Generations Advantage

We’re here for you.

During these challenging times, it’s comforting to know that all of us at Martin’s Point Generations Advantage are here for you. We understand that our members are dealing with many concerns during the current coronavirus outbreak. We want to make sure your health coverage isn’t one of them.

Helping You Understand Your Benefits during the COVID-19 Outbreak

You’ll be reassured to know that the Centers for Medicare and Medicaid (CMS) have made some benefit changes to Medicare to support the health of members during the COVID-19 outbreak. Below, you’ll find information about those changes and how your Generations Advantage plan covers health care services during this time.

Testing: Labs used to directly test for the Coronavirus (COVID-19) are covered at no cost to you. This includes the collection of the sample and the lab analysis.

Treatment: If you are diagnosed with the Coronavirus (COVID-19), copays/coinsurance will be waived for the following services if related to COVID-19:

• Emergency room visits
• Urgent care visits
• Office visits
• Telehealth services.

Hospital Coverage: If you are admitted to a hospital, the standard inpatient copay will still apply.

Out-of-Network Coverage: If you must see an out-of-network provider for any covered service, you will receive the in-network cost share. This applies even if your Generations Advantage plan does not normally include out-of-network coverage.

Telehealth: Generations Advantage covers all telehealth services covered by Original Medicare. Due to the COVID-19 outbreak, Medicare has relaxed their requirements for telehealth services to allow members to get needed care. Members can now use readily available platforms, like Skype and Facetime, to receive care from their providers. Visits by telephone are also permitted, when appropriate. Copays for any telehealth services related to COVID-19 will be waived. 
For all other visits, the in-network primary care copays will apply for telehealth services with a primary care provider, and in-network specialist copays will apply for telehealth services with a specialist. These copay amounts will be the same as if you received care through an in-office visit.

Face Masks for Protection

Face masks are now covered under the Wellness Wallet and subject to your benefit maximum. Masks must be purchased through a website, retail store, or Durable Medical Equipment (DME) provider. The approved benefit includes:

• Cloth masks
• Surgical masks are now covered (limit 50 per month to reserve supplies for health care workers and medical first responders).
• Other exclusions: N95 respirators, homemade cloth mask supplies.

If you have questions about your coverage, don’t hesitate to contact Member Services at 1-866-544-7504. We’re here for you!