Coronavirus: Benefit and Coverage FAQs
Friday, April 3, 2020
Updated February 28, 2022
We understand that you may have questions relating to your benefits and coverage during these uncertain times. We’ve compiled this list of frequently asked questions to help provide information about what’s covered and what’s not in response to the COVID-19, or coronavirus, pandemic. If you have additional questions, please contact us through the Message Center.
Benefit Related Questions
Is COVID-19 testing covered?
TeamCare will cover medically necessary diagnostic tests that are consistent with CDC guidance related to the COVID-19 outbreak. In compliance with federal law, the COVID-19 testing will be covered at no cost to you.
How are at-home COVID tests purchased on or after 1/15/22 covered and reimbursed?
You can get coverage for at-home COVID tests two ways:
- Point of Sale (POS)- you can present your Benefit card to any participating CVS pharmacy to obtain the test with no upfront out-of-pocket costs. Pharmacies have the option to opt out of this program so members must check with their local pharmacy to see if they participate or not.
- Reimbursement- you can purchase tests at the pharmacy of your choice and then submit the reimbursement request through Caremark at www.caremark.com or through the CVS Caremark mobile app. Members will be required to submit a receipt and attest that the test was bought for personal use and not for resale or employment. Reimbursement may be limited to the network reimbursement cost of $12/test.
You are allowed coverage for 8 tests (or 4 kits containing 2 tests) per person in a 30 consecutive day period.
Are State, Government or employer mandated COVID tests covered?
No, these tests would not be covered by TeamCare.
Is COVID-19 testing for surveillance or employment purposes covered?
No, testing conducted to screen general workplace health and safety (such as employee “return to work” programs), for public health surveillance, or for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-19 would not be covered.
If I receive multiple diagnostic tests for COVID-19, will those multiple tests be covered?
Yes, COVID-19 coverage is not limited with respect to the number of diagnostic tests for an individual, provided the tests are diagnostic and medically necessary as determined by a healthcare professional.
If I was tested for COVID-19 but not diagnosed, would the claims still be covered at 100%?
Yes, all COVID testing, regardless of diagnosis, is covered at 100%.
Will TeamCare cover antibody/immunity testing?
Yes, we will pay for the test if you meet the requirements for testing and is ordered by a physician/health care provider. Antibody tests will be paid at 100%, no deductible.
Is COVID Anti-Viral Infusion and Drug treatment covered?
Yes, when medically necessary, any FDA approved COVID-19 treatment would be covered.
Are COVID-19 vaccines and Boosters be covered?
Yes, COVID-19 vaccines and boosters will be covered at 100%.
Can I use a non-Teladoc telemedicine service if my physician offers one?
We will temporarily allow non-Teladoc telemedicine providers during this pandemic crisis. However, Teladoc will still be the only service we cover 100%.
Is telemedicine (teledental) covered for a dental visit to be used to determine if it is indeed a dental emergency?
At this time, it would not be covered.
Coverage Related Questions
Will there be an exception made for late COBRA payments if I am not working and do not have an income? Will my coverage be extended if they cannot make their payment?
Certain situations do qualify for relief based on COVID-19 Federal Extensions. Please see the article here on federal extensions. Outside of these specific exceptions, our standard COBRA rules apply.
Would TeamCare offer an extension of coverage for a dependent who turned 26 during the pandemic, lost their job, and does not have health insurance coverage?
An extension of coverage would not be provided. The dependent’s only option would be to apply for COBRA.
If I am off of work due to COVID-19, will my employer continue to make health contributions to provide coverage during this period? Some employers are implementing a policy directly related to COVID-19 that requires health contributions for a defined period. In addition, most national collective bargaining agreements (UPS, ABF NMFA, YRCW, NMATA), have an employer-pay obligation that requires an employer to make health contributions for four weeks while an employee is off work due to an illness or non-work-related injury. Further, an employer may be required to pay contributions under the Family Medical Leave Act under certain circumstances. We recommend that you check this information with your employer/human resources department.