Stay up to date on COVID-19

The COVID-19 pandemic is likely to raise questions about what your plan covers. Several frequently asked questions (FAQs) are addressed below, along with information on medication availability, and other useful links to COVID-19 information. For additional questions or concerns, contact the Member Services team at (855) 624-6463, Monday through Friday, 8 a.m. to 6 p.m., or via email memberservices@healthoptions.org.

 

COVID-19 related healthcare coverage

What is Health Options’ coverage for COVID-19-related provider appointments?

Through the duration of the COVID-19 health emergency, we are waiving cost sharing for provider-recommended COVID-19 testing and associated lab processing fees, the office, ER, or urgent care visit to collect the specimen, COVID-19 telehealth screening services with your provider's office, and COVID-19 treatment among our in-network acute care facilities. All other testing, treatment, and services are subject to applicable cost share.

Where can I get tested for COVID-19?

The Maine Department of Health and Human Services (DHS) offers testing for residents and visitors through "swab and send" sites. These sights offer specimen collection and testing free of charge to individuals, with or without symptoms, who believe they may have COVID-19 or could have been exposed.

As a reminder, please bring your health insurance ID card with you whenever you seek medical care, including any appointments for testing or vaccine administration.

When can I get vaccinated for COVID-19?  

Maine has an age-based approach to vaccinating Maine residents. The timing and age ranges are: 

  • March 3: Age 60 and older
  • March 23: Age 50 and older 
  • April 19: All Maine residents age 16 and older 

For additional information, please go to: https://www.maine.gov/covid19/vaccines 

Is the COVID-10 vaccine recommended for individuals with immunocompromised status (immune system defenses are low) due to an underlying chronic health condition or certain medications that may decrease immune system function?

Individuals who are/may be immunocompromised due to a chronic health condition or certain medications may benefit from having a conversation with their provider to discuss the most appropriate timing of getting the COVID-19 vaccine.

Is the COVID-19 vaccine free?

Vaccine doses will be available with no out-of-pocket cost.

Will my vaccination be free even if I don’t receive it from my in-network primary care provider?

Vaccine doses will be available with no out-of-pocket costs, even if you get vaccinated from a facility or provider other than your PCP.

What does it mean to be “fully vaccinated?”

People are considered fully vaccinated:

  • 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
  • 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

If I have been vaccinated, do I still need to wear a mask?

Yes, even after vaccination, we should continue to wear our masks, keep our distance, and wash our hands regularly.  

What activities can I do once I have been fully vaccinated?

You Can:

  • You can gather indoors with fully vaccinated people without wearing a mask or staying 6 feet apart.
  • You can gather indoors with unvaccinated people of any age who are not at risk for severe illness.
  • Travel domestically without a pre- or post-travel test or quarantine (You still must wear a mask).
  • Travel internationally without a pre-travel test or quarantine depending on the destination (You still must wear a mask). *Please note you still need a negative test result to board a flight into the United States. You should still get tested 3-5 days after international travel.
  • If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms.

You Should Not:

  • Visit indoors, without a mask, with people at increased risk for severe illness from COVID-19
  • Attend medium or large gatherings.

Learn more here.

How do I know if I need to quarantine?

Quarantine keeps people who might have been exposed to COVID-19 away from others to help prevent the spread of disease. Not everyone infected shows or feels symptoms. If you think you may have been exposed to COVID-19 or have traveled out of the state, please check Maine’s quarantine guidelines here.

Where can I get help for COVID-19 related stress and anxiety?

Click here to use the Health Options’ provider lookup tool to find a behavioral health provider near you. Some providers offer telehealth services. Ask the provider if this option is available. If you are in an emergency, dial 911, go to a local emergency room or call the State of Maine Crisis Hotline at 1-888-568-1112.

 

Getting non-COVID-19 care during the pandemic

Is remote access to providers available during the pandemic?

Some providers offer telehealth services that enable you to get advice via remote access. Contact your provider’s office to see if this option is available.

Are telehealth visits covered?

A telehealth visit with your in-network provider is treated in the same manner as an in-person appointment. Coverage is based on your plan benefits.

 Can I receive infusion therapy at home as a covered service?

Home infusion may be possible. Health Options partners with local companies that provide infusion services in your home. Find out what medications are eligible for home infusion services by calling Member Services at (855) 624-6463, Monday through Friday, 8 a.m. to 6 p.m.

Can I obtain an early refill for my medications?

In many cases, due to the virus outbreak, you can receive an early refill on medications taken regularly. Contact your local pharmacy or take advantage of our home delivery pharmacy here.

Can I obtain an early refill of medications from Accredo?

You can request, and in many cases, obtain what pharmacists call an “emergency refill too soon” order by calling the phone number on your prescription label or calling Accredo at (877) 895-9697.

Can I use Home Delivery for my medication needs?

Yes, you can sign up for Home Delivery by calling (800) 282-2881. You can request, and in many cases, receive an early refill from Home Delivery by calling their pharmacy at (877) 861-0376 and asking for an early refill due to the virus outbreak.

If you have other questions, please contact Member Services at (855) 624-6463 or memberservices@healthoptions.org.

Other sources of COVID-19 information

The posted content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your provider or another qualified health provider with any questions you may have regarding a medical condition.