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COVID19 Network & Benefit Enhancements…

Starting March 25, 2020, Premera Blue Cross will be expanding their telehealth network to include 98point6 and Doctor on Demand to give our clients greater access and address the increased demand related to COVID-19.

This expanded network will be available until June 30, 2020, with the potential to extend the duration based on business and epidemiological considerations.

Cost shares will be waived for telehealth services as follows:

  • For members enrolled in PPO plans: all cost shares will be waived.
  • For members enrolled in a QHDHP plan: they must meet their deductible before cost sharing will be waived for telehealth medical and behavioral health-related services. If the telehealth service provided is to treat COVID-19, the deductible will be waived.
  • If federal guidance or legislation is adopted after implementation that allows us to extend the cost share waivers prior to deductible for all telehealth medical and behavioral health-related services to QHDHP plans, Premera Blue Cross will allow such waivers based on said guidance or legislation.

Who is eligible for this in-network expansion?

  • All group, individual, grandfathered, non-grandfathered, associations, and OptiFlex members are eligible for this benefit.
  • Medicare Advantage, Medicare Supplement, FEP, Shared Administration, and Self-funded groups that opt-out aren’t eligible for this network expansion.

Can Telehealth providers diagnose COVID-19?

  • Telehealth providers can’t diagnose COVID-19 or order any COVID-19 testing. Your clients will need to contact their primary care doctor for further instruction.
  • Telehealth providers can:
    • Diagnose and treat acute and chronic illnesses that don’t include COVID-19 symptoms
    • Fulfill necessary prescriptions or order lab tests at local facilities

For questions relating to this in-network provider expansion and how Premera Blue Cross is responding to COVID-19, contact Tri-Cities Insurance Professionals 509 380-5980 1 866-334-3073.

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