What you should know about the COVID-19 Vaccine

• COVID-19 vaccines

  Vaccines are an important tool to help communities fight the spread of COVID-19 and help people stay healthy. However, widespread availability of a vaccine likely will not occur for many months. Therefore, it is critically important to continue following the advice of health professionals in order to minimize the chances of catching or spreading the disease. According to the Centers for Disease Control and Prevention (CDC), wearing masks, practicing social distancing, and washing your hands remain the best protections against the virus.

  1. Is there a vaccine for COVID-19?

     Yes. There are currently two authorized COVID-19 vaccines. Vaccines from Pfizer-BioNTech and Moderna have both received Emergency Use Authorization (EUA) in the United States, meaning that they can be made available to the public during the pandemic. There are three other COVID-19 vaccines in earlier stages of development in the United States.

  2. When will a vaccine be widely available?

     According to the CDC, “There is currently a limited supply of COVID-19 vaccines in the United States, but supply will increase in the weeks and months to come. The goal is for everyone to be able to easily get vaccinated against COVID-19 as soon as large quantities are available.”

  3. When will I be able to get the vaccine?

     Because of limited initial supply, the CDC has recommended that the vaccine be distributed in phases, beginning with those most at risk. For Phase 1a of the distribution, CDC recommended healthcare workers and residents of nursing homes and other long-term care facilities receive the vaccine first. CDC recently updated its recommendation for the next rollout phases.

     For Phase 1b, CDC recommended two groups be the next to receive the vaccine:

     • Frontline essential workers such as fire fighters, police officers, corrections officers, food and agricultural workers, United States Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the educational sector (teachers, support staff, and daycare workers.)
     • People aged 75 years and older because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 75 years and older who are also residents of long-term care facilities should be offered vaccination in Phase 1a.

     For Phase 1c, CDC recommended three groups be the next to receive the vaccine following 1b:

     • People aged 65—74 years because they are at high risk of hospitalization, illness, and death from COVID-19. People aged 65—74 years who are also residents of long-term care facilities should be offered vaccination in Phase 1a.
     • People aged 16—64 years with underlying medical conditions which increase the risk of serious, life-threatening complications from COVID-19.
     • Other essential workers, such as people who work in transportation and logistics, food service, housing construction and finance, information technology, communications, energy, law, media, public safety, and public health.

     It is important to note that states are developing their own prioritization plans based on the CDC’s recommendations, so eligible groups may vary somewhat from state to state.

     For the latest information about COVID-19 vaccines, visit the CDC’s website(link opens in new window).

     The CDC provides a webpage with links to health department websites for every state where you can learn more about your state’s vaccine plans. Visit that page here(link opens in new window).

  4. Where will I be able to get the vaccine once it becomes available for me?

     At this time, the specific locations where you will be able to receive the vaccine are still uncertain. However, according to the CDC, “The plan is to have several thousand vaccination providers available, including doctors’ offices, retail pharmacies, hospitals, and federally qualified health centers.”

     Wherever you get the vaccine, it is important to confirm the source is safe and reputable to avoid becoming a victim of fraud. A recent warning from the FBI provides information on potential indicators of COVID-19 vaccine related fraud and tips on how to avoid it. You can find a link to the FBI warning here(link opens in new window).

  5. Is the vaccine safe?

     According to the CDC, “The U.S. vaccine safety system ensures that all vaccines are as safe as possible. Learn how federal partners are working together to ensure the safety of COVID-19 vaccines(link opens in new window).”

  6. Are there any side effects?

     It is possible that you will experience some side effects after receiving the COVID-19 vaccine. According to the CDC, “After COVID-19 vaccination, you may have some side effects. This is a normal sign that your body is building protection”. Common vaccine side effects highlighted by the CDC range from pain at the injection site to flu-like symptoms. For more information from the CDC on dealing with these symptoms and when to call the doctor, visit: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html(link opens in new window).

     There have been extremely rare incidents of significant allergic reactions reported. The CDC is working with vaccine providers to put safeguards in place for dealing with severe allergic reactions. Learn more about COVID-19 vaccines and severe allergic reaction here(link opens in new window).

     After receiving the vaccine, consider signing up for V-safe from the CDC. “V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from CDC may call to check on you and get more information. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one.” Learn more about V-safe here.(link opens in new window).

  7. How is it administered? How many doses will I need?

     The COVID-19 vaccines will be delivered via injection. Most will require two doses to be effective, including the two vaccines that recently received Emergency Use Authorization. The Pfizer-BioNTech vaccine will require two shots, administered about 21 days apart. The Moderna vaccine will require two shots, administered about 28 days apart.

  8. What if I am high risk or have a specific medical condition?

     If you have concerns due to your health status or a specific medical condition, consult with your doctor about whether the vaccine is appropriate for you and the safest way to get it.

     If you have an underlying or chronic medical condition, make sure you are in communication with your doctor during this pandemic. Getting these conditions well-managed—by staying on top of your preventive and regular medical care—will help to manage your health risk during this pandemic. This is one of the best ways to protect yourself while awaiting the availability of the vaccine.

  9. Will CarePlus cover the cost of the vaccine?

     Yes. All FDA-authorized COVID-19 vaccines will be covered at no additional cost for CarePlus members during the public health emergency. Coverage applies no matter where you get the vaccine—including at both in-network and out-of-network providers. It also covers instances in which two vaccine doses are required.

     While the $0 share cost applies across CarePlus’s Medicare, there are some technical differences with how claims are processed:

     • CarePlus Medicare Advantage Members: Original Medicare is responsible for coverage of COVID-19 vaccinations. Your vaccine provider will submit vaccine-related charges to Medicare and you will not be responsible for those costs.

     For the latest information about COVID-19 vaccines, visit the CDC’s website(link opens in new window).

• Care kits

  1. Who is going to be receiving care kits from CarePlus? What if my family members, who are not CarePlus members, need a mask? Can I get a care kit for them too?

     We are providing care kits to all CarePlus members, while supplies last. We are only currently able to supply our members with this care kit. The CDC’s directions for making your own mask can be found here (link opens in new window).

  2. What exactly will the care kit include?

     The care kit contains two washable facemasks, as well as instructions on how to care for the masks.

  3. When should I expect to receive my care kit?

     Care kits were delivered to existing members’ homes in the summer and will continue to be sent to new members while supplies last.

  4. How can I get more care kits?

     We currently do not have additional supply. We will be monitoring the situation with our members to determine how we can continue to support them during this difficult time. The CDC’s directions for making your own mask can be found here (link opens in new window).

  5. How long do the masks last? Can they be washed? If so, how many times? Can I receive additional masks if needed?

     The masks can be washed 30 times. We currently do not have additional supply and will be monitoring the situation with our members to determine how we can continue to support them during this difficult time. The CDC’s directions for making your own mask can be found here (link opens in new window).

  6. How can I get help with food and groceries, securing prescription refills and solving routine medical issues to help avoid a trip to the doctor or ER?

     CarePlus is working to ensure members in need have access to basic necessities – including food, medication access and access to care. CarePlus is providing resources to members and connecting members with community organizations in their local areas. Members who are having difficulty obtaining these necessities can call the number on the back of their CarePlus ID card for support.

  7. Who should NOT wear a mask?

     According to the CDC, cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.²

  Sources:

  2. About Cloth Face Coverings. (2020, May 22). Retrieved June 18, 2020, from Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html (link opens in new window>
• COVID-19 Treatment

  Waiving out-of-pocket costs related to coronavirus treatment

  1. Is CarePlus waiving all member costs for treatment related to COVID-19?

     Yes. CarePlus is waiving out-of-pocket costs related to COVID-19 testing. Additionally, CarePlus will waive out-of-pocket costs related to treatment for confirmed cases of COVID-19. These cost share waivers apply to all CarePlus members. Finally, there are no prior authorization requirements related to COVID-19 testing.

     This could include telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home health and ambulance services.

     We also intend to cover the cost of Food and Drug Administration (FDA) approved vaccines and medications when they become available.

  2. Is a confirmed COVID-19 diagnosis required in order for out-of-pocket costs to be waived for treatment?

     Yes. We will waive member costs for treatment for confirmed COVID-19 cases.

  3. When does the cost-share waiver end?

     There is no current end date; we will reassess as circumstances change

  4. Will these costs be included in or apply to the member’s maximum out-of-pocket (MOOP)?

     Only a member’s cost share is applied to the maximum out-of-pocket (MOOP) calculation. Since the member cost share for COVID-19-related treatment of confirmed cases is being waived, nothing will be applied to MOOP.

  5. Does this impact in- and out-of-network claims?

     CarePlus encourages members to continue to see or consult with the health care provider they already know. We will cover the member responsibility for member copays, deductibles or coinsurance costs for COVID-19-related services for in-network or out-of-network covered benefits during this time of crisis.

  Prescription and vaccine coverage

  6. Regarding COVID-19 treatment, what medications will CarePlus cover? Will CarePlus cover Remdesivir?

     CarePlus intends to cover the medical cost of treatment and Food and Drug Administration (FDA) approved vaccines and medications when they become available for pharmacy/Part D or medical/Part B benefit. If a member is prescribed non-FDA-approved medications for the treatment of COVID-19, he or she will be responsible for any cost sharing required per the plan design. Non-FDA approved drugs are excluded Part D drugs and ineligible for any Part D coverage.

  7. Are any of the existing medications that could help treat COVID-19 covered (e.g., anti-RA drugs, HIV/malaria drugs)?

     We intend to cover member responsibility for medical cost of treatment and FDA-approved vaccines and medications when they become available for pharmacy/Part D or medical/Part B benefit.

  8. How can I ensure access to my prescription medications while practicing social distancing or sheltering in place?

     Members should check with their current network pharmacies to see if they offer local prescription delivery to support patients in social isolation. As an alternative, members may use PrescribeIT Rx*, CarePlus’ preferred cost-sharing mail order pharmacy, to have their prescription drugs delivered to them. Members can register for PrescribeIT Rx’s mail order delivery by calling 1-800-526-1490. Their hours of operation are Monday through Friday from 8 a.m. to 6 p.m., Eastern Time. Please keep in mind that first-time setup takes approximately five to ten days for processing and delivery after prescription orders are received. To find a list of participating pharmacies in our network, please refer to our Provider Directories page located in our website at www.careplushealthplans.com/members/pharmacy-directories.

     *Other pharmacies are available in our network

  9. Will CarePlus waive refill limits to ensure I have access to my regular medications?

     In accordance with applicable public health and state emergency orders related to COVID-19, CarePlus is here to help customers prepare for supply needs with an extra 30- or 90-day supply, as applicable, on their prescription and specialty tier medications.

  10. I am concerned about shortages. Will PrescribeIT Rx have my medication and be able to fill and ship my medication to me?

      CarePlus is continually monitoring the drug supply chain. PrescribeIT Rx is currently working with its suppliers to ensure patients do not experience disruptions in receiving their prescriptions in the future. The Food and Drug Administration is closely monitoring supply chains and asking all manufacturers to report any disruptions.

  11. Can I get a vaccine and will CarePlus cover it?

      At present, there are no available vaccines for COVID-19; however, if one were to become available, CarePlus would cover that vaccine for its members.

• In-home care

  1. Should I cancel my in-home care appointments because of COVID-19?

     Your care is important, and it is vital to maintain coordination with your healthcare providers. Call your Primary Care Provider to discuss and consult regarding your upcoming appointments, and the recommended methods for obtaining the care you need. If you have a history of recent travel and symptoms like fever, cough, or shortness of breath, please consult your healthcare provider. Call ahead before you request a home visit and tell the representative about your symptoms and any recent travel.

• Best practices to protect your health

  • What can you do?

    Take precautions as recommended by the CDC. There is no vaccine for the virus that causes COVID-19 at this time, although, many scientists are working around the clock on this.

    The CDC recommends washing your hands often to maintain your health, especially during these key times when you are likely to get or spread germs:^{3, 4}

    • Before, during, and after preparing food
    • Before eating food
    • Before and after caring for someone at home who is sick with vomiting or diarrhea
    • Before and after treating a cut or wound
    • After using the toilet
    • After changing diapers or cleaning up a child who has used the toilet
    • After blowing your nose, coughing or sneezing
    • After touching an animal, animal feed or animal waste
    • After handling pet food or pet treats
    • After touching garbage

    The following hand washing procedures will help reduce your risk of infection:⁴

    • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
    • Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air dry them.
    • If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol
    • Avoid touching your eyes, nose or mouth with unwashed hands

    If you are sick with COVID-19 or think you might have COVID-19, follow the steps below to care for yourself and to help protect other people in your home and community.⁵

    • Stay at home except to get medical care
    • Separate yourself from other people
    • Monitor your symptoms and look for emergency warning signs for COVID-19. If you are showing any of the emergency warning signs, seek emergency medical care immediately.
    • Call ahead before visiting your doctor
    • If you are sick wear a cloth covering over your nose and mouth
    • Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash your hands
    • Clean your hands often
    • Avoid sharing personal household items
    • Clean all “high-touch” surfaces everyday

  Sources:

  3. How to Protect Yourself & Others. (2020, April 4). Retrieved April 7, 2020, from Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html (link opens in new window)
  4. When and How To Wash Your Hands (2020, April 2). Retrieved April 7, 2020, from Centers for Disease Control and Prevention, https://www.cdc.gov/handwashing/when-how-handwashing.html (link opens in new window)
  5. What to Do if You Are Sick. (2020, May 8). Retrieved June 22, 2020, from Centers for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html (link opens in new window)
• Protect yourself from COVID-19 scams

  • Don’t fall for coronavirus scams

    Here is some important information to help you recognize and protect yourself from scammers trying to take advantage of the ongoing coronavirus situation.

    What you should know:

    • If someone comes to your door: Some scammers are going door to door offering free medical services such as in-home COVID-19 test kits and reserving future COVID-19 vaccination appointments. These fraudsters are using these promises to access your home and gather your personal information.
    • If you receive a COVID-19-related call: Scammers claiming to represent a government agency, a public health agency or an insurance company are calling individuals to offer free COVID-19 test kits or reservations for future COVID-19 vaccination appointments. The scammers are requesting personal information like insurance numbers, Medicare IDs and credit card information, often claiming that government agencies are requiring that you provide this information. They may even tell you that you may have been exposed to the COVID-19 virus and that your personal information is needed for public health purposes.

    What you should do:

    • CarePlus will never send anyone to your door without first calling or emailing you to schedule an appointment. If someone you are not expecting comes to your home claiming to be a CarePlus representative, do NOT open your door.
    • If you receive a phone call from someone who says they’re from CarePlus and you are asked for your social security number, credit card or banking information, DO NOT provide this information. CarePlus will never ask you for this information over the phone.
    • If ANYONE calls you about the coronavirus, ask for the caller’s full name, job title and a call-back number before you give any information. Don’t feel rushed or intimidated! It is okay to end the call and contact the agency or company directly to verify that the call is valid.
    • If you suspect a scammer has contacted you by phone or in person, please let us know so we can help:
      • Call CarePlus Member Services at 1-800-794-5907 ; TTY: 711 to report any suspected fraudulent activity related to COVID-19. From October 1 - March 31, we are open 7 days a week; 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail message after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.
      • You can also report any suspicious activity around COVID-19 fraud by calling the National Center for Disaster Fraud Hotline at 1 866 720 5721 or emailing disaster@leo.gov.

      And always, check back with www.careplushealthplans.com/coronavirus (link opens in new window) regularly for information you can trust.

      For more information, visit the Federal Trade Commission’s coronavirus scam alert (link opens in new window) site.

• Tips to prepare for telehealth visit

  Ten helpful tips for making the most of your telehealth visit. A little preparation goes a long way.

  Making the move from in-person doctor visits to telehealth appointments—even temporarily—can be intimidating. Here is some practical advice to help get you started.

  1. Telehealth visits are scheduled just like in-person appointments. You will need to call your healthcare provider to set up a specific time for your phone call or video chat. If you do not have a regular doctor, or if your doctor does not offer telehealth visits, call the Member Services number on the back of your CarePlus member ID card. We will help you find a telehealth provider.
  2. To be able to see and hear your healthcare provider, you will need a smartphone, a tablet or a computer that is connected to the internet. If you are new to video chatting, consider a practice run with a friend or family member so you are comfortable with the equipment.
  3. Using headphones or ear buds instead of your device’s microphone and speaker will offer better sound clarity—and more privacy if there are other people in your household.
  4. Be prepared with a list of prescriptions, over-the-counter medicines or supplements you are currently taking. If you have a pharmacy, you like to use, have the name and address handy in case your healthcare provider suggests prescription medication.
  5. You will also want to have your CarePlus member ID card on hand. Although CarePlus is currently waiving member out-of-pocket cost for telehealth services, your healthcare provider will still need your plan information to submit a claim to CarePlus.
  6. While not required, if you have a thermometer, bathroom scale, or blood-pressure monitor at home, you may want to have them handy. Likewise, if you have diabetes and use a glucometer, you may want to keep that close by as well during your telehealth visit.
  7. It is a good idea to make some notes about your symptoms or concerns before your call begins so you do not forget to mention anything. Be ready to tell your doctor or nurse practitioner exactly what you are experiencing. (For routine issues like record requests or bill payment, a telehealth visit is not required. Simply call your provider’s office to get the help you need.)
  8. If you are dealing with an injury, rash or other visible issue, take a picture of it to share with your telehealth provider via email, if your telehealth provider requests it.
  9. Be punctual—ready to answer your provider’s call at the scheduled time. And start by asking what to do if you become disconnected during your visit.
  10. Always remember that in the event of a emergency like chest pain, breathing trouble or another major health event, call 911!