What You Need to Know About Coronavirus (COVID-19)

The health and safety of our members is of the utmost importance during the worldwide outbreak of a new coronavirus, called COVID-19. Rest assured that we are closely monitoring the latest updates from the Centers of Disease Control and Prevention (CDC), and will work with our federal, state, and local partners to protect our members and UP citizens as this situation evolves.

According to the CDC, COVID-19 is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. Though the virus is serious, most cases of COVID-19 result in mild respiratory illness. Older adults and individuals with chronic disease or weakened immune systems are the most at risk.

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness.

Symptoms may appear two to 14 days after exposure to the virus. People with these symptoms or combinations of symptoms may have COVID-19:

  • Cough
  • Shortness of breath or difficulty breathing

Or at least two of these symptoms:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell
 
  • Practice social distancing.
  • Wash your hands with soap and water often for at least 20 seconds.
  • If soap and water are not available, use hand sanitizer that contains at least 60% alcohol.
  • Cover your nose and mouth when sneezing or coughing with a tissue, then throw the tissue away.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick, except to get medical care.
  • Clean and disinfect frequently touched surfaces daily or more often, if necessary.
  • Call ahead before visiting your doctor: If you think you have been exposed to COVID-19 and develop a fever and symptoms of respiratory illness, such as cough or difficulty breathing, call your health care provider immediately. Calling ahead will help the health care provider’s office take steps to keep other people from getting infected or exposed.
  • Follow other tips from the CDC.

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 effective March 16, 2020, through June 15, 2020. 
  • 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 situation is changing rapidly. Please check back frequently for updates.

Health Risk Assessments

Healthy Michigan Plan members are asked to complete a Health Risk Assessment (HRA) with their primary care provider (PCP) annually. Due to COVID-19, we understand you may be unable to complete your HRA with your PCP at this time.

UPHP wants to support your commitment to healthy behaviors and ensure you maintain qualifying reductions in copays and contributions. As a result, you may now complete the entire HRA with UPHP staff instead of scheduling an appointment with your PCP.

If you are due to renew your HRA and you would like to complete this now, please call our Customer Service department at 1-800-835-2556 (TTY: 711) Monday through Friday from 8 a.m. to 5 p.m. Eastern Time. Otherwise, UPHP staff may contact you to complete your HRA if we show you are due.

If you’re feeling stressed or anxious because of the COVID-19 pandemic, know that you’re not alone and there are free resources available to help you. 

INFORMATION FOR PROVIDERS:

Telemedicine has become an essential tool when caring for your patients while keeping your staff safe during the COVID-19 outbreak. As a result, coverage for telemedicine services has been expanded and face-to-face requirements have been relaxed by the Michigan Department of Health and Human Services and Centers for Medicare and Medicaid Services. Please review the resources below and check back often as guidance for this is continually being updated.

  • Prior authorizations (PAs) for medical or prescription drugs for UPHP Medicaid members set to expire between now and May 31, 2020, have been extended by 60 days. Although not mandated at this time, UPHP has relaxed PA requirements in an effort to reduce the administrative burden on providers during the COVID-19 outbreak. UPHP will reevaluate further extensions as we approach May 31, or if additional guidance is received.
  • UPHP wants to decrease the likelihood that pharmacy prior authorization requirements create issues for members during the COVID-19 pandemic. Some drugs on UPHP’s formularies have prior authorization requirements that mandate prior therapy such as infusion therapy (for example, biologics) or laboratory testing that may not be feasible at this time. Please provide detailed information on prior authorization requests if you feel there are barriers to treatment, such as social distancing precautions, lack of infusion therapy options, access to laboratory testing, transportation issues or increased risks of health complications due to COVID-19. UPHP will work to assist you in decreasing risks for the patient while also maintaining patient outcomes.

  • COVID-19 Pharmacy Network Claims Processing Update (3/13/2020)

  • CMS Memo – Minimizing Face-to-Face Contact for Medication Delivery or Dispensing (3/20/2020)

  • MDHHS Numbered L Letter 20-20 – Medicaid Pharmacy Flexibilities in Response to COVID-19 Emergency to Facilitate Early Refills and Mailing Medications (3/26/20)

Up-to-date information from the CDC can be found below. For information specific to Michigan, please visit www.michigan.gov/coronavirus.

 


Page Last Updated: 07/22/2020

What You Need to Know About Coronavirus (COVID-19)