What is coronavirus disease 2019 (COVID-19)?

What are the symptoms of COVID-19?

How does COVID-19 spread?

Is there a test for COVID-19?

What coverage do I have for COVID-19 testing and treatment?

Is telehealth an option?

Can I refill my prescriptions early to ensure I have an adequate supply?

How can I get a 90-day supply of medicine?

Is there a treatment for COVID-19?

Is a vaccine available? Will the flu vaccine protect me from COVID-19?

Should I wear a face mask?

Where can I get the latest information about COVID-19?

Who can I call at Harvard Pilgrim with questions?
 

What is coronavirus disease 2019 (COVID-19)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.

What are the symptoms of COVID-19?

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.

How does COVID-19 spread?

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.

Is there a test for COVID-19?

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.

What coverage do I have for COVID-19 testing and treatment?

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

Connecticut fully insured plans

COVID-19 testing*

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment

Your plan cost sharing (i.e., copays, deductibles and coinsurance) will apply

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Pharmacy

You can get a one-time 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) through your pharmacists or providers

Prior authorizations and referrals (where applicable) Not required for COVID-19 testing

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

Maine fully insured plans

COVID-19 testing*

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment

Your plan cost sharing (i.e., copays, deductibles and coinsurance) will apply

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Pharmacy

You can get a one-time refill of your prescription medications before the scheduled refill date

Prior authorizations and referrals (where applicable) Not required for COVID-19 testing

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

Massachusetts fully insured plans

COVID-19 testing*

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment*

Copays will not apply; deductibles and coinsurance will apply if your plan has them

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Prior authorizations and referrals (where applicable) Not required for COVID-19 testing and treatment

* 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

COVID-19 testing*

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment

Your plan cost sharing (i.e., copays, deductibles and coinsurance) will apply

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Pharmacy

You can get a one-time refill of your covered maintenance prescription medications for up to a 90-day supply

Prior authorizations and referrals (where applicable) Not required for COVID-19 testing and treatment

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

Medicare Advantage plans

COVID-19 testing*

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment*

Your plan cost sharing (i.e., copays, deductibles and coinsurance) will apply

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Pharmacy

You can get a one-time refill of your covered maintenance prescription medications for up to a 90-day supply

Referrals (where applicable) Not required for COVID-19 testing and treatment

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

Medicare Supplement plans

COVID-19 testing

Covered in full (no copays, deductibles or coinsurance)

COVID-19 treatment

Your plan cost sharing (i.e., copays, deductibles and coinsurance) will apply

All telemedicine services

Covered in full (no copays, deductibles or coinsurance)

Is telehealth an option?

Telemedicine services, such as video visits with  Doctor On Demand, are available to members on individual and group fully insured plans. If you have concerns related to COVID-19, you can check in with a health care provider from home (via smartphone, tablet or computer) to determine whether you need to take further action and to avoid long emergency room waits. Telehealth visits may help limit the spread of the disease. It may also be an option for individuals in self-imposed quarantine to check in with a health care provider.

Medicare members may have access to virtual visits with qualified Medicare providers.

Can I refill my prescriptions early to ensure I have an adequate supply?

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

How can I get a 90-day supply of medicine?

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.

Is there a treatment for COVID-19?

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.

Is a vaccine available? Will the flu vaccine protect me from COVID-19?

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.

Should I wear a face mask?

If you are well, the 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 workers and people who are taking care of someone in close settings, such as at home or in a health care facility.

Where can I get the latest information about COVID-19?

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

 

Who can I call at Harvard Pilgrim with questions?

Benefits and coverage questions:

(888) 333-4742

Monday, Tuesday and Thursday 8 a.m. – 6 p.m.

Wednesday 10 a.m. – 6 p.m.

Friday 8 a.m. – 5:30 p.m.  

 

Medicare Advantage Plan:

(888) 609-0692

8 a.m. – 8 p.m.

Oct. 1 – March 31: 7 days a week

April 1 – Sept. 30: Monday - Friday

 

Medicare Supplement Plan:

(877) 907-4742

Monday, Tuesday and Thursday 8 a.m. – 6 p.m.

Wednesday 10 a.m. – 6 p.m.

Friday 8 a.m. – 5:30 p.m. 

TTY: 711

Health plan support and clinical coordination: Call (866) 750-2068 to speak to a nurse care manager

Hours of operation are 8:30 a.m. - 5:00 p.m., Monday through Friday. If you are not feeling well, please contact your primary care provider to discuss active symptoms.