BCBS of AL COVID-19 Update

As the illness caused by the novel coronavirus, COVID-19, continues to spread, many are concerned about the possible impacts to themselves and their families. 

Blue Cross and Blue Shield of Alabama is closely monitoring the situation and has prepared contingency plans to ensure business operations continue to run smoothly in the event of a widespread outbreak. While these steps may not be necessary, these plans include: 

·       Continuing to process claims electronically. (Please note that 99% of claims are processed electronically, so we do not anticipate any disruption to claims processing.)

·       Heavily utilizing telework to maintain staffing of critical business areas. We expanded our telework capabilities, and currently have almost 100% of the workforce working from home.

In addition, Blue Cross has taken the following steps for benefits related to COVID-19:

·       Telehealth services are available to all members beginning March 16, 2020. Telehealth allows in-network PPO providers to provide medically necessary services to members that can be appropriately delivered via telephone consultation. This is applicable for members who wish to receive their care remotely and wish to limit their exposure. It can also serve as an initial screening for members who need to be tested for COVID-19.
PLEASE NOTE FOR GROUPS WITH TELEDOC COVERAGE

·       The newly expanded services being provided for telehealth are different from the services provided by Teladoc. The expansion of telehealth services effective 3/16/2020 is available to all members on both Underwritten and Self-Funded groups and allows in-network PPO providers to provide medically necessary services that can be appropriately delivered via telephone consultation. If the telehealth service is filed with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association, the telehealth service will be covered at 100% with no member cost sharing. If the telehealth service is not filed with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association, the telehealth service will be subject to member cost sharing (copays, deductibles, etc.) and contract benefits will apply.

·       In addition to the newly expanded services being provided for telehealth, Teladoc services are also available separately to members that have the Teladoc benefit on their benefit plan. Please note that Teledoc copays are not being waived at this time. 

·       In-network diagnostic tests for COVID-19 will be covered at 100% with no member cost sharing. Out-of-network diagnostic tests for COVID-19 will be covered at the out-of-network benefit level.

·       If an in-network office visit, urgent care visit, emergency room visit, behavioral health visit, or telehealth service results in a claim being filed by the in-network PPO provider with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association, that office visit, urgent care visit, emergency room visit, behavioral health visit, or telehealth service will be covered at 100% with no member cost sharing. Out-of-network services will be covered at the out-of-network benefit level.

·       More than one in-network office visit, urgent care visit, emergency room visit, behavioral health visit, or telehealth service for the same member incurred on the same day will be covered if the urgent care visit, emergency room visit, behavioral health visit, or telehealth service is rendered by different in-network PPO providers and the claims are filed with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association.

·       Inpatient deductibles and copays will be waived if a member is admitted to an in-network hospital with a COVID-19 related diagnosis as outlined by the CDC and American Medical Association.

·       We will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan) and/or encouraging members to use their 90-day mail order benefit.   The early refill allowance applies to prescription drugs including retail, maintenance, mail order and specialty drugs and will be effective until 5/31/2020.  We will also ensure formulary flexibility if there are shortages or access issues. Patients will not be liable for additional charges that stem from obtaining a non-preferred medication if the preferred mediation is not available due to shortage or access issues.

Please contact Blue Cross Blue Shield of Alabama at 800-292-8868 with further questions.

IMPORTANT - STATEMENT OF PRIVACY AND DISCLAIMER

This site is maintained by Plumbers & Steamfitters Local Union 52, on behalf of the Local 52 Fringe Benefits Fund (Fund).  The site is intended primarily for Fund participants and beneficiaries to provide them with additional access to Fund information that they may find helpful.  Your use of this site constitutes your acceptance of the below limitations and your acknowledgment that the content and services provided at this site are for information only. 

Please note: this site does not permit access to any confidential health related information or financial information. 

Do not rely on this site or its links for determination of questions that you may have about your eligibility or entitlement to Fund benefits or for Plan coverage and benefits.  Neither this site nor its links can provide you with a binding answer as to whether any claim you may have for Fund benefits will be allowed or denied.  If you have questions concerning your benefit eligibility, coverage or a benefit claim by you or your beneficiaries, you should contact the Fund Office located at 334-272-0240. 

Any general medical and other information provided by this site and its links is for your convenience only.  Do not rely on this information if you have specific medical questions.  Specific questions about medical issues should be addressed to your doctor.  And, do not disregard any medical advice you may have received because of information you may obtain from this site. 
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