Protecting Our Members Against COVID-19

Coronavirus disease 2019 (COVID-19) is an emerging illness. Many details about this disease are still unknown, such as treatment options, how the virus works, the total impact of the illness, and many other factors.

COVID -19 is a respiratory disease that is caused by a new strain of the coronavirus. The number of cases is increasing around the country and the world.
The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, shortness of breath and lower respiratory illness. It may be contagious before a person begins showing symptoms.
Influenza (the flu), a contagious respiratory illness caused by Type A and Type B influenza viruses, is highly active in the United States now. Everyone 6 months of age and older should get a flu vaccine.
If you have been exposed or begin showing symptoms of the coronavirus or flu, contact your healthcare provider or health department right away.
We all have a role to play in protecting our communities and families from the spread of this virus, just as with other contagious viruses. You can also follow these tips to prevent infection:
  • Wash your hands thoroughly and often. Use soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizer with at least 60 percent alcohol.
  • Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
  • Promptly dispose of tissues in a wastebasket after use.
  • Clean public surfaces thoroughly.
  • Stay home when you are sick.
  • Avoid shaking hands.
  • Avoid close contact with people who are sick.
  • Get a flu vaccine.

QualChoice is taking extra steps to care for our members during the coronavirus outbreak. In accordance with guidance from the Centers for Medicare & Medicaid Services, we are taking the following measures to enhance coverage for care related to COVID-19.

Your QualChoice plan will cover COVID-19 testing without any copay, cost sharing or pre-authorization (pre-approval). If an in-network provider thinks a member needs testing, there should be no cost barriers.
Early prescription refills at your pharmacy and by home or mail delivery are being allowed. This will ensure that you can get your regular prescriptions even if you can’t go to the pharmacy.
Virtual doctor visits—by smartphone or other video-capable device—can take the place of face-to-face office visits. This also applies to care not related to COVID-19 during the outbreak.

  • There is no copay or cost sharing.*
  • Any care that can be delivered this way is covered.
  • No pre-authorization is required from March 17, 2020 through June 30, 2020.
  • Any type of connection technology may be used.**
Get Medical Help via Video and Phone

 

*For Health Savings Account (HSA)-Qualified plans, IRS guidance is pending as to deductible application requirements for telehealth/telemedicine related services.

**Providers should follow state and federal guidelines regarding performance of telehealth services including permitted modalities.

QualChoice is committed to the health of our members. Your QualChoice plan will cover the cost of medically necessary COVID-19 tests and the associated doctor's visit. We do not require pre-authorization for these services.

Yes, when medically necessary diagnostic testing or medical screening is ordered and/or referred by an in-network provider, your plan will cover the cost of tests and the associated doctor’s visit. Your copayment, coinsurance and/or deductible cost-sharing will be waived.
No, pre-authorization for medically necessary COVID-19 diagnostic testing and medical screening is not required when ordered and/or referred by an in-network provider.
Medically necessary COVID-19 diagnostic testing and/or medical screening and the associated doctor’s visit will be covered when ordered, referred and/or performed in the following in-network settings:
  • Virtual visit (telehealth services)
  • Doctor’s office
  • Independent laboratory/diagnostic facility
  • Urgent care facility
  • Emergency department facility
During this outbreak, a virtual care (telehealth) visit is recommended. This type of care, by smartphone or other video capable device--is covered for COVID-19 as well as unrelated care. This limits possible exposure in a doctor’s office or other healthcare facility.

UAMS Health, a QualChoice in-network facility, provides online screening.

If you have been exposed to or show symptoms of the coronavirus or flu, contact your healthcare provider or health department right away.
No, your plan will cover medically necessary COVID-19 diagnostic testing and/or medical screening at no charge to you when ordered and/or referred by an in-network provider. Your copayment, coinsurance and/or deductible cost-sharing will be waived for testing and the associated doctor’s visit.
Any medically necessary treatment related to COVID-19 is considered a covered benefit, consistent with the provisions of your policy for treatment of an illness. Any cost-sharing requirements will apply. We are committed to ensuring access to COVID-19 treatment in accordance with federal and state law.
Yes, QualChoice members will be able to refill prescriptions o the refill date if needed.
COVID-19 is a new disease and we are still learning more about it. At this time there is no evidence that pregnant women are more likely to contract COVID-19 or get more sick from it than other people. But pregnant women should always protect themselves from illness.

Learn more about COVID-19, Pregnancy and Breastfeeding.

More Resources

For more information, including travel advisories, please visit cdc.gov.

For information on the outbreak in Arkansas: