COVID-19 Health Resources
Due to the COVID-19 pandemic, we understand that these are uncertain and stressful times in our world. Faculty and staff covered by Loyola's medical plans have access to extra benefits through Aetna to help support good health during this challenging time.
Aetna members have access to the following resources:
- Aetna is waiving co-pays for all diagnostic testing related to COVID-19. In addition, beginning May 1, 2020, CVS Health COVID-19 Self-Swab Testing will be available at no cost.
- Until June 4, 2020, Aetna will waive member cost sharing for any covered telemedicine visits — regardless of diagnosis.
- Through Aetna's Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms.
- Through existing care management programs, Aetna will proactively reach out to members most at-risk for COVID-19.
- Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna members as a fully-covered benefit.
- Now Available: CVS Health: 17 Illinois Test Sites.
- A complete list of the testing sites located across the country can be found here.
View the COVID-19 Aetna Health Resources for a complete list and more details. Aetna's COVID-19 website also contains additional information.
As a reminder, the LUC.edu/coronavirus site has a number of resources available, including CDC guidance on how to protect yourself and a list of tips for managing anxiety caused by the spread of COVID-19. Additional emotional support resources are also available through Perspectives, our Employee Assistance Program.
The CARES Act was passed on March 27, 2020 as an effort to help Americans during the COVID-19 (coronavirus) pandemic. This new provision allows for adjustments to certain employee benefits, including the following:
- Over-the-counter health care products as eligible expenses
The CARES Act permanently reinstated over-the-counter drugs and medicines as eligible expenses for Health Savings Account (HSA), Flexible Spending Account (FSA) and Health Reimbursement Arrangement (HRA) funds without a prescription. (Under the Affordable Care Act, only drugs and medicines that required a prescription were eligible for reimbursement.) This change takes place for over-the-counter drugs and medicines purchased dating back to January 1, 2020.
- Feminine care products as eligible expenses
The CARES Act also includes feminine care products such as tampons and pads to be considered eligible expenses for HSA, FSA, and HRA funds. This change takes place for feminine care products purchased dating back to January 1, 2020.
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COVID-19 testing covered at no costThe CARES Act clarifies that all testing for COVID-19 is to be covered by private insurance plans (fully-insured and self-insured) without cost sharing. Coverage extends to any services or items provided during a medical visit—including an in-person or telehealth visit to a doctor’s office, an urgent care center, or an emergency room—that results in COVID-19 testing or screening. This coverage requirement began on March 18, 2020 (when the Families First Coronavirus Response Act was enacted) and remains in effect only while there is a declared public health emergency (as defined under federal law).
Teladoc can answer questions about the COVID-19 virus, assess a member’s risk, and provide support to help relieve symptoms. Additionally, Teladoc can serve to help members avoid unnecessary risk of exposure to COVID-19 by addressing other medical needs virtually. Until June 4, 2020, Aetna members' telemedicine visits are covered free of charge — regardless of diagnosis.
Members who do not want to leave their homes risking infection are using this service for other low risk health concerns versus going to the doctors office, urgent care or walk in clinic.
Teladoc is unable to conduct COVID‐19 diagnostic testing services and therefore cannot confirm diagnoses. However, Teladoc care providers can provide the appropriate direction and next steps to access testing, if required.
Note: The wait times for Teladoc appointments can now be up to two hours for an appointment once requested, due to very high call volumes.
Learn more about the CVS Health: 17 Illinois Test Sites. In addition, a complete list of the testing sites located across the country can be found here.
Aetna members diagnosed with COVID-19 are eligible for a free Healing Better kit from Aetna. A COVID-19 Healing Better Box contains CVS over-the-counter medications to help relieve symptoms, as well as personal and household cleaning supplies to help keep others in the home protected from potential exposure. The package will be delivered to the member’s home (at their last known address) within 1-3 days of Aetna receiving notification of diagnosis of an inpatient hospitalization or member self-report.
Aetna is ensuring that Loyola Medical Plan members have timely and safe access to medication. Steps are being taken to help prevent stockpiling and gaps in therapy, including implementing quantity limits and extending prior authorizations.
Extending Prior Authorizations to Maintain Member Access
CVS has acknowledged an emergency around the Coronavirus, as declared by the Trump administration as of March 13, 2020. When a declaration of emergency is issued, for coronavirus (or other disaster, such as a weather event), CVS activates a standard process to enable pharmacists to enter disaster overrides at point of sale. Pharmacists are able to enter the appropriate “Submission Clarification Code” (SCC13) where the “Refill Too Soon” edit is bypassed, allowing them to fill an emergency script for an impacted member. All controlled substances are automatically excluded from the standard emergency refill process. A new prescription from the prescriber is required to provide an emergency supply of a controlled substance.
CVS has acknowledged an emergency around the Coronavirus, as declared by the Trump administration as of March 13, 2020. When a declaration of emergency is issued, for coronavirus (or other disaster, such as a weather event), CVS activates a standard process to enable pharmacists to enter disaster overrides at point of sale. Pharmacists are able to enter the appropriate “Submission Clarification Code” (SCC13) where the “Refill Too Soon” edit is bypassed, allowing them to fill an emergency script for an impacted member. All controlled substances are automatically excluded from the standard emergency refill process. A new prescription from the prescriber is required to provide an emergency supply of a controlled substance.
In order to prevent gaps in therapy, Aetna is extending many clinical prior authorization records – set to expire between March 23 and June 30 – for 90 days. For instance, if a prior authorization is set to expire on May 15, the expiration date will be extended to August 15.
The process is activated when a Declaration of Emergency is issued by the state and stays in effect until the Declaration ends, or if no end date is indicated, for a period of 30 days from the date the Declaration is issued.
Preventing Potential Shortages of Key Drugs
While there is no evidence at this time of widespread shortages, it is important to ensure that members with ongoing needs can maintain access to medications, while also enabling patients with COVID-19 to obtain treatment. Some of the medications being identified as possible treatments for COVID-19 are also used by members to treat existing conditions like HIV and lupus. Aetna introduced a utilization management (UM) product bundle, which institutes quantity limits on medications that potentially treat COVID-19 and are used by members for other conditions.
While there is no evidence at this time of widespread shortages, it is important to ensure that members with ongoing needs can maintain access to medications, while also enabling patients with COVID-19 to obtain treatment. Some of the medications being identified as possible treatments for COVID-19 are also used by members to treat existing conditions like HIV and lupus. Aetna introduced a utilization management (UM) product bundle, which institutes quantity limits on medications that potentially treat COVID-19 and are used by members for other conditions.
These limits include:
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Albuterol inhalers: limit of two (200 inhalations per device) per 30 days at retail or six devices per 90 days at mail
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Chloroquine, hydroxychloroquine: 10-days’ supply, limit of one fill per 60 days
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Kaletra: 14-days’ supply, limit of one fill per 60 days
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Azithromycin: 250mg tablets, limit of six tablets or one blister pack of six tablets per five days; limit of one fill per 60 day
CVS Health announced COVID-19 resources for Aetna members on March 6, 2020. View the announcement for more information.
The Families First Coronavirus Response Act was signed into law on March 18, 2020. The implications to healthcare coverage for Loyola Medical Plan members is that in addition to the cost of the COVID-19 test, plans must cover the cost of a health care provider, urgent care center, or emergency room visit that results in the ordering or administration of a test for COVID-19. Coverage must be provided with no cost-sharing by the member. Aetna was already waiving for the cost share for the COVID-19 test and ER services, but has been expanded to urgent care cost-sharing as a result of this act.
