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

Coronavirus disease (COVID-19) was identified in 2019 as an emerging illness. In the past few years, we've gained a great deal of knowledge about treatment options, how the virus works, and the total impact of the illness. New information, obtained daily, will further inform the risk assessment, treatment options and next steps.

ABOUT CORONAVIRUS

  1. What is the coronavirus?
    COVID-19 is a respiratory disease that is caused by a new virus called a coronavirus, which has become a public health emergency. The number of cases continue to increase nationally and globally.
  2. What are the symptoms?
    The symptoms of coronavirus include mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath, and lower respiratory illness. COVID-19 can be contagious before a person begins showing symptoms
  3. What else causes similar symptoms?
    Influenza (the flu), a contagious respiratory illness caused by the influenza viruses (Type A and Type B), has high activity in the United States at this time. Everyone 6 months of age and older should get a flu vaccine. Contact your PCP to get a flu vaccine.

PREVENTION AND SCREENING

We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:

  1. Protect yourself and your community.
    We all have a role to play in protecting our communities and families from the spread of coronavirus. It is similar to other communicable viruses. You can also follow these tips to prevent infection:
    • Get vaccinated.
    • Wash your hands thoroughly and frequently. Use soap and water for at least 20 seconds.
    • Use an alcohol-based hand-sanitizing rub (must contain at least 60 percent alcohol).
    • Cover your mouth when you cough or sneeze by coughing/sneezing into your elbow.
    • Promptly dispose of tissues in a wastebasket after use.
    • Clean public surfaces thoroughly.
    • Stay home when you are sick.
    • Avoid shaking hands.
    • Avoid close contact with people who are sick.
    • Get a flu vaccine.
  2. I may have symptoms. What do I do?
    If you have been exposed or begin showing symptoms of the coronavirus or flu, contact your healthcare provider or health department immediately.
  3. Where may I receive COVID-19 testing/screening services under my Health Net Plan coverage?
    Medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment and the associated physician's visit will be covered when ordered, referred and/or performed in the following In-Network locations:
    • Physician’s/Practitioner’s Office
    • Independent Laboratory/Diagnostic Facility/Testing Center
    • Urgent Care Facility
    • Emergency Department Facility

If you are unsure if you have been exposed to or at-risk of being infected with COVID-19 (coronavirus), scheduling a virtual care visit with a provider is a good option for non-urgent care to limit potential exposure in a physician’s office or other healthcare facility.

  1. How else can I get healthcare services?
    Teladoc® is a convenient way for Health Net members to obtain telehealth services. You will receive 24 hour access to in-network healthcare providers for non-emergency medical issues. Get medical advice, a diagnosis or a prescription by video or phone. For more information about telehealth services, please visit the Teladoc® website or call 1-800-835-2362.
  2. Will I be able to refill my prescriptions before the refill date?
    Yes, members will be able to refill prescriptions prior to the refill date.
  3. Are there strategies for coping with the COVID-19 outbreak?
    Worry and anxiety can rise about the spread of COVID-19. Concern for friends and family who live in places where COVID-19 is spreading or the progression of the disease is natural.
    • Get vaccinated.
    • Take care of your body. Take deep breaths, stretch or meditate.
    • Connect with others. Share your concerns and how you are feeling with a friend or family member. Maintain healthy relationships and a sense of hope and positive thinking.
    • Share the facts about COVID-19 and the actual risk to others. People who have returned from areas of ongoing spread more than 14 days ago and do not have symptoms of COVID-19 do not put others at risk.
    • For more information, see the CDC’s suggestions for mental health and coping during COVID-19.

WHAT IS THE COVID-19 VACCINE?

There is now a vaccination available that will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future. The vaccine will have two doses a few weeks in between each shot. You will get a reminder card so you don’t forget your second shot. It is important to get both doses of the vaccine as instructed.

    LANE COUNTY Vaccine Clinics

  1. Where can I get the COVID-19 vaccine?
    To find out if you are eligible to receive the COVID-19 vaccine, you can text message ORCOVID to 898211 for a quick reply. You can also visit Get Vaccinated Oregon to find out if you are eligible and for next steps. You may also contact your doctor or pharmacist with questions about when and how you may receive the vaccine.

    Local public health agencies and health care systems are working on vaccine distribution. Find vaccine distribution information on the Oregon Health Authority website.

    LANE COUNTY Pre-Registration

    • COVID-19 Vaccine Pre-Registration Form (English)
    • COVID-19 Vaccine Pre-Registration Form (Spanish)

    If you are unable to access the Internet, you may call the LCPHA (Lane County Public Health Authority) Call Center at 541-682-1380.

    TRI-COUNTIES Pre-Registration

    All Oregonians, including senior adults age 65 and over, can sign up to be notified about vaccination events when they are eligible at Get Vaccinated Oregon using the signup tool. 

    The new appointment scheduling process for eligible older adults who live in Clackamas, Columbia, Multnomah or Washington counties will be based on names being pulled from the Get Vaccinated Oregon tool.
  2. Am I required to get my COVID-19 vaccine?
    While it is not a requirement, getting your COVID-19 vaccine will give you the best chance of protecting yourself and your loved ones from getting COVID-19 in the future.
  3. I already had COVID-19. Should I still get the vaccine?
    Even if you have already had COVID-19, you should still get the vaccine.  It may be possible to be infected more than once so getting the vaccine is a safe choice.
  4. Can my child get the vaccine?
    Currently, the Pfizer-BioNTech vaccine is recommended for people ages 16 and older. The Moderna vaccine is currently recommended for those ages 18 and older.
  5. When I get the vaccine, can I stop wearing a mask or "social distancing?”
    It will take time for your body to build immunity after the vaccine. It is important to continue to social distance, wear a mask in public and continue handwashing in order to keep from getting sick.
  6. ls the vaccine safe? 
    The safety of the COVID-19 vaccine is a top priority! The Food and Drug Administration (FDA) carefully reviews all safety data from clinical trials and authorizes emergency vaccine use only when the expected benefits outweigh potential risks. COVID-19 vaccines were tested in large clinical trials to make sure they meet safety standards.
  7. Will there be any side effects when I get the vaccine?
    You may run a fever after you get the vaccine. This is normal as your body builds immunity and fights off future COVID-19 exposures. You may feel sick after getting vaccinated. You could develop a fever, headache or body aches. This is your body reacting to the vaccine, which is a normal response. It is important to know that it is impossible to get COVID-19 from the vaccine. The vaccines currently in use and others being developed do not contain a live virus.
  8. Do I have to pay for my vaccine? Or get prior authorization?
    No. Both doses of the COVID-19 vaccine will be at no cost to you. You do not need to get a prior authorization for your vaccine.
  9. I lost my COVID-19 Vaccination Record Card. What should I do now?
    Please call the administering facility/provider you received your first dose from to ask about your vaccine information and verify your second appointment/location.
  10. I am due for my second dose. I got my first dose from another provider who is not my PCP but I don’t have their contact information. What do I do now?
    The provider should have scheduled a second appointment with you at the same facility when you received the first dose. However, you can receive your second dose from another provider/facility and you should present your COVID-19 Vaccination Record Card.

AT-HOME COVID-19 TESTS

How do I get an at-home COVID-19 test for free?
If you have pharmacy coverage as part of your Health Net plan, you can get an over the counter (OTC), FDA-approved, EUA at-home COVID-19 test at no cost if you visit one of Health Net’s in-network retail pharmacies. View approved in-network pharmacy test kit list (PDF).

Get the test from the pharmacy itself. Do not get a test and pay for it at the store's normal register. If you pay for the test at the normal register, then you will need to submit a medical claim form to get reimbursed.

Visit our website to find an in-network pharmacy for your plan type.

Are there tests not covered through pharmacy?

COVID test kits that are not covered include:

  • Kits that have to be sent to a lab (collection kits)
  • Kits that are not indicated as “OTC”
  • COVID kits obtained outside of the United States

I have a Health Net group medical plan, but the prescription coverage is through another company. How do I get an at-home COVID test for free?

Check with your pharmacy to see if they can bill the vendor through their pharmacy system. You can then get an OTC at-home COVID-19 test at no cost. You can also purchase an OTC FDA- approved, EUA at-home COVID-19 test and be reimbursed by Health Net for the cost of the test. Please complete and submit a Health Net medical claim form.

I bought an at-home COVID-19 test on my own, will I be reimbursed?

Yes. If you bought an OTC FDA-approved, EUA at-home COVID-19 test at any place outside of our in-network pharmacies (e.g., Amazon, grocery store, drug store, etc.), you will be reimbursed for the cost of the test kits (up to $12 per test) as follows:

  • Purchase an at-home test that is on the FDA-approved EUA list. View the FDA-approved EUA at-home test list. Tests available without a prescription will include “OTC” (for over-the-counter at-home tests) in the Attributes column.
  • Complete and submit a separate claim form for each member:
  • You must include a copy of your receipt. On your receipt, write or circle (if the information is on the receipt):
    • The name of the OTC COVID Test Kit.
    • The UPC code found on the box.
  • Complete Section 1 and Section 2 of the claim form.
  • For Section 3, include this information in the fields as follows:
    1. The store where you bought the test kit (Amazon, grocery store name, drug store name, etc.)
    2. The address of the store if applicable.
    3. Write “COVID-19 Home Test” and the number of tests.
    4. The date you purchased the kit(s).
    5. The amount being asked for reimbursement.

 

 

  • Sign and return your claim form (don’t forget the receipt).
    Mail to: Health Net Health Plan of Oregon, Inc., PO Box 9040 Farmington, MO 63640-9040
  • You will be reimbursed based on federal guidance set on January 10, 2022 which states:
    • The cost of the at-home test – up to $12 per test
    • Maximum of 8 tests per covered member in a 30-day period
    • A single testing kit box that includes two tests would count as two (e.g. $12 x 2 = $24)

If you purchased a physician ordered, FDA/EUA approved test before January 15, 2022, Health Net will reimburse you when the claim form is turned in based on what you paid.

If I bought an FDA-approved EUA at-home COVID-19 test on Amazon, how do I show my proof of purchase?

Please print an image of the digital receipt and submit it along with the claim form. If you can’t provide a digital receipt, please put the order or invoice number for the purchase on the claim form. This is for proof of purchase and tracking. See above FAQ on how to be reimbursed.

Will Health Net limit the number of tests that a member can get for free?

Yes. Health Net will cover 8 OTC FDA-approved, EUA at-home COVID-19 tests purchased over-the-counter per covered member in a 30-day period. This follows the federal guidance released on January 10, 2022.

 

INSURANCE AND COST

Health Net is committed to the health of our members. Your Health Net plan will cover the cost of medically necessary of COVID-19 tests and the associated physician’s visit. We do not require prior authorization for these services.

  1. Does my Health Net plan cover COVID-19 testing/screening/treatment services?
    Yes, when medically necessary diagnostic testing, or medical screening services and/or treatment is ordered and/or referred by a licensed health care provider, we will cover the cost of medically necessary COVID-19 tests, screenings, associated physician’s visit(s) and/or treatment. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment.
  2. Is prior authorization required for COVID-19 testing, screening services and/or treatment under my Health Net plan coverage?
    Our Health Net plans will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing and medical screening services when medically necessary services are ordered and/or referred by a licensed health care provider. Effective 7/1/21, prior authorization requirements for COVID-19 treatment and virtual care are required.
  3. Will I be responsible for any out-of-pocket costs for COVID-19 testing/screening/treatment services?
    We will cover medically necessary COVID-19 diagnostic testing and/or medical screening services at no charge to you, when such services are ordered and/or referred by a licensed health care provider. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services, along with the associated physician’s visit. Effective 7/1/21, you may be responsible for out-of-pocket costs for COVID-19 treatment and virtual care.  
  4. If I need treatment for coronavirus, is that covered by my Health Net Plan?
    Any medically necessary treatment related to COVID-19 would be considered a covered benefit.We are committed to ensuring access to COVID-19 treatment services in accordance with federal and state law.

HELPFUL RESOURCES

Get News and Important Plan Updates

To help keep you informed, we're constantly updating our news sections to bring you important information regarding COVID-19, your health care plan and more.

How to Create Positive New Habits in Our New World

Our lives and routines have changed because of COVID-19. How can we stay healthy with our habits broken? Here are some tips to help you.

ADDITIONAL INFORMATION

For more information, including travel advisories, please visit the CDC website.