Coronavirus: Your Guide to Care

The coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by a newly identified strain of coronavirus, SARS-CoV-2, that was first detected in Wuhan, China.

The virus is thought to spread mainly:

• Between people who are in close contact with one another (within about 6 feet).
• Through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

It may also be possible that a person can get COVID-19 after touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes; this is not thought to be the main way the virus spreads, however.

Help protect yourself with these tips:

• Avoid close contact with people who are sick
• Avoid touching your eyes, nose and mouth
• Stay home from work or school if you are sick
• Wash your hands often with soap and warm water, and for at least 20 seconds. Do this especially:
  • Before eating
  • After using the bathroom
  • After coughing, sneezing or blowing your nose
• If soap and warm water aren’t available, use hand sanitizer with at least 60% alcohol
• Cover coughs and sneezes with tissue, and put the tissue in the trash
• Clean and disinfect doorknobs, phones and other surfaces and objects you frequently touch
• Get rest, eat healthy, drink fluids and be physically active to keep your immune system strong
• Review the CDC’s travel guidance if you have recently been or plan to travel overseas

Call your health care provider if you have a fever with a cough or difficulty breathing, and:

• You have been in close contact with someone who has coronavirus
• You live or recently traveled somewhere that has an ongoing spread of coronavirus

Your health care provider will work with your state’s public health department and the CDC to determine if you need to be tested for coronavirus.

If you are well, the Centers for Disease Control and Prevention (CDC) does not recommend wearing a face mask to protect yourself from respiratory diseases, including COVID-19.

Properly fitting face masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of face masks is also crucial for health care workers and people who are taking care of someone in close settings, such as at home or in a health care facility.

There is currently no vaccine that prevents COVID-19. The flu vaccine, which offers protection from the flu, will not protect you from COVID-19. Researchers are currently working on the development of a COVID-19 vaccine, but it may take 12 – 18 months before it is commercially available.

Government agencies are receiving reports about scammers offering COVID-19 tests in an attempt to steal personal and financial information.

If you receive a call or email or see an online advertisement from someone offering COVID-19 tests, please do not respond; this is fraudulent activity.

If you are feeling unwell, please call your doctor’s office. Your doctor will determine if you need a COVID-19 test and direct you to the appropriate facility.

Coverage will be provided in accordance with plan requirements. Some employers are self-insured and may offer different coverage.

Please note: You can get a one-time early refill of your covered maintenance prescription medications for up to a 90-day supply at your usual cost sharing (i.e., copays, deductibles and coinsurance).

Connecticut fully insured plans

* You can receive an initial COVID-19 test from out-of-network providers when in-network providers are not available.

Maine fully insured plans

* You can receive an initial COVID-19 test from out-of-network providers when in-network providers are not available.

Massachusetts fully insured plans

* You can receive initial COVID-19 testing and treatment from out-of-network providers when in-network providers are not available. 

New Hampshire fully insured plans

* You can receive an initial COVID-19 test from out-of-network providers when in-network providers are not available.

Medicare Advantage plans

* You can receive a COVID-19 test or COVID-19 treatment from out of network providers. In-network cost sharing applies.

Medicare Supplement plans

Yes. Employees who lose group health coverage can apply for coverage through the state health care exchanges. They may also be eligible for premium assistance.

No. The U.S. Food and Drug Administration (FDA) considers chloroquine and hydroxychloroquine experimental treatments for COVID-19. These medications are currently limited to clinical trials or closely monitored emergency use. Remdesivir is a third drug that has been in the news; it is currently being studied and not yet FDA approved.

COVID-19 can cause a range of symptoms. Some are mild (fever, cough, shortness of breath), but the virus can lead to more severe respiratory illness, such as pneumonia, especially in people with co-existing medical conditions. Based on information that is currently available, symptoms may appear 2 – 14 days after exposure. People can infect others up to 14 days after exposure.

Yes, the CDC has developed a test. Your health care provider will work with your state’s public health department and the CDC to determine if you need to be tested for COVID-19.

Here are some options if you are looking for support:

• Behavioral Health Access Center: Call (888) 777-4742 to speak with a licensed care advocate. They answer member calls 24/7 and direct can direct you to resources, including tele-mental health and virtual care options.

• Virtual visits: If you are currently in treatment, speak with your behavioral health provider about having virtual visits either by secure video or telephone. Harvard Pilgrim covers outpatient virtual visits (telemedicine) using HIPAA-compliant platforms.

You can use our online provider directory to find behavioral health providers who offer virtual visits. Choose your plan, then select “Behavioral Health Providers” under “Search By Provider Type.” Under “Narrow Your Results,” click the arrow on the right for the option to show just those providers that offer virtual visits. Behavioral health virtual visits are also available through Doctor on Demand.*

• United Behavioral Health/Optum’s Public Crisis Line: Call (866) 342-6892. Open 24/7, this emotional support help line is free of charge and available to anyone.

*Doctor On Demand is not available to members in our Medicare Enhance, Medicare Advantage and Medicare Supplement plans. Medicare Enhance and Medicare Supplement members must use providers that accept Medicare.

First, call your provider’s office to see if you can get a telemedicine appointment. If not, you can use Doctor On Demand (for medical and behavioral health) or Optum/United Behavioral Health’s virtual visits platform.

Please note: In the event that providers are requiring copays for telemedicine services, you will be reimbursed.

If you are on our Medicare Enhance, Medicare Advantage or Medicare Supplement plans, you can use medical and behavioral health providers who accept Medicare and offer telehealth services. You should ask the provider’s office directly if you have questions about Medicare status and telehealth availability.

There is currently no specific antiviral treatment recommended for COVID-19. People with COVID-19 should talk to their health care provider or pharmacist about what they can do for symptom relief.

If your health care provider thinks you can be treated at home, they may give you special instructions, such as to isolate yourself as much as possible from family while you’re sick and to stay home for a period of time. If you’re very ill, you may need to be treated in the hospital.

If you think you or a loved one may have been exposed to COVID-19, contact your health care provider immediately.

Yes, you can refill prescriptions early if you need to.

To ensure that you have enough medicine on hand, you can fill a 90-day supply of maintenance medicines. Maintenance medicines are those you take regularly, such as birth control, blood pressure or cholesterol medicines.

To get a 90-day supply of maintenance medicines you can use our mail order pharmacy, OptumRx Home Delivery. Most orders arrive within seven days of when you place the order. Your options are to:

Log in to your member account at harvardpilgrim.org and click “Check drug coverage and costs” to order your medicines from OptumRx Home Delivery.

• Use the OptumRx app, available for download from the Apple Store or Google Play.
• Ask your health care provider to e-prescribe your medicine(s) to OptumRx Home Delivery.
• Ask your health care provider to phone your medicine(s) to OptumRx Home Delivery at (855) 258-1561.

You can also ask your health care provider for a 90-day prescription for the medicines you take regularly and have them filled at a participating retail pharmacy.

You may also want to check your supplies of over-the-counter pain relief, fever and cough medicines.

Note: Not all employer-sponsored plans offer Harvard Pilgrim’s prescription drug benefits and mail order program. Please check your plan benefits or with your employer.

Centers for Disease Control and Prevention (CDC)

Connecticut Department of Public Health

Maine Center for Disease Control and Prevention

Massachusetts Department of Public Health

New Hampshire Department of Health and Human Services

• Small groups (fewer than 20 employees): We will provide benefits to small employers in accordance with “mini COBRA” under state continuation.
• Large groups (more than 20 employees): We will provide benefits to large employers in accordance with federal COBRA.

In either case, the employer’s policy must be active and up-to-date with premium payments. Other conditions apply. Please speak with your Harvard Pilgrim account executive to learn more.

Through May 15, 2020, we have reduced the number of hours (from 20 to 0) that employees who are currently covered must work to stay eligible for coverage, assuming at least one employee of the company continues to actively work at least 20 hours per week.

Employees of self-insured businesses who lose their group coverage can elect COBRA in accordance with applicable law. COBRA eligibility decisions under self-insured plans are made by the employer as the plan administrator. Neither Harvard Pilgrim nor its affiliates are the plan administrator.