing-related office visits associated with COVID-19. This is mandatory for all health plans.

Is our plan required to cover treatment for COVID-19?
If a member tests positive and treatment is required, your health plan benefits coverage will apply. It would be your plan’s decision to waive or reduce any member copays or coinsurance that may be in place on your company’s plan. Check with your human resources/benefits department for specifics.

Can telehealth services screen for COVID-19?
All major telehealth providers have put in place specific protocols recommended by the Centers for Disease Control and Prevention (CDC). If an individual meets criterion to be tested, the provider can advise on next steps. Telehealth providers can answer questions about the disease, evaluate your risk, and provide support by a phone or video call to help relieve symptoms for affected patients.

What steps should a member take if they think their symptoms indicate they have COVID-19 or they have been in close contact with a person known to have COVID-19?

  • Call your primary care provider or your local city or county health department first. Be prepared to discuss your symptoms and answer screening questions. If you don’t have a physician, members should visit the member portal at www.hfbenefits/enrollment, enter the Web Group # shown on their member ID card, and under Inquiry, select Links, then search for a provider within the network.
  • If the members’ plan includes Teladoc, members can conduct a virtual visit with a physician, by phone at 1-800-TELADOC or through the Teladoc App.

Why is the use of telehealth one of the options for members?
Telehealth is bridging the gap between people, physicians and health systems, enabling everyone, especially symptomatic patients, to stay at home and communicate with physicians through virtual channels. This helps to reduce the spread of the virus to mass populations. It is also a usual option in treating quarantined patients infected with COVID-19. Check with your human resources/benefits department for coverage information.

Information for HR Teams/Brokers:

If we change our plan to cover COVID-19 testing and/or treatment without cost sharing, does our plan need to be amended?
Yes, you must change your plan terms to cover either the testing or treatment without cost sharing. Your third party administrator will create the amendments requiring signatures. This will also require updating your benefits section in employee handbooks.

Does COVID-19 require a change in telehealth coverage?
Many providers have transitioned to providing telehealth and other communication-based office visit services in lieu of traditional office visits in order to limit members’ unnecessary exposure to COVID-19 and other illnesses. In order to ensure plan members continue to have access to care, we recommend that plans add language to their plan documents to cover these visits.

Disclaimer: As plans vary from company to company, if you have questions about coverage, please call HealthFirst’s customer service at 1-800-477-2287 or contact your HR department.

If you have additional questions, email communications@hfbenefits.com or contact your account executive.