Generations Advantage Update June 8th 2020

Message #6

June 8, 2020

 

Dear Martin’s Point Generations Advantage Member,

WE’RE HERE FOR YOU

As coronavirus-related restrictions slowly start to ease, we thank you for doing your part to continue to keep yourselves and our community protected from COVID-19. We want to assure you that we continue to be here to support your health in every way we can. Below, you’ll find links to resources that we’d like to share to help you stay up to date on COVID-19 developments and stay safe at home and in public.

Wondering about your Generations Advantage plan’s coverage for services related to COVID-19? You’ll find a quick rundown of benefits below. If you have any questions about your coverage—COVID-19-related or otherwise—please don’t hesitate to call Member Services at 1-866-544-7504 (TTY: 711). We're available 8 am-8 pm, Monday through Friday.

COVID-19-RELATED COVERAGE

Testing: Labs used to directly test for 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 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, your plan’s 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.

PLEASE DON’T DELAY NEEDED MEDICAL CARE

 If you have a pressing or urgent medical issue, please don’t delay getting in touch with your primary care provider so they can talk through your symptoms and make sure you get appropriate care when you need it. If you are concerned about scheduling an in-office visit, call and ask if a telehealth visit may be appropriate for your needs.

STATE COVID-19 POLICIES

For the most up-to-date information about your state’s COVID-19 related guidelines and restrictions, please check at these websites:

State of Maine COVID-19 Information
State of New Hampshire COVID-19 Information

CDC COVID-19 INFORMATION

For information from the CDC about COVID-19, including how to protect yourself and your community, go to CDC Coronavirus Information
 
MARTIN’S POINT COVID-19 RESOURCES:

You can also find benefit information, as well as helpful resource links, on our website at martinspoint.org/covid19.

If we can be of service to you, please don’t hesitate to call Member Services at 1-866-544-7504. We're available 8 am-8 pm, Monday through Friday. As always, and especially during these difficult times, we are here for you!

Heather Mullen
Chief Operating Officer