Member Coronavirus Information

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 late October, 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.

COVID-19 is a respiratory disease that is caused by a new virus called a coronavirus, which has become a public health emergency. The number of cases continue to increase nationally and globally.

The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. COVID-19 can be contagious before a person begins showing symptoms.

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 virus or flu, contact your healthcare provider or health department immediately. 

For members that cannot reach their healthcare provider, the Augusta University Health ExpressCare app provides free virtual COVID-19 screenings, 24/7, with no appointment required. https://www.augustahealth.org/expresscare/covid-19-virtual-screening

Your doctor may have a telehealth option for you.

You can get medical advice, a diagnosis or a prescription by phone or video. You can use telehealth for illnesses such as:

• Colds, flu and fevers
• Rash, skin conditions
• Sinus problems, allergies
• Upper respiratory infections, bronchitis

As a Peach State Health Plan member you have access to healthcare professionals 24/7. You can reach health providers for non-emergency health issues through the 24/7 Nurse Advice Line. For more information about this service call us at: 1-800-704-1484 or TDD/TYY 1-800-255-0056.

We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. 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.

Yes. When medically necessary diagnostic testing, medical screening services and/or treatment is ordered and/or referred by a licensed health care provider, we will cover the cost of medically necessary COVID-19 tests, screenings, associated physician’s visit(s) and/or treatment. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment.

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

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

• Physician’s/Practitioner’s Office
• Independent Laboratory/Diagnostic Facility   
• Urgent Care Facility
• Emergency Department Facility

Are you unsure if you have been exposed to or at-risk of being infected with COVID-19? Schedule a virtual care visit with a provider. It is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility. 

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

Any medically necessary treatment related to COVID-19 would be considered a covered benefit. We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

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

Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.

• Take care of your body. Take deep breaths, stretch or meditate.
• Connect with others. 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.
• Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
• For more information, see the CDC’s suggestions for mental health and coping during COVID-19

Tip #1: Clean your phone right now

Drop what you’re doing! Clean your phone and case right now! You can use disinfecting wipes or sprays.

Why is this important?

It’s easy to say “I can always clean my phone later”. If you do it right now, you won’t forget! We’ve also told you how so you don’t have to figure that out on your own.

Tip #2: Use an alarm

Set a phone alarm called “clean phone.” Set an alarm on your phone called “clean phone” once per day. When it goes off, clean your phone right then and there!

Why is this important?

Even if you just cleaned your phone right now, you’re going to forget later! That’s why reminders are so important. You’ll have to clean.

For more information about cleaning and disinfecting visit the CDC Cleaning And Disinfecting Your Home page.

Protect yourself and those around you. Please consider the following before returning to adult day services.

• If you feel sick, stay home.
  • Avoid public places.
  • Contact your health care provider.
• Practice healthy habits.
  • Wash your hands after touching public surfaces.
  • Avoid touching your face.
  • Sneeze or cough into a tissue. You can also use the inside of your elbow.
  • Clean frequently used items and surfaces as much as possible.
  • Use a face mask while in public.
• Personal Protective Equipment (PPE) and frequent hand washing
  • Your provider may require a face covering and gloves during a visit. They may also require frequent hand washing.
  • Your service plan may be updated based on how you tolerate these changes.
• This has been a stressful time. If it’s affecting your mental health, you may need to speak to someone.

As a Peach State Health Plan member, you have access to health professionals 24/7. You can call the 24/7 Nurse Advice Line for non-emergencies. For more information about this service, call us at 1-800-704-1484.

It’s important to change how we use public spaces. Consider whether you need to touch certain objects and surfaces. Be sure to wipe public items before and after you touch them.

Things to be aware of while at your adult day center.

We have all had to make changes to reduce the spread of COVID-19. To reopen, we will need to continue these safe practices.

• Social distancing
  • Stay 6 feet away from others when going into a shared space.
• Wash your hands.
  • Wash hands with soap and water for at least 20 seconds.
  • Use sanitizer with at least 60% alcohol when soap and water are not available
• Wear a face covering.
• Avoid touching your eyes, nose, and mouth.
• Stay home when sick.
• Clean frequently touched items and surfaces.

It’s important to follow state and local guidance as we reopen. This will help you to change your plan as situations change.

Make sure your provider has a plan to maintain a safe environment.

When you return home from your adult day center.

We should think about our safety and the safety of others. The following can help reduce the spread of COVID-19.

• Disinfect “high touch” surfaces and items every day.
  • This includes personal devices and electronics.
  • Be sure to follow the cleaning product’s instructions.
• Consider changing your clothes before entering your home.

If you cannot return to your adult day center

As a Peach State Health Plan member, you may have respite hours available for your caregiver. These may be used if you cannot return to your day service program. For more information, call us at 1-800-704-1484.

You can use the Georgia Department of Public Health’s Find a Covid Vaccination Site tool. It will help you find locations near you. Be sure to check back often as the COVID vaccine site locations are updated regularly.