UPDATED: What to know about COVID-19: coverage, testing, and vaccinations
By Sanjay Basu, M.D., Ph.D. and Rajaie Batniji, M.D., D.Phil.
At Collective Health, we are committed to keeping our customers, members, and the rest of our community informed, while also providing resources to help navigate the uncertainty and complexity of the ongoing pandemic.
VACCINATING FOR CORONAVIRUS COVID-19
At the time of this post, two major vaccines are available, with three others pending authorization. The first wave of vaccinations were directed to healthcare workers and long-term care facility residents, followed by people over the age of 65, and shortly thereafter other groups such as teachers and first responders will start to be vaccinated.
Collective Health members are fully covered for their vaccine costs under the CARES Act, and the cost of vaccination does not incur deductibles, copays, or coinsurance. We understand the frustration around where and when to get vaccinated and how to schedule getting the vaccine, so Collective Health has gathered resources to help navigate the decentralized and often confusing process.
- For members in California, the most accurate and updated information we’ve found on vaccine availability, locations, and scheduling is available at VaccinateCA, which is built by a group of volunteers who call vaccination sites daily to confirm their availability and processes.
- For members in other states, we recommend a page that links directly to each state’s vaccine notification and sign-up tools (see the drop-down menu here under ‘How Do I Get A Vaccine?’). Many of these state sites will further link to county-level sign-up systems that notify individuals of when and where they can be vaccinated, based on their location, age and other risk factors. Additional guidance about scheduling websites and hotlines can be found here.
- Details about the administration of the vaccines, including guidelines for people who are pregnant, immunocompromised, or have had prior exposure/infection have been reviewed in this helpful overview from the CDC.
- We understand that the media and other online resources can have differing reports and many of us have common questions ranging from whether the vaccines affect fertility to whether the safety profiles of the vaccines have been sufficiently evaluated. Our colleagues at Johns Hopkins have provided a helpful evidence-based response to common myths about the vaccines.
As plans for vaccine distribution continue to evolve at the state and national level, many companies are looking for information in order to help their employees. Our clients are some of the most innovative and forward-thinking companies in the nation, and we work tirelessly to help them navigate these unprecedented challenges.
- We have created a planning and budgeting tool for on-site vaccination clinics, in collaboration with our research partners at the Harvard Center for Primary Care and Ariadne Labs. The tool enables planning for indoor or outdoor walk-through vaccination clinics following CDC protocols referenced in the tool. Vaccine administration often requires a pharmacist, nurse or physician dispensing the vaccine itself, and the tool links to key training and certification modules. Collective Health continues to assist clients with identifying partners who perform on-site vaccination services in their area.
- People under all health plans will be fully covered without fees in receiving the vaccine, under the CARES Act. Individual employers sponsoring healthcare should note that the government has pre-purchased the several hundred million doses and that these are being offered at no cost under current plans, with plan sponsors only paying administrative costs. Plan sponsors will eventually be required to pay for the vaccine costs not subsidized by the government, once the government-purchased allotment has been provisioned. The Medicare list prices are available online.
- HR Questions on COVID-19? SHRM shared a recent helpful review of COVID-19 vaccines and employer liability, and Gibson Dunn has a helpful review of common legal questions such as whether or how to mandate vaccination.
TESTING FOR CORONAVIRUS COVID-19
The CDC recommends that anyone with symptoms of coronavirus or who has been exposed to a person with known coronavirus infection should be tested. Symptoms of COVID-19 vary widely and may not be only limited to fever, cough, or shortness of breath; additional symptoms and an interactive self-assessment are on the CDC website.
In addition to guidance from the WHO and CDC, Collective Health follows guidance from the Infectious Disease Society of America when recommending testing modalities and strategies. More broadly, we have authored an occupational health protocol peer reviewed by our academic partners, to help reduce the risk of transmission in the workplace among both employees in essential roles who are currently at worksites, and among all workforce populations as people return to work.
COVID-19 testing is covered under almost all private and public insurance. This includes all Collective Health members, but having coverage does not mean people won’t face costs related to evaluation and potential treatment. We are closely monitoring the availability and effectiveness data on new treatments, and how to best address complications of COVID-19 as well as problems due to other conditions whose care has been compromised by disruptions to usual care provision.
HOW COLLECTIVE HEALTH CAN HELP
- We continue to assist members in receiving appropriate medical evaluation, including testing and follow-up, often including assistance with finding and ensuring health plan coverage for testing, evaluation, and treatment. Our Collective Care team (Member Advocates and Care Navigators) is on-call to receive member questions and help direct members to testing sites around the country, and to answer common questions about testing as the situation evolves quickly
- We work with clients to change plan designs and help offset the costs of COVID-19-related testing and treatment to members. Keep in mind, other elements of care may have regular cost-sharing. Our member’s resources have been reflected to show a plan’s specific cost-sharing for COVID-19 testing and treatment
- Additionally, Care Navigation, our specialized care management team, may be able to help members in need to find a healthcare provider to evaluate members for testing or if they are trying to arrange home delivery of other medications and avoid the infection risk of going to a pharmacy
Note: If you are a Collective Health member facing challenges related to COVID-19, our Member Advocates can share benefit plan specifics and potential costs. If you have questions about the details of your coverage or about paying for testing or treatment, contact our Member Advocates by phone, our website, or through the Collective Health app.
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