Last updated on 5/27/20
Have a question about COVID-19? We’re here to help.
Does Independence cover testing for COVID-19?
Independence Blue Cross (Independence) is committed to ensuring that our members have access to the care they need, at the right time, and in the right setting. As COVID-19 has escalated into a serious global health threat, we are working to make sure that our members can receive appropriate testing and treatment for this virus if needed.
In March, we quickly announced that we would cover testing for active COVID-19 (RT-PCR) at no cost to our members. Independence will cover and reimburse member cost-sharing (such as co-pays, deductibles, and coinsurance) for the COVID-19 test and the administration of the test when performed at an in-network physician’s office, urgent care center, by a home health agency, or an emergency room. Independence will cover COVID-19 antibody testing with no member cost-share in accordance with federal guidelines and company medical policy for the duration of the COVID-19 pandemic.
These temporary changes to our testing policy include out-of-network coverage for Medicare Advantage members. The cost-sharing waiver will not apply to testing done by providers unless the member has Medicare coverage.
For services not related to COVID-19, we will continue to apply the appropriate member cost-sharing. This includes members enrolled in our commercial, CHIP, Medicare Advantage, Medigap, Medicare Supplemental Coverage, and the individual and family plans available through the Affordable Care Act.
Effective March 6, 2020, through June 30, 2020, Independence is waiving the requirement that commercial and Medicare Advantage members must be homebound to receive COVID-19 testing at home by a visiting nurse. Members need not be homebound to receive COVID-19 testing at home by a visiting nurse. Members need not be homebound (as defined in the medical policy) to receive a nurse visit from a home health agency for the purpose of laboratory specimen collection for COVID-19 testing in their home, when the nurse visit for specimen collection:
- is medically necessary for the individual’s condition; and,
- has been ordered by an eligible professional provider.
The specimen must be delivered to an appropriate Independence-participating laboratory to perform the test and the results sent to the prescribing professional provider. (Please note that for Medicare Advantage members, this includes out-of-network laboratories as well.)
Given that the diagnostic tests are new and specific billing codes for commercially available tests were only recently designated, members should report any concerns about claim payment to our customer service staff at the number on their member card. At this time, the Centers for Disease Control and Prevention (CDC) and state labs currently performing the diagnostic testing are not billing for COVID-19 testing, so members should not incur costs when tested by these labs.
If members have any questions about whether they should be tested, they should contact a health care professional who will work with the state public health department in the member’s state and the CDC to determine if they need to be tested for COVID-19.
How can members find a testing location?
If you suspect that you may have COVID-19, your first step should be to contact your primary doctor. Your primary doctor will screen you for testing based on CDC guidelines. If you meet the testing criteria, your doctor will discuss your testing options with you. If you don’t have a primary doctor, most members with telemedicine benefits can utilize MDLive services without cost-sharing until June 4. A MDLive physician can perform the screening and determine your next steps. You can register for MDLive at ibx.com. If your benefits program does not include telemedicine benefits, you can contact your state health department for information on testing. Pennsylvania residents can call 1-877-PA-HEALTH. New Jersey residents can contact the NJ Department of Health for more information at 1-800-962-1253 or 1-800-222-1222.
What about treatment?
Independence is waiving member cost-sharing for in-network, inpatient, acute care treatment for COVID-19. This means members will pay no co-pay, co-insurance or deductible in this scenario. In addition, for Medicare Advantage members, these temporary changes to our treatment policy include coverage for out of network providers.
Independence will also waive cost-sharing for Emergency Department visits when members are admitted to the hospital under these same conditions. These changes are effective March 30, 2020 and will extend through June 30, 2020. The changes are for fully-insured business and Medicare Advantage members; self-insured customers can opt-out of coverage.
Cost-sharing will continue to be applied to all post-acute care (e.g. skilled nursing, rehabilitation and long-term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out-of-network care. In addition, for Medicare Advantage members, these temporary changes to our treatment policy include coverage for out-of-network providers.
Independence also temporarily suspended prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through June 30, 2020. In addition, prior authorization requirements are temporarily suspended for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required. In addition, for Medicare Advantage members, these temporary changes to our treatment policy include coverage for out-of-network providers.
This includes suspending prior authorization requirements for in-network transportation from an acute inpatient facility to a post-acute facility. (Please note that for Medicare Advantage members, this includes out-of-network transportation as well. These steps are intended to facilitate and reduce administrative processes for the placement of COVID-19 patients to the most appropriate care settings.
If our members would like information about specific symptoms they are experiencing or have questions about their personal health, we recommend that they contact their doctor. For reliable information about the coronavirus disease (COVID-19), we suggest visiting the CDC website at cdc.gov/coronavirus. We will continue to evaluate member needs as the situation changes.
Should members be using telemedicine?
To help reduce potential exposure, Independence encourages members to utilize telemedicine services if they are available as part of a member’s plan.
Independence announced on March 6 that it would waive copays for primary care telemedicine services for eligible members through June 30, 2020. On March 20, Independence expanded telemedicine services for specialty and ancillary services subject to applicable member cost sharing. This expansion includes:
- Specialist visits (via video or telephone)
- Physical therapy and occupational therapy (via video)
- Speech therapy (via video or telephone)
- Urgent care visits (via video or telephone)
- Nutritionist visits (via video or telephone)
- Behavioral health visits to include members with autism spectrum disorder so that they can receive Applied Behavior Analysis support while they are at home*.
As noted, regular cost-sharing will apply to telemedicine visits with specialists and ancillary providers that are not related to COVID-19 testing. Cost-sharing will be waived for telemedicine visits with specialists and ancillary providers when they are related to COVID-19 testing and treatment. Cost-sharing will also be waived for COVID-19 testing and primary care telemedicine visits for high-deductible health plan members and will be covered before deductible.
Independence will also cover preventative well visits for Commercial members and annual wellness visits for Medicare Advantage members via telemedicine through June 30, 2020.
All changes will be in effect through June 30, 2020. To access telemedicine options, Independence members should log in to the member website at ibx.com.
Are telemedicine visits with non-participating providers covered for members with out-of-network coverage?
Given Independence’s broad network, it is unlikely that a member would need to seek care from an out-of-network provider.
However, telemedicine visits with non-participating providers are covered for members with out-of-network coverage and are subject to the out-of-network cost-sharing under the member’s benefit plan. This applies to specialists as well as behavioral health providers. (Please note: Medicare members have out-of-network telemedicine coverage, per the Centers for Medicare & Medicaid Services. The coverage is not limited to COVID-19 related care.)
Will Independence waive prescription drug refill limits?
In March Independence announced that we were lifting prescription refill restrictions, such as the “refill too soon” limit, for members with Independence pharmacy benefits. At that time, we also began encouraging members to talk with their doctor regarding using their 90-day mail order benefit to see if that option made sense for them. The measures we took in March are important and help members access the prescription drugs they need to manage chronic conditions and maintain good health.
You may have seen stories regarding medication shortages in parts of the country in the news. Out of an abundance of caution and to help prevent drug shortages, we are modifying the prescription refill restrictions that were previously lifted. Now, members must have used at least two-thirds of their current medication supply before a refill would be possible.
We are carefully monitoring COVID-19 developments and will make adjustments to policies as appropriate. We recommend that members call the Pharmacy Services number on their ID cards as needed if they require additional medication refills due to a potential quarantine situation.
If a member has Medicare Part D and needs their medication, they can request that the pharmacy call the Pharmacy Help Desk for an override.
NOTE: Self-funded groups can opt-out of the new prescription refill modifications. Also, the modification do not impact Medicare Advantage members.
If a member’s procedure was cancelled or postponed due to the COVID-19 outbreak, will the member need to obtain new pre-certification?
As of March 16, all pre-certifications for pending procedures are being extended for six months in order to accommodate both our members and our doctor and health system partners.
These procedures may still occur as scheduled, but it’s also possible that a health care provider, hospital, or ambulatory surgical center may decide it’s in the best interest of the patients to delay elective procedures during the next few weeks. We want to make things easier for all and extending the authorization period will allow the flexibility our providers need to make the best possible care decisions for patients.
How is Independence helping members who may be affected financially by the COVID-19 situation?
Independence encourages all members who are able to pay their health plan bill on time to continue to do so, but we understand the toll this crisis is taking on many families and individuals.
As such, members can pay their premium via credit card payments until July 31, 2020. Credit card payments may be used to satisfy past due premiums as well as any current amounts that are due. Independence will accept American Express, Discover, Visa, and MasterCard. To further help consumer members, Independence will waive the fees associated with credit card payments. Members can make credit card payments by:
- Calling 1-888-879-4891 (TTY: 711)
- Using eBill: Log in at ibx.com and click Manage Account
If members have questions or need additional help related to premium payments, they can call Independence at 1-800-503-1253 (TTY: 711).
How is Independence communicating with its employees about COVID-19? How is Independence working to keep its workforce safe?
Independence remains steadfast in the aim to reduce the impact of COVID-19 on our workforce, our members, our customers, and our business. We communicate regularly with our associates and have taken several steps to safeguard their health.
On Tuesday, March 17, Independence announced the closing of its office in Philadelphia and all affiliates’ offices in New Jersey and Minnesota, effective March 18, until further notice. All employees in all offices will be required to work remotely during that time to reduce the risk of illness through person-to-person contact. Prior to this, Independence “stress-tested” technology by asking certain departments to work from home on March 2, and then offering the option company-wide on March 10.
In May, Independence introduced additional safety measures and protocols for entering and working in our buildings. Access to company buildings remains limited to those individuals whose work requires them to be onsite. Company leadership is developing a reentry strategy based on guiding principles that focus on the health and safety of our associates. We remain committed to maintaining high-performing operations to ensure the stability of our business and service to our members and customers.
How is Independence working with, and communicating with, providers related to COVID-19?
Independence is fortunate to have strong relationships with the providers, hospitals and health systems that provide care for our members. Our executives are staying in close contact with leaders within the provider community to monitor this rapidly changing situation and make the most appropriate decisions to help maintain the health and wellness of people in the communities we serve.
Independence launched a COVID-19 Provider Hub website to inform doctors, hospitals, health systems, and other health care professionals on everything Independence is doing to support front line workers during the pandemic. We have also been communicating the latest news and information about COVID-19 to providers through our existing communication channels.
How is Independence working with elected officials related to COVID-19 planning and prevention?
Independence is collaborating with public health organizations and elected officials at the regional, state and federal levels. Our executives are staying in close contact with leaders at all levels to monitor this rapidly changing situation and make the most appropriate decisions to help maintain the health and wellness of people in the communities we serve.
If members or employers want more information about COVID-19, where should they go?
If our members or employers would like information about specific symptoms they are experiencing or have questions about their personal health, we recommend that they contact their doctor.
For reliable information about the coronavirus disease (COVID-19), we suggest visiting the Centers for Disease Control and Prevention (CDC) website at cdc.gov/coronavirus. The City of Philadelphia and Commonwealth of Pennsylvania have also established websites with information about COVID-19.
Independence launched a comprehensive website dedicated to COVID-19 information and resources at ibx.com/covid-19. As well, we will continue to update our Newsroom and our social media channels with the latest information about COVID-19, and we will continue to proactively communicate with our key stakeholders through our existing channels, as needed.
We encourage our provider partners to visit the Provider News Center at ibx.com to get the latest changes in policy and coverage related to the COVID-19 pandemic.
Additional resources include:
- City of Philadelphia Information and Recommendations
- How to prepare: Managing anxiety and stress, CDC
- COVID-19 helpline for Greater Philadelphia residents: 1-800-722-7112 (launched by the Philadelphia Department of Public Health and supported by the Children’s Hospital of Philadelphia)
- Mental Health COVID-19 resources, Magellan Health
- Living with threats of violence, Magellan Health
- What to do if you are sick with COVID-19 or caring for someone with COVID-19, CDC
How can members protect themselves against fraud?
Unfortunately, Independence has received some reports of potential frauds and scams related to the COVID-19 situation. Members should be aware of individuals attempting to profit from this emergency and should remain diligent in protecting personal and health insurance information. Some of the reports we have received include:
- Individuals and businesses selling fake tests, treatments and cures for COVID-19 online.
- Phishing emails from entities posing as trusted organizations like the World Health Organization or the Centers for Disease Control and Prevention.
- Know the vendor you’re buying from. Online sellers may falsely claim to have in-demand products like cleaning, household, and health and medical supplies.
- Unsolicited calls, e-mails or home visits from individuals offering free services or supplies in exchange for member numbers.
Members can help to avoid fraud by following these tips:
- Reviewing medical claims submitted at ibxpress.com for accuracy.
- Protecting their insurance card.
- Protect your identity. Do not provide your Social Security Number.
- Declining to provide insurance information to anyone that is not directly providing care to a member.
- Being cautious of unsolicited telemarketers and recruiters.
If members suspect that something potentially fraudulent has occurred with respect to their Independence Blue Cross health insurance, they should contact Independence. All reports can be submitted anonymously.
Here are three options for submitting a report:
- Submit the Online Fraud & Abuse Tip Referral Form electronically at ibx.com/antifraud.
- Call the confidential anti-fraud and corporate compliance toll free hotline at 1-866-282-2707 / TTY# 888-789-0429.
- Mail the report. Write a description of your complaint, enclose copies of any supporting documentation, and mail it to Independence Blue Cross, Corporate & Financial Investigations Department at 1901 Market Street, 42nd Floor, Philadelphia, PA 19103.
Website last updated: 4/29/2020
Independence Blue Cross offers Medicare Advantage plans with a Medicare contract. Enrollment in Independence Medicare Advantage plans depends on contract renewal.
Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company — independent licensees of the Blue Cross and Blue Shield Association.
MDLive is an independent company.