Grace&Porta Blog

BCBSM and COVID-19

 

Blue Cross Blue Shield of Michigan has published several guides for its clients since the onset of the COVID-19 pandemic in winter of 2020.

 

Employer Resources

To your employees, you're a listening ear and an expert guide. And we want to help keep it that way. We've created resources to help you answer your employees' questions about the coronavirus, while keeping them engaged in good health. Your employees count on you to be there for them. You can count on us to be here for you. It's part of our commitment to delivering smarter, better health care in Michigan, and beyond.

 

Regarding the vaccine >>


Comprehensive materials:

Additional resources and publications:

Helpful webinars:

 

Educational Master Class Series

These webinars touch on a variety of business-critical topics, including COVID-19.

Sign up now

Watch the Financial Wellness Strategies webinar

 

You can also see the FAQs by logging in to your employer secured services account.

 

 

Employee Resources

 

Share these with your employees to help them weather the challenges of this time

  • Employer toolkit. This COVID-19 toolkit includes email templates, flyers, and other materials to help keep your employees informed on their health care options during the pandemic.
  • Virtual well-being webinars. See webinars discussing topics like employee resiliency, staying productive at home, and the importance of self-care.
  • MI Blues Perspective, BCBS’ blog covering health care issues that affect members.
  • Our webpage for members and this link: bcbsm.com/coronavirus.

Click here for a quick and easy reference page on the benefits Blue Cross is offering to its members at this time:

Quick Reference BCBS COVID Resources for Employees as of 12/16/20

 

 

 

--Update from Blue Cross on 5/20/2020--

 

https://www.bcbsm.com/content/dam/microsites/corpcomm/Agent/BMP/2020/may/2020_05_20-SE-1.pdf

 

--Update from Blue Cross on 3/23/2020--

 

Frequently asked questions about coverage, rates and membership in light of COVID-19, for our commercial and Medicare Advantage groups.

 

1. Will Blue Cross Blue Shield of Michigan and Blue Care Network allow employers to extend coverage to their employees who are affected during temporary closures or are temporarily laid off or have temporary reduced hours?

A: Yes, Blue Cross and BCN will allow extension of coverage for all group sizes provided premiums are paid based on current payment policies. Paying the premium is all that is required; no need to submit additional paperwork for current employees.

 

The following would apply:

  • The employer still considers the individual an employee and therefore eligible for coverage under the group’s
  • The employer maintains premium
  • The employer should notify the employee that benefits would be maintained for a specified number of
  • If the employee does not return after the specified period, the group would proceed with the normal loss of coverage/termination

2. What is the standard employer premium payment grace period and are you making any changes to that policy?

 A: Blue Cross and BCN will continue with our current grace periods – for fully insured customers this is a 30-day grace period. We recognize, however, that COVID-19 is rapidly changing our health care ecosystem and we will continue to assess our approach.

 

3. Will Blue Cross and BCN allow employers to modify open enrollment, new hire, reinstatement policies after returning from furlough?

 A: Yes, Blue Cross and BCN will allow and is willing to waive waiting periods. Groups can re-add employees through the usual membership processes.

 

4. Will Blue Cross and BCN re-rate experience rated insured coverage or stop loss for changes in contracts or other fluctuations in eligibility that are driven by responses to the COVID-19 pandemic?

 A: We realize that there may be several types of unique eligibility changes that occur in the near-term in response to COVID-19. To avoid creating concerns for our group customers we will place a temporary hold on our re-rating practices related to large changes in enrollment until further notice.

 

5. For customers that are experiencing a change in membership due to COVID-19, will Blue Cross and BCN allow the employer to self-adjust their bill?

Group customers or agents should not self-adjust the bill. Membership changes will automatically be applied in the group’s next billing cycle. If there is more than a 25% change in the group’s fully insured membership, groups should work with their managing agent or Blue Cross account representative before the due date.

 


 

--Update from Blue Cross on 3/10/20 with select updates from 3/16/20 included--

 

Blue Cross Blue Shield of Michigan Will  Waive Member Copays and Deductibles for COVID-19 Tests, Among Series of Proactive Steps on Coronavirus

In a statement made on the MI Blues Perspectives, fully-insured members of BCBSM and BCN health plans will be fully covered for the cost of medically-necessary COVID-19 tests. Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will work with self-insured employers to make decisions regarding their benefits.

BCBSM will:

  • waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
  • cover the full cost of medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19.
  • increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and encouraging members to use 90-day mail-order benefits if available.
  • expand access to telehealth and its 24-hour nurse hotline.

Also available to members are Online Visits.

Frequently Asked Questions about Blue Cross COVID-19 Initiatives

  1. Does Blue Cross provide anything I can post at my organization for employee education on the coronavirus?
    Yes, we do. Visit our www.bcbsm.com/engage site, and there is a toolkit you can download with useful flyers. In addition, we  are updating our blog www.miblueperspectives.com several times per day as information comes in and changes.

2. Will my employees need a prior authorization before they get a test for COVID-19 testing?

No. We want to help make the testing process as easy as possible. There is no prior authorization requirement as long as the physician is providing medically necessary COVID-19 tests that follow guidelines from the Centers for Disease Control.

It's important to note that if your employee is admitted to the hospital as part of their illness, normal prior authorizations for hospitalization will apply.

 

3. How much does the COVID-19 test cost?

We do not have a final price as we are waiting for further guidance from the government and from labs. We initially are looking at $70 but that could change. Providers will use the Health Care Procedure Coding System (HCPCS) codes identified by CMS for testing - U0001 and U0002.

 

4. How does the testing process for COVID-19 work?

Because this process is new, we have been in contact with health officials and providers. Here is our understanding of how the process will work: The provider decides if the test is appropriate for the patient based on symptoms and history. The provider should call the health department to discuss testing the patient. Patients will be tracked as the provider fills out a Michigan Department of Health and Human Services form to list symptoms. After the provider and the department agree to give the test, the provider tells the patient how to receive it.

 

5. What if there is a shortage of drugs during an outbreak?

During a state of emergency when drugs are in short supply, we will do everything possible to make sure that people have the medications they need for their situation. That includes being flexible and filling a medication that may not be on Blue Cross' preferred drug list.

 

In addition, employees will not have to pay extra if there are additional charges for a medication that is on our non-preferred list and is needed for the treatment of COVID-19. We realize that this could mean increased costs for our self-funded groups in this situation, but we would only exercise this option to help people during extreme times.

 

6. If my employees are sick what steps should they follow during this outbreak?

If your employees feel they have symptoms of COVID-19, they should first call their health care provider. Their primary care physician will provide guidance. It is not recommended to show up at a health care provider unannounced in this situation. Some other things to note:

- If their doctor belongs to a large health system, that health system may have information online about COVID-19.

- If their symptoms are severe - high fever or rapid and difficult breathing - call 911. Alert 911 that you are calling for help related to COVID-19.

- If they are experiencing mild symptoms, public health authorities are asking people to isolate themselves at home and avoid going out in public. They can also use Blue Cross' alternative options (see below) in these situations.

 

7. What other options are there for treatment if an employee can't get to a doctor or doesn't want to visit a doctor's office?

Overall, we encourage people who are sick, and when it's a non-emergency situation, to call their doctor's office prior to visiting so they can get direction from their primary care physician. However, Blue Cross does have choices for care if an employee doesn't want to go to a doctor's office.

 

Our 24-hour nurse line is a benefit for all Blue Cross members and provides them with a registered nurse who can help assess symptoms and provide guidance for next steps.

Our commercial and Medicare Advantage PPO members can call 1-800-775-2583 and our commercial and Medicare Advantage HMO members can call 1-855-624-5214.

Also available for customers who have purchased the option is the Blue Cross Online Visits . With this option, your employees can use a smartphone, tablet or computer to visit online with a board-certified doctor.

 

Calling or getting care online could help reduce potential infections that may occur at a doctor's office.

 

For more information about our online option, go to bcbsm.com/engage and select getting care online. If you want to find out how to add online visits to your current plan, contact your sales representative.

 

8. Where can members get further information about COVID-19?

We encourage members to check the Centers for Disease Control website for information at https://www.cdc.gov/coronavirus/2019-ncov/index.html

Our company is posting information on its blog - www.MIBluesPerspectives.com - to inform customers and members of the latest on the national impact of coronavirus and provide counsel on what to do and where to seek care if members come down with symptoms.

 

9. When are these changes effective?

These changes are effective immediately. We will pay claims for testing retroactive to February 4.

 

Click this link https://www.bcbs.com/coronavirus-updatesg/covid19-coronavirus if you don't live in Michigan and have Blue Cross coverage. Then select your state.

 

Click this link https://www.bcbsm.com/index/common/important-information/covid-19.html?spiff=coronavirus&location=Homepage-1 if you do live in Michigan and have BCBS or BCN coverage; you can view FAQs and the latest updates from the carrier.

 

Click this link https://www.mibluesperspectives.com/2020/03/18/coronavirus-outbreak-what-you-need-to-know/ to visit Blue Cross' blog and updates there.

 

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