Thursday, April 2, 2020

State Health Plan to Waive Costs Associated with Treatment of COVID-19 Coronavirus Waiver also Includes Screening-Related Costs

Apr 2, 2020


(Raleigh, N.C.) – State Treasurer Dale R. Folwell, CPA, and the State Health Plan (Plan) today announced that the Plan is waiving the cost of treatment for members diagnosed with COVID-19, including associated deductibles, copayments, and coinsurance. The Plan previously announced that it was also covering the cost associated with the testing of COVID-19. 

The member cost-share waiver for COVID-19 related treatments is effective immediately through June 1, 2020, at which time the Plan will continue to re-evaluate this and other measures. The Plan is taking this action to help ensure that members receive the COVID-19 testing and treatment they need when they need it.

This coverage is in addition to the following changes to medical and pharmacy benefits for Plan members in the 80/20 Plan, 70/30 Plan and High Deductible Health Plan:

  • Expanded virtual access to providers. Visits to providers who previously required a face-to-face encounter can now be performed virtually so long as they are a medical necessity and meet criteria. This will further encourage the use of virtual visits and allow doctors to monitor members at home, minimizing the spread of infection and easing the burden on emergency rooms.
  • Waived prior authorizations for covered services related to COVID-19 that are ordered by a physician, medically necessary, and consistent with Centers for Disease Control and Prevention (not mentioned again, no need for abbreviation) guidance related to COVID-19.
  • Increased access to maintenance medications by waiving the early medication refill limits on 30-day prescription maintenance medications. Member cost-sharing will apply as normal.

For the Plan’s UnitedHealthcare (UHC) Medicare Advantage members, the following changes to medical benefits, pharmacy benefits and program offerings have been made:

  • There will be no cost for the COVID-19 test. Copays and coinsurance are also waived for visits associated with the COVID-19 testing, regardless if the test takes place in a physician’s office, urgent care or ER.
  • Members can request an early prescription refill for any medication.
  • There is a $0 copayment for each Medicare covered Virtual Doctor visit and a $20 copayment for each Virtual Behavioral Visit. Members may use Virtual Visit through a computer or a mobile device like a tablet or a smart phone. To find a list of participating Virtual Visit providers or Virtual Behavioral Visit providers, members should visit
  • UHC is also offering free emotional support for those who feel extra stress or fear due to COVID-19. Members can call the Emotional-Support Help Line offered by Optum at 866-342-6892, TTY 711, 24 hours a day, seven days a week.
  • The UHC HouseCalls program was suspended for the health and safety of members and clinicians. However, to ensure that members continue to receive their HouseCalls visits even during the COVID-19 national health emergency, UHC has introduced HouseCalls Virtual Visit. Members will need to have an email and proper webcam capability to be offered a virtual visit.
  • To find out more about these offerings through UHC, members should call Customer Service at 866-747-1014.

More information can be found on the State Health Plan website under Coronavirus Updates.

The State Health Plan, a division of the N.C. Department of State Treasurer, provides health care coverage to more than 727,000 teachers, state employees, current and former lawmakers, state university and community college personnel and their dependents, including non-Medicare and Medicare retirees.