Email 8 July 16th 2020

Message #8

July 16, 2020

Dear Martin’s Point Generations Advantage Member,

WE’RE HERE FOR YOU

As coronavirus-related restrictions slowly start to ease, it’s more important than ever to continue to follow safe practices to keep ourselves, our loved ones, and our community as healthy as possible. We want to assure you that we continue to be here to support your health in every way we can. Below, you’ll find information and links to resources to help you stay up to date on COVID-19 developments and stay safe at home and in public.


COVID-19-RELATED COVERAGE

One important way we support your health is by providing benefits that help you safely get the COVID-19-related and other care you may need at this time. You’ll find a quick overview of these benefits and helpful information below. 

Testing: Viral (diagnostic) COVID-19 tests as well as antibody (serologic) tests are covered at no cost to you. This includes the collection of the sample and the lab analysis. There is no frequency limit on testing. If you feel you should be tested for COVID-19 you can reach out to your primary care provider (PCP) to schedule an appointment. You can also find up-to-date testing site locations and information in your area by visiting 211.org or dialing 211. 

Treatment: If you are diagnosed with 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. Medicare has put this change into effect only for the duration of the COVID-19 pandemic. We will notify you when Medicare resumes normal coverage guidelines. 

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 Zoom, 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.

IMPORTANCE OF FACE MASKS – HELP SLOW THE SPREAD OF COVID-19

The Centers for Disease Control and Prevention (CDC) recommends that people wear cloth face coverings in public settings when social distancing is difficult to maintain. For more information from the CDC, go to CDC: Effectiveness of Cloth Face Coverings.  

Please remember that health care facilities now require the use of face coverings to help keep you and our community safe and healthy during the course of the pandemic.

Face mask costs are reimbursable under your plan’s Wellness Wallet (subject to your benefit maximum). Masks must be purchased through a website, retail store, or durable medical equipment (DME) provider.

The benefit includes:

  • Cloth masks
  • Surgical masks (limit 50 per month to reserve supplies for health care workers and medical first responders)
  • 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.

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