- Members can receive COVID-19 services via telephone consultation with their physician. An in-person office visit is not required to get an order for the test.
- No member cost-sharing (copays, deductible or coinsurance) will be required for COVID-19 testing and testing-related services. The plan will pay 100%.
- The MDLive copay for telemedicine services will be waived through the end of the current benefit plan year.
Here is how your benefits work for COVID-19 testing and treatment:
I: Determining whether a test for COVID-19 is needed:
Members experiencing symptoms of the virus, or who believe they have been exposed to it, will need a doctor's order to be tested for COVID-19. Members have a choice between an on-site doctor visit or a consultation with their physician via telephone conference to determine whether testing is needed.
- A telephone consultation with an in-network physician will be paid by the plan at 100% (no member cost-share).
- For an in-person office visit, the member will not be required to pay an office visit copay or deductible and/or applicable coinsurance*.
- A telephone consultation with an out-of-network physician will require payment of an office visit copay or deductible and/or applicable coinsurance.
* While we do not anticipate a member being required by the doctor's office to pay a copay or deductible for services related to COVID-19 testing, if this happens the member will be able to request a refund through BCBSTX.
II: If the doctor provides an order for COVID-19 testing:
No member out-of-pocket (copay or deductible/coinsurance) will be required for the test kit or the laboratory service to process the test.
III: If test result is positive for COVID-19:
Treatment will be covered like any other illness. Member cost-share will apply as defined in each individual group's benefit plan, i.e. subject to copays, deductibles and/or co-insurance.
TAC HEBP strongly recommends that members who are unsure if they are experiencing COVID-19 symptoms first use their telemedicine benefit, MDLive, by calling 1-855-357-5228 or accessing the service through the mobile app.
- The copay for MDLive will be waived for all TAC HEBP benefit plans, through the end of your benefit plan year (example: for groups with an Oct. 1 anniversary date, the waived copay is in effect through Sept. 30, 2020.
- MDLive physicians cannot order COVID-19 testing but can provide guidance to members regarding whether their symptoms are consistent with the virus.
- MDLive also provides behavioral health services if an employee is feeling fearful or worried about COVID-19 related matters.
- As always, for other conditions that can be diagnosed via a telephone or video conference, MDLive physicians can call in prescriptions and/or provide recommendations for treatment at home.
Please note that these changes to your health plan benefits are subject to revision based on government mandates as we continue responding to changing COVID-19 conditions. TAC HEBP will be reviewing our plan benefits once the pandemic/disaster declarations have been lifted to determine whether other actions are needed.
You may access information about your county or district's health benefits here: www.mybenefits.county.org.
Please contact your Employee Benefits Specialist at 1-800-456-5974 if you need more information.