UPHP Coverage Information Updates for Members Amid COVID-19 Outbreak

Marquette, Mich. – Upper Peninsula Health Plan (UPHP) will be taking action to ensure the health and safety of our members during the worldwide outbreak of a new coronavirus. The disease caused by the new coronavirus, called COVID-19, causes symptoms including fever, cough and shortness of breath. The number of cases of COVID-19 in the U.S. continue to spread from state-to-state and are increasing daily.

The information below outlines coverage changes for UPHP amid the COVID-19 outbreak. These changes will take effect immediately until further notice.

Diagnostic Testing Coverage Related to COVID-19

• For all UPHP members types (which includes Medicare Advantage, MI Health Link, Medicaid, Health Michigan Plan, and Children With Special Health Care Services [CSHCS]): UPHP is waiving all costs associated with any diagnostic laboratory tests for COVID-19, when used in accordance with Centers for Disease Control and Prevention (CDC) testing recommendations. This measure will ensure patient testing and ensuing care is completed in an efficient, coordinated way with specialists at every level.
• For all UPHP member types: UPHP is waiving prior authorizations for diagnostic tests and for covered services related to COVID-19 that are medically necessary and in accordance with CDC guidelines. Prior authorization is approval from a plan that is required before the plan pays for certain services, medical equipment, prescriptions.

Prescription Medication Coverage

• For UPHP MI Health Link, Medicaid, Healthy Michigan Plan, and CSHCS members: UPHP is removing the current 30-day prescription limit and allowing 90-day supplies for maintenance medications, except for Controlled Substances and Specialty Medications.
• For UPHP Medicare Advantage (UPHP Advantage and UPHP Choice) members: UPHP continues to encourage members to utilize 90-day supplies of medications at their local or mail-order pharmacies.

Telehealth Services

Individuals seeking care for mild issues other than COVID-19 should consider telehealth options in order to avoid clinics and health care facilities with COVID-19 patients. This will help to stop the spread of disease and reduce the burden on health care facilities that may be overwhelmed with patients seeking care for respiratory illness.

• For UPHP Medicare Advantage (UPHP Advantage and UPHP Choice) members: UPHP is waiving all copays for telehealth services for the next 90 days.
• For UPHP MI Health Link, Medicaid, Healthy Michigan Plan, and CSHCS members: Access to telehealth services has been expanded by the State of Michigan and will be a covered benefit until further notice.
  • Note: Telehealth services must meet Centers for Medicare and Medicaid Services and Michigan Department of Health & Human Services guidelines, be HIPAA compliant, and be furnished by a physician or other authorized practitioner.
• All UPHP member types: A 24-hour Nurse Advice Line is available anytime of the day or night at no cost to members. This help over the phone can answer your questions regarding symptoms and help point you in the right direction for any next steps in care. If you have questions about your health, please call the 24-hour Nurse Advice Line at 1-844-411-3695.

This is situation is developing quickly and information is constantly being updated as officials learn more about the virus. We will continue to track all updates regarding the disease’s activity, symptoms, travel restrictions and risk assessments from our federal, state, and local partners. UPHP staff are working diligently to provide our members with the utmost level of care and access to services at this time. Please visit http://www.uphp.com/coronavirus for up-to-date member information or call UPHP Customer Service at 1-800-835-2556 (TTY: 711). 

Upper Peninsula Health Plan currently manages the care of nearly 50,000 Upper Peninsula residents enrolled in Michigan Medicaid, Children’s Special Health Care Services, the Healthy Michigan Plan, MI Health Link, and Medicare Advantage. Its network exceeds 2,000 providers. Learn more at www.uphp.com.