COVID-19 Information | Ambetter of Tennessee


What You Need to Know About Coronavirus

Symptoms, Testing, and Treatment

COVID-19 is a respiratory illness that is caused by a new virus called a coronavirus, which has become a public health emergency. Coronavirus illness 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. However, there are steps you can take to prevent the spread of coronavirus and stay healthy.

The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. Other symptoms include fatigue, mucus production, and muscle aches. Some individuals have also experienced gastrointestinal symptoms, such as diarrhea and nausea, prior to developing respiratory symptoms. It may be contagious before a person begins showing symptoms.

The CDC’s "Coronavirus Self-Checker” can provide you with information about seeking appropriate medical care based on COVID-19 related symptoms; however it is not intended to diagnose COVID-19. People who think they may have been exposed to COVID-19 should contact their healthcare provider immediately.

Symptoms may appear 2 – 14 days after exposures. However, infected individuals can be contagious before symptoms arise (i.e. from an asymptomatic individual). 

Influenza (the flu), a contagious respiratory illness caused by the influenza viruses (Type A and Type B), has high activity in the United States at this time. 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 immediately. We would be happy to help you locate an in-network provider.

If you are unsure if you have been exposed to or at-risk of being infected with COVID-19 (coronavirus), scheduling a virtual care visit with a provider is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. Due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times.

Emergency warning signs for COVID-19 include, but are not limited to: trouble breathing, persistent pain or pressure in the chest, blueish lips or face, new confusion or inability to arouse. If you are experiencing any of these warning signs, you should seek immediate medical attention. Contact your healthcare provider if you have symptoms which are worsening or concerning to you.

To receive the fastest support, you can contact Teladoc by mobile App or through the web to request a virtual visit. You will also be able to see a wait time estimator to help you to anticipate when a provider will call you back. You can download the Teladoc app on the App Store or Google Play. You can also call Teladoc to request a virtual visit. If there is a wait, you can request a callback from a service representative to request a visit, so you don’t need to stay on hold.

If you haven’t used Teladoc before, you can set up an account and share your medical history before requesting a visit to make the process go quicker. You can set up your account on the Teladoc app or on their account set up page. If you need assistance setting up your account, you can call Teladoc for help.

We encourage our members to use telehealth visits for non-urgent health issues or if you need to speak to a provider about your COVID-19 risk. However, due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times. Ambetter is committed to ensuring you have access to quality, affordable healthcare during this time, and are working closely with Teladoc to make sure members have access to virtual care when they need it.

Ambetter is working closely with Teladoc to ensure that there is enough provider capacity to address the high demand for virtual visits at this time. As the demand for virtual visits increases, Teladoc is continually working to make more providers available to meet the needs of our members. You may also be able to set up a telehealth consultation directly with your primary care provider. You can reach out to your primary care provider or their office to see what kind of virtual care options are available to you.

We encourage members to call the Nurse Advice Line with questions about symptoms of illness or other health-related issues. Registered nurses are available through the Nurse Advice Line 24 hours a day, 7 days a week, 365 days a year. However, due to a high demand at this time, please anticipate that there may be longer than usual wait times when you call the Nurse Advice Line. As a reminder, the Nurse Advice Line cannot answer general member services questions, providing plan benefits or making provider referrals, including questions related to COVID-19 coverage and benefits.

Medically necessary COVID-19 diagnostic testing and/or medical screening services and the associated physician’s visit will be covered when ordered, referred and/or performed in the following locations:

  • Physician’s/practitioner’s office
  • Independent laboratory/diagnostic facility
  • Urgent care facility
  • Emergency department facility

If you have been exposed or are showing symptoms of the coronavirus or flu, contact your healthcare provider or health department immediately. 

If you are unsure if you have been exposed to or at-risk of being infected with COVID-19 (coronavirus), scheduling a virtual care visit with a provider is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. However, due to a high demand for virtual health visits at this time, please anticipate that there may be longer than usual wait times.

We all have a role to play in protecting our communities and families from the spread of coronavirus. There are steps you can take to prevent the spread of coronavirus and stay healthy. If you have been exposed or begin showing symptoms of the coronavirus or flu, contact your healthcare provider or health department immediately.

You can also follow these tips to prevent infection:

  • Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizing rub (must contain 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.

Older adults, individuals with underlying medical conditions, such as heart disease, lung disease, diabetes, asthma, kidney disease, severe obesity, and those with weakened immune systems (due to medications or underlying illness) are at higher risk for complications from COVID-19 illness.

Yes, Ambetter members will be able to refill prescriptions prior to the refill date.

Yes, as an Ambetter member, you can have your prescriptions mailed to you by Homescripts, a mail-order pharmacy, and it is less expensive than filling through retail pharmacy. Eligible members pay only 2.5x their regular copay for a three-month fill via Homescripts. Delivery is free, and enrolling is easy:

Cost and Coverage

On July 23, 2020, HHS Secretary Alex Azar renewed the COVID-19 Public Health Emergency (PHE). This extends flexibilities and funding tied to the PHE to continue for another 90 days.

With this renewal the various testing, screening, billing, and telehealth coverages that were implemented in response to the COVID-19 PHE earlier this year will be extended to our members. This extension will go through October 23, 2020, until the PHE is either terminated or extended again. This extension does not affect coverages that had already been made effective through December 31, 2020.

Do you have any questions about this extension or the covered benefits impacted by it? Please contact Member Services.

Yes, when medically necessary diagnostic testing is ordered and/or referred by a licensed health care provider, your Ambetter plan will cover the cost of COVID-19 tests and the associated physician’s visit. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services.

 

Yes, when medically necessary antibody testing is ordered and/or referred by a licensed health care provider, your Ambetter plan will cover the cost of COVID-19 antibody tests. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived on COVID-19 antibody tests.  

No, our Ambetter plans will not require prior authorization, prior certification, prior notification and/or step therapy protocols for COVID-19 diagnostic testing and medical screening services, when medically necessary services are ordered and/or referred by a licensed health care provider.

No, your Ambetter plan will cover medically necessary COVID-19 diagnostic testing and/or medical screening services at no charge to you, when such services are ordered and/or referred by a licensed health care provider. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services along with the associated physician’s visit.

Yes, your plan will cover medically necessary COVID-19 treatment related services consistent with benefit coverage provisions of your policy for treatment of an illness. We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

No, our Ambetter plans will not require prior authorization, prior certification, prior notification and/or step therapy protocols for COVID-19 treatment, when services are ordered and/or performed by a licensed health care provider.

No, your Ambetter plan will cover medically necessary COVID-19 treatment at no charge to you, when such services are performed by a licensed health care provider. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for COVID-19 treatment related services. 

Yes, your plan utilizes Teladoc to provide telehealth services. All telehealth consults are now screened for COVID-19 symptoms and risk factors. Teladoc providers will evaluate your symptoms and contact history to assess your COVID-19 risk, and then help guide you through the next steps for care and testing, if needed. We are also encouraging members use telehealth visits for non-urgent health issues. If you haven’t used Teladoc before, you can visit their website or download the mobile App to get started. You can download the Teladoc app on the App Store or Google Play.

In addition to Teladoc, you may also be able to set up a telehealth consultation directly with your primary care provider. You can reach out to your primary care provider or their office to see what kind of virtual care options are available to you. We are temporarily waiving prior authorization for in-network telehealth services.

No. Ambetter members can have a telehealth visit with a provider at no cost to the member. At this time, this also applies to our members enrolled in Health Savings Account-eligible High Deductible Health Plans (HDHPs.).

Yes, as an Ambetter member, you can have your prescriptions mailed to you by Homescripts, a mail-order pharmacy, and it is less expensive than filling through retail pharmacy. Eligible members pay only 2.5x their regular copay for a three-month fill via Homescripts. Delivery is free, and enrolling is easy:

Payment and Financial

Ambetter understands you may be experiencing financial difficulty at this time. If you’ve experienced an income change or job loss, we recommend that you visit https://www.healthcare.gov/ or call 1-800-318-2596 (TTY: 1-855-889-4325) to update your income information. Updating your information could affect the amount of your tax credit, possibly lowering your monthly premium.

If you’ve experienced financial hardship or job loss, you may qualify for additional annual premium tax credit. Visit Healthcare.gov or call at 1-800-318-2596 (TTY: 1-855-889-4325) to update your income information. Updating your information could affect the amount of your tax credit, possibly lowering your monthly premium.

If you’ve experienced financial hardship or job loss, please visit Healthcare.gov or call at 1-800-318-2596 (TTY: 1-855-889-4325) to update your income information. Updating your information could affect the amount of your tax credit, possibly lowering your monthly premium. If you enrolled with a broker, they can also help update your information.

You may also be eligible for an Economic Impact Payment through the Federal government’s Coronavirus Tax Relief program. For more information, visit the IRS Coronavirus special section.

If you are in need of additional support right now, you can find programs in your area through the Aunt Bertha online platform. Aunt Bertha is a free tool that makes it easy to find and apply for assistance program. You can search for free or reduced cost services available in your zip code -including food, housing, job training, financial assistance and much more.

Social and Emotional Support

Yes, mental health services are a covered benefit. Visit your online member account to understand any costs associated with mental health specialist visits, specific to your health plan. To find mental health professionals near you, search for “Behavioral Health” in the Provider Search tool.

Through Ambetter Telehealth’s partner, Teladoc, you can talk to a therapist or psychiatrist.

To speak with a mental health professional, you will be prompted to schedule an appointment time. Visit the Teladoc website or download the mobile app from the Apple or Google Play app stores to get started.

There is no co-pay associated, however, coinsurance and deductible may apply to some plans for the session. Visit your online member account to understand any costs associated with mental health specialist visits, specific to your health plan.

We encourage members to take care of their body. Take deep breaths, stretch or meditate. While observing social distancing, connect with other through email, video chats, phone, texting, etc. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking. For more information, see the CDC's suggestions for mental health and coping during COVID-19.

If you are in need of additional support right now, you can find programs in your area through the Aunt Bertha online platform. Aunt Bertha is a free tool that makes it easy to find and apply for assistance program. You can search for free or reduced cost services available in your zip code - including food, housing, job training, financial assistance and much more.

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Healthcare is essential. Ambetter can help.

Our members’ health is important to us, now and always. That’s why you can count on us to cover COVID-19 testing and treatment. And if you’ve lost access to insurance, we want to help you get the coverage you need.

Because protecting peoples’ health is why we’re here, and it’s what we’ll always do.