COVID-19

COVID-19 Vaccination Information

COVID-19 vaccines are available at many pharmacies and remain at no cost to members. For a vaccination provider near you check https://www.vaccines.gov/search/

COVID-19 Testing Information

There are 2 types of COVID-19 tests:

1. Over-the-counter (OTC) at-home COVID-19 test kits:
   • During Public Health Emergency, members with Medicare Part B coverage or enrolled in Medicare Advantage can obtain up to 8 free OTC test kits per month. Eligible members may visit participating pharmacies or health care providers to receive the kits. Participating pharmacies and health care providers will submit claims directly to Original Medicare (Not ATRIO). Members will need their original Medicare red-white-blue ID card to receive the free tests. For more information, go on-line or Call 1800-MEDICARE (1-800-633-4227) or TTY 1-877-486-2048
   • In addition, each household can order a one-time shipment of 2 sets of 4 free OTC at-home COVID-19 tests through the Federal government. Visit covidtests.gov to order your free at-home tests
2. Covid-19 diagnostic lab testing can be ordered by your provider are a covered service: Listed below are local testing resources for our service areas
   • Oregon COVID Testing
   • Louisiana COVID Testing
   • Nevada COVID Testing
   • Tennessee COVID Testing

Be Aware of Fraud Schemes

Review the helpful resources below to education yourself on fraud schemes related to the novel coronavirus (COVID-19).

• Office of Inspector General Fraud Alert
• Social Security Benefit Suspension Scam

The Secretary of Health and Human Services has renewed the COVID-19 public health emergency, effective 10/13/2022, with no known end date.

Refer to the ‘Benefit Information’ below for covered services during a public health emergency.

Benefit Information

This benefit information applies only for duration of the United States Public Health Emergency.

• During a declared emergency or disaster, you can seek care from any health care provider, pharmacy or hospital that is contracted with Medicare, and you will pay in-network copays or coinsurance. This is true even if you see a provider outside of ATRIO’s network, and even if your health care need is not an emergency. ATRIO Health Plans will not require you to get prior authorization before seeing an out-of-network provider. If the event impacts our ability to process your reimbursement requests in the usual time frame, we will notify you of a delay.
• We will not require prior authorization for COVID-19 testing.
• Member cost share is waived for FDA authorized services with these codes (codes 0014M eff 04/01/2020, C9803, G2023 and G2024 all three eff 03/01/2020, U0001 and U0002 both eff 02/04/2020, U0003 and U0004 both eff 03/15/2020, 87635 eff 03/13/2020 and 86328, 86769 both eff 04/10/2020).
• As of 3/18/2020, the below services are $0 cost share when performed in conjunction with COVID-19 related testing, evaluation or treatment and when billed with a CS modifier:
  • Office and other outpatient services
  • Hospital observation services
  • Emergency department services
  • Nursing facility services
  • Domiciliary, rest home, or custodial care services
  • Home services
  • Online digital evaluation and management services
• Our “refill too soon” policy for medications (except opioids) has been adjusted to allow members to prepare as needed.
• ATRIO will waive step therapy requirements for medications.
• Telehealth visits, Virtual check in visits, and E-visits visits are covered. Please ask your provider’s office if they have this option available.
• As of 02/28/2020 and through the duration of this emergency, we are removing the prior authorization requirement for out of network services for ATRIO members. We will still follow the prior authorization grid, but if the service is not on the grid, it no longer requires prior authorization whether being provided/performed/supplied by an in or out of network provider.
• Following CMS’ policy, we are loosening requirements for required criteria, such as face to face evaluations for lost, stolen, or damaged DME equipment.

How to protect yourself from coronavirus and many other common viruses:

• Get your COVID-19 vaccine.
• Avoid close contact with people who are sick.
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
• If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
• To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Avoid touching your face, nose, eyes, etc.
• Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
• If you feel sick or have been in close contact with someone with COVID-19 call your doctor’s office or your county/region public health department

List of Resources and Helpful Information:

If you have questions, please call 211. They can provide general COVID-19 information.

• Center for Disease Control and Prevention
• CDC Coronavirus Self-Checker
• For a vaccination provider near you check https://www.vaccines.gov/search/