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Frequently Asked Questions about COVID-19

For Individual & Family Members

 

If your income has changed, you may be eligible for extra help paying for your monthly health insurance premium and/or what you pay for the health benefits and services you use. Log into your Health Insurance Marketplace account to update to your income to see if you qualify for additional help.

Log in to MNsure Marketplace (MN residents)

Login into Health Insurance Marketplace (all other states)

We will waive your copays, co-insurance and deductibles for medically necessary in-network COVID-19 diagnostic testing. This applies to testing that meets guidelines from Centers for Disease Control and the Food and Drug Administration (FDA), and is ordered by an appropriate medical professional. These changes are retroactive to March 1, 2020, and will extend through October 31, 2020.

Home tests for COVID-19 that are FDA-approved, ordered by a practitioner and medically necessary are eligible for coverage, except when done for a return to work or public surveillance.

Yes. Medica will waive your copays, co-insurance and deductibles for Food and Drug Administration (FDA)-approved antibody tests after a suspected (not confirmed) COVID-19 diagnosis. Tests must be ordered by a medical professional and considered medically necessary.* Coverage for the antibody test applies both in-network and out-of-network, and will extend to office visits and other charges related to the antibody test when performed at in-network locations. This new coverage will extend through October 31, 2020.

*Not covered as part of a return to work request.

We will waive your copays, co-insurance and deductibles for COVID-19 inpatient hospital care. These changes are retroactive to March 1, 2020, and will extend through September 30, 2020.

It depends on the state where you purchased your policy.

Iowa, Kansas, Missouri and Nebraska Policies

You must see a network provider for coverage of COVID-19-related costs.

Oklahoma Policies

You must see a network provider for coverage of COVID-19-related costs. If you visit an out-of-network provider, services will apply to out-of-network benefits.

Minnesota, North Dakota and Wisconsin Policies

You can see any provider for coverage of COVID-19-related costs.

Yes. Prior authorization requirements will not be required for admissions to long-term care facilities, acute in-patient rehabilitation and skilled nursing and home health care facilities. This change will extend through September 30, 2020.

Maybe. If you have prescription benefits with Medica, and your medication needs to be filled early, submit your refill request to your pharmacy. They will determine if your prescription can be filled early.

Yes, members can request a 90-day supply of some long-term medications used to treat chronic conditions. Medica, at this time, will not authorize requests to fill medications that are not eligible for 90-day refills.

Your options include:

  1. Express Scripts Home Delivery (mail order) Prescription Services*

    Mail order home delivery of your prescriptions is available with most Medica plans. To learn more and request mail order delivery of your medications, visit My Prescriptions using your secure member site..
    Log in

  2. Retail pharmacy home delivery 

    Many retail pharmacies will mail your prescription to your home, free of charge. Check with your pharmacy for details.

 

*Some home delivery requests may require an in-person office visit and a new prescription from a prescriber.

Yes, virtual care is covered when you visit a network provider. Log into your secure member site and select Find Care to find a provider in your network.

We expanded the availability of telehealth visits to include:

  • Visits from your home
  • Visits using additional technologies such as FaceTime or Skype
  • Visits using audio only when video is not available

Keep in mind:

  • Not for emergencies
  • Most providers are available 24 hours a day, 7 days a week
  • No appointment needed

Log in

Call your primary care provider if you have a cough, fever or shortness of breath to find out if you are eligible for testing.

If your primary care provider recommends that you be tested, they will send you directly to a testing center.

Minnesota Residents: MNsure Health Insurance Marketplace announced a limited Special Enrollment Period that will allow uninsured individuals to get covered. You must enroll in coverage by April 1. Coverage will start on April 1. Visit MNsure for more information.

Go to mnsure.org


Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma and Wisconsin Residents: At this time, you can only enroll in coverage if you experience a qualified life event. Examples include losing your employer-sponsored coverage, having a baby or moving outside your plan’s service area.

Learn more or see if you qualify

Date: 8/6/2020 8:13:47 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB02