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COVID-19 (Coronavirus) Coverage

Your health is important to us. Here's what you need to know.

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COVID-19 Coverage - Updated August 12, 2020


Regardless of your plan, in-network testing and treatment for COVID-19 (novel coronavirus) is covered 100%.
There is no member cost-sharing—that means no copays, coinsurance, or deductibles. All plans provide coverage for treatment and services related to COVID-19. Medications administered as part of a hospital stay for COVID-19 are also covered 100%. If you have questions about any of this information, please call Member Services at 800-538-5038.

 

Instacare

If you are insured on an Individual and Family plan, a Large or Small Employer plan, or FEHB plan and need to be screened and/or tested for COVID-19, we recommend you choose an in-network provider. These costs will be waived when these services are received through Intermountain Connect Care, office visits, urgent care (such as Intermountain InstaCare), hospital emergency rooms, or from the Department of Health. Testing is also covered out of network; however, you may be still be billed for excess charges beyond what we pay for these services.

Treatment for COVID-19 is covered on all plans when received by an in-network provider or when it’s an emergency service provided by an out-of-network provider. If your plan has out of network benefits, COVID-19 treatment is also covered for non-emergency services. Cost sharing will be waived when you receive treatments from an in-network provider; otherwise, regular plan guidelines will apply.

Please note: If you are insured through an employer with a self-funded plan, your benefits may be different. Please verify your benefits through your Human Resources team.

We’ve complied with the federal government’s extension of timely filing deadlines for claims and appeals, COBRA, and Special Enrollment periods for those enrolled on an employer-sponsored plan*. These changes apply from March 1 and end 60 days after the end of the COVID-19 Public Health Emergency Period.

In compliance with federal guidelines, between March 1, 2020, and 60 days after the announced end of the Public Health Emergency Period, the following periods and dates are suspended:

  • The date you can file a claim
  • The date you can file an appeal of adverse benefit determination
  • The date you can file a request for external review after receiving an adverse benefit determination
  • The date you can elect COBRA coverage and the date you can make your first COBRA premium payment
  • The date you can elect or change coverage if you qualify for a Special Enrollment Period

For example – Assume you have 12 months to file a claim for a service that was rendered on September 2, 2019. The claim entered day 179 of the 365-day timeline to file the claim on February 29, 2020. The time to file this claim is suspended starting on March 1, 2020, until 60 days after the Public Health Emergency Period is declared over. If the Public Health Emergency Period were over on October 1, 2020, 60 days later is November 30, 2020. In this scenario, you would have 186 days from November 30, 2020, to still file the claim (these are the days remaining in the 365-day timeline to file the claim).

*This only applies to members of all fully insured and self-funded groups that are regulated by the Employee Retirement Income Security Act. 

 
Treatment

SelectHealth Advantage members are covered according to the Centers for Medicaid and Medicare guidelines under a national emergency. Screening and/or testing for COVID-19 is covered in- and out-of-network for a $0 copay. All emergency services and in-network COVID-19 treatments will also be covered for a $0 copay.

 
Network Coverage

For Medicaid members (those on a SelectHealth Community Care plan), COVID-19 testing and treatment is covered as an emergency service and can be received through in-network and out-of-network providers.Copays are not required.

 
Zero Copay icon

If your child is covered by a CHIP plan, testing and treatment for COVID-19 is covered as an emergency service and can be received from in- and out-of-network providers. No copay is required.


 
Pharmacy Delivery

As always, Intermountain Home Delivery is a great option to have your maintenance medications delivered to your home. Intermountain Specialty can deliver your specialty medications. More information can be found at https://selecthealth.org/pharmacy/home-delivery-and-specialty-pharmacy.

  
Prescriptions Covered

We've changed frequency and refill limits for certain Miscellaneous Medical Supplies and Durable Medical Equipment to allow more lenient timelines for members who are unable to get the supplies they need like enteral formula and oxygen.

 
Connect Care

We’ve expanded our telehealth to help members seek services safely and to help ensure important continuity of care. This includes adding temporary coverage for digital and telephonic services for medical and behavioral health needs.

 

 

COVID-19 Screening and Testing 

Utah

If you believe you have COVID-19, use the symptom checker at intermountainhealthcare.org, visit Intermountain’s coronavirus resources, or call the COVID-19 Hotline at 844-442-5224. A healthcare professional will screen you for COVID-19. If testing is appropriate, they will provide information on testing options and availability.

Intermountain Healthcare offers community screening and testing locations, which are listed at https://intermountainhealthcare.org/covid19-coronavirus/get-testing/. Most locations screen for possible testing while you remain in your vehicle; however, the following hospitals require an order before arrival: American Fork Hospital, Cassia Regional Hospital, and Garfield Memorial Hospital. Not all people who are screened (over the phone or in person) will be tested. Testing is only recommended for those who meet certain criteria set by the Utah State Department of Health and Intermountain Healthcare. There are limited in-person screenings available at select locations.

Idaho

In Idaho, you can visit coronavirus.idaho.gov, St. Luke’s Health System COVID-19 Resources page, or call your healthcare provider, 211, or the St. Luke’s Health System COVID-19 Hotline at 208-381-9500. 

Nevada

In Nevada, you can visit p3hp.org/coronavirus or nvhealthresponse.nv.gov for more information.

You can also visit CDC.gov/coronavirus or your state's Department of Health website.

 

The information and updates contained in this communication reflect current knowledge and policy for the date indicated. Information evolves on a day-to-day basis during the COVID-19 pandemic. SelectHealth will provide updates with additional information as it becomes available from providers, state officials, federal officials, etc.