Coronavirus Update for Our Clients

People with mild, flu-like symptoms should call their health care provider before going to a health care facility.

• Many providers offer telehealth services. Ask your primary care provider if they do.
• Until further notice, fully-insured members who access services from Tufts Health Freedom Plan network providers via telehealth will have no cost share.¹

Tufts Health Freedom Plan Commercial members can also use our telehealth solution powered by Teladoc, teladoc.com/tuftshealthfreedomplan. With telehealth from Teladoc, members can access U.S.-based, board-certified providers for general medical needs and diagnoses from anywhere in the world and for $0 copay for plans issued or renewed in 2020. Members can contact a Teladoc doctor 24/7 if they’re concerned about their symptoms or have questions about coronavirus. Until further notice, there will be no member cost for this service for our members, including members of self-funded groups that have elected this benefit and have not opted-out of cost sharing modifications.

People with COVID-19 or with other flu-like symptoms should stay home and follow all quarantine procedures. Their close contacts may also be advised to stay home. If someone has more significant symptoms, they should go to their health care provider, urgent care or the emergency room. But they are advised to call in advance and follow any protocols that the facility has in place.

They should visit the CDC website and click on “Coronavirus Disease 2019.”

We are contracting with commercial labs and hospitals as they make the test available and it is not a very expensive test. In this crisis situation, we are watching claims closely. Specific codes for COVID-19 have just been implemented so we will watch for their use by providers.

The earliest testing for coronavirus was mostly done by the CDC or state labs and not all of those will be billed back to health plans.

Yes, if a claim is submitted using the codes for the coronavirus test, we are tracking it. Testing is being done by state labs, commercial labs and some hospitals now.

Approximately 80% of individuals who contract coronavirus will have mild symptoms. They will be quarantined at home with treatment that is similar to that for a cold or the flu.

Those with significant symptoms may need hospitalization. This may include stays in the Intensive Care Unit with ventilator support. Because there are no specific treatments for COVID-19, it is likely the claims will closely resemble the costs associated with other significant respiratory illnesses, such as severe flu cases in individuals with other medical conditions. We are monitoring this closely and it is expected that some individuals will have prolonged ventilator needs. We are working with provider partners to explore the ability to transition patients to less acute settings, such as dedicated COVID-19 units at acute rehabilitation centers or skilled nursing facilities.

Our pharmacy team works closely with our pharmacy benefit manager, CVS Health, and with our specialty pharmacies to monitor for drug shortages. At this time, there is no specific concern about shortages.

The pharmacy team is also part of our Pandemic Preparedness plan. They will watch for any need to alter usual processes in response to changing needs. For instance, if generic drugs are not available, there are policies to provide brand-name substitutes.