Have a question about COVID-19? We’re here to help.
Does Independence cover the COVID-19 vaccine?
COVID-19 vaccines are an important step in slowing the spread of the virus. However, widespread availability of a vaccine likely will not occur for months. During that time, we urge members to continue following the advice of health professionals in order to minimize the chances of catching or spreading the disease. We also encourage members to continue to wear a mask, practice social distancing, and wash their hands regularly.
The U.S. Food & Drug Administration has granted Emergency Use Authorizations for two COVID-19 vaccines, and a few additional ones are also likely to be authorized soon. As more vaccines are authorized and manufactured, more people will be able to receive the vaccine.
The Federal government is currently covering the cost of the COVID‑19 vaccine itself. Independence will cover the cost of health professionals administering the vaccine with no cost sharing (co-pays, deductibles, coinsurance) for commercial members – regardless of where the vaccine is given or if the health professional administering the vaccine is in the Independence network.
- Cost sharing for COVID-19 vaccines being administered to high-deductible health plan members by health care providers in and out of the Independence network will be waived/covered before deductible.
- Cost sharing for COVID-19 vaccines administered by a home health agency will be waived/covered, even if the home health agency is not in the Independence network. The requirement that a member needs to be home-bound to receive the vaccine from a home health agency will be waived for COVID-19.
- Cost sharing for members who get the COVID-19 vaccine from a health care provider in and out of the Independence network during a preventative office visit will waived/covered. If a member gets the COVID-19 vaccine from a health care provider but the office visit is not considered preventative, cost sharing for the office visit will still apply.
For Medicare Advantage members, the cost of the COVID-19 vaccine and its administration will be covered by Original Medicare so long as the health care provider administering the vaccine participates in the Medicare program (the health care provider does not need to be in the Independence network). This is in accordance with CMS guidance and will be paid by Original Medicare.
- Providers must submit all claims for the COVID-19 vaccine and any associated costs to Original Medicare.
Does Independence control the availability or distribution of the vaccine?
Independence does not control the availability or distribution of any vaccines. This includes the COVID-19 vaccine. Distribution of the vaccine will be controlled by the federal government, which will collaborate with local and state governments and Departments of Health. After the initial phases of immunization, it is expected that providers will be able to acquire vaccine through the usual distribution channels.
Will Independence provide additional reimbursement to providers for the vaccine?
Independence will not provide additional reimbursement for the COVID-19 vaccine itself until government sponsorship ends. We will, however, take responsibility as a health plan to bear the costs for the administration of the vaccine.
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 continues to escalate, we are working hard to make sure our members can receive appropriate testing and treatment for this virus if needed.
At the start of the pandemic, we quickly announced that we would cover testing for active COVID-19 (RT-PCR) at no cost to our members. We continue to cover and reimburse member cost-sharing (such as co-pays, deductibles, and coinsurance) for COVID-19 diagnostic and antibody tests and the administration of the tests when performed at an in-network physician’s office, urgent care center, drive-thru testing site, pharmacy, by a home health agency, or an emergency room. This coverage is available in accordance with federal and state mandates and company medical policies for the duration of the public health emergency.*
These temporary changes to our testing policies 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.
Effective March 6, 2020, and for the duration of the public health emergency*, we will be waiving the requirement that commercial and Medicare Advantage members must be homebound (as defined in the medical policy) to receive COVID-19 testing at home by a visiting nurse. Please note the following:
- The homebound requirement is only waived 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 collected must be delivered to an in-network laboratory to perform the test and the results must be sent to the prescribing professional provider. For Medicare Advantage members this includes out-of-network laboratories as well.
Members should report any concerns about claim payment to our customer service staff at the number on their member card. If you have any questions about whether you should be tested, please contact a health care professional.
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 testing options with you.
If you don’t have a primary doctor but have telemedicine benefits, you may be able to contact an MDLive physician without cost-sharing.* MDLive physicians can perform COVID-19 screening and help you determine next steps. You can register for MDLive at ibx.com.
You can also 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 members’ cost (co-pays, co-insurance, deductibles) for in-network, acute in-patient treatment of COVID-19 through March 31, 2021.
Cost sharing will be applied to:
- 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
- Out-of-network care
For Medicare Advantage members, these temporary changes to our treatment policy will be offered for the duration of the public health emergency* and include coverage for out-of-network providers. Please note that treatment for acute in-patient treatment of COVID-19 is covered for our Medicare Advantage members through their new 2021 plans.
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 through March 31*, 2021 for fully-insured business and through the end of the public health emergency* for Medicare Advantage members. Self-insured customers can opt-out of coverage.
How are prior authorizations being handled?
Independence has temporarily suspended pre-authorizations until March 31, 2021 for the following services if the member has a COVID-19 diagnosis:
- Acute inpatient admissions to in-network facilities from an emergency department
- Transfers from acute in-network facilities to in-network post-acute care facilities
- Transfers from acute in-network inpatient facilities to other in-network inpatient facilities
- In-network ambulance transport
Pre-authorizations for members without a COVID-19 diagnosis are also waived through January 31, 2021 for transfers between in-network facilities. Facilities are still required to notify Independence.
For Medicare Advantage members, these temporary suspensions of pre-authorization also include out-of-network providers.
Should members be using telemedicine?
To help reduce potential exposure to COVID-19, we encourage members to utilize telemedicine services if they are available as part of their health plan. We have expanded members’ access to primary care and specialists through telemedicine for COVID-19 related diagnoses by waiving copays for these visits through March 31, 2021. This expansion includes:
- Specialist visits (via video or telephone)
- Physical 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, including those related to autism spectrum disorder.*
Access to primary care and specialists through telemedicine is also available for non-COVID related diagnoses; however, member cost sharing will apply. Telemedicine services for Medicare Advantage members will be effective for the duration of the public health emergency.*
Some members may have access to MDLive telemedicine visits. Cost sharing for those visits vary based on members’ benefits. If you have questions about your access to MDLive telemedicine services, please check your member benefits at ibx.com.
To access telemedicine options, log in to the member website at ibx.com.
Can members do wellness visits through telemedicine?
Independence will cover preventative well visits for commercial members via telemedicine through March 31, 2021. Annual wellness visits are always covered for members enrolled in Medicare Advantage, and for the duration of the public health emergency*, can be done via telemedicine.
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. Telemedicine visits with out-of-network providers are covered for commercial 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.
Medicare Advantage 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?
At this time, we are not waiving prescription drug refill limits. However, we are carefully monitoring COVID-19 developments and will adjust policies as appropriate. We recommend that members call the Pharmacy Services number on their ID cards as needed if they require additional medication refills. If a member has Medicare Part D and needs their medication, they can request that their pharmacy call Independence’s Pharmacy Help Desk for an override.
How is Independence helping members who may be affected financially by COVID-19?
Independence encourages all members who can pay their health plan bill on time to continue to do so. However, we understand the toll this pandemic continues to take on everyone and therefore are allowing individual members (both on and off exchange) to pay their premium via credit card until March 31, 2021.
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 and keeping them 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 employees and have taken several steps to safeguard their health.
In March 2020, Independence closed all of its office in Philadelphia and all affiliates’ offices in New Jersey and Minnesota. All employees have been required to work remotely since that time to help reduce the risk of illness through person-to-person contact. Additional safety measures and protocols were put in place for those that had to enter and work in our buildings. Access to company buildings remains extremely limited to those individuals whose work requires them to be onsite.
Our company’s leadership is developing a reentry strategy based on guiding principles that focus on the health and safety of our employees. 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 addressing the needs of the health care community on the frontlines of fighting COVID-19?
Independence is fortunate to have strong relationships with the health care community that provides care for our members. Our executives are staying in close contact with the health care leaders in our region to monitor this rapidly changing situation and to make the most appropriate decisions for health and wellness of people in the communities we serve.
We launched a range of clinical and business initiatives since the start of the pandemic to address the key needs of the health care community on the frontlines of fighting the virus. These initiatives were put in place to help ensure that providers had the support they needed to continue delivering high-quality care to their patients.
Our COVID-19 Provider Hub website, which outlines everything we are doing to support frontline workers during the pandemic, is accessible to doctors, hospitals, health systems, and other health care professionals. We have also been communicating the latest news and information about COVID-19 to providers through our existing communication channels.
If someone wants more information about COVID-19, where should they go?
If you are looking for more information about specific symptoms you are experiencing or have questions about your personal health, we recommend you contact your doctor. For reliable information about 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.
Our comprehensive website dedicated to COVID-19 also has information and resources available. We also continue to update our Newsroom and social media channels with the latest information about COVID-19.
Additional resources include:
- City of Philadelphia Information and Recommendations
- How to prepare: Managing anxiety and stress (provided by the CDC)
- COVID-19 helpline for Greater Philadelphia residents: 1-800-722-7112
- Mental Health COVID-19 resources (provided by Magellan Health)
- Living with threats of violence (provided by Magellan Health)
- What to do if you are sick with COVID-19 or caring for someone with COVID-19 (provided by the CDC)
How can members protect themselves against fraud?
Unfortunately, fraud exists everywhere. Independence, like many other organizations, have received some reports of potential frauds and scams related to COVID-19.
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
- Online sellers falsely claiming 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 ibx.com for accuracy
- Protecting their insurance card
- Protecting their identity and not providing their 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 us. All reports can be submitted anonymously. Here are three options for submitting a report:
- Submit through the Online Fraud & Abuse Tip Referral Form at 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.
*Please note: The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security (CARES) Act mandate that member cost sharing (deductible, co-pays and coinsurance) is waived both in and out-of-network for the testing and diagnosis of COVID-19 through the public health emergency. The waiver of member cost sharing for both in and out of network will continue through the public emergency, which has been extended through January 21, 2021, unless otherwise modified by the federal government. For High Deductible Health Plans, in-network cost sharing waivers detailed above will remain in effect through December 31, 2020 unless prohibited by law.
2If a member has coverage through an employer, benefits and coverages may vary.
MDLive is an independent company.
Website last updated: 1/3/21
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.
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