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INFORMATION FOR DC RESIDENTS AND SMALL BUSINESSES
DC Government
Centers for Disease Control (CDC)
INFORMATION FROM THE EXECUTIVE DIRECTOR
06/24/2020
Small Business Update - A one-time premium reduction for DC Health Link enrolled employers
04/10/2020
Small Business Update - New flexibility for deferring your DC Health Link health insurance premiums
04/03/2020
Coronavirus (COVID-19) Update – Your Uninsured Employees Can Enroll in Health Insurance Now
03/20/2020
COVID-19 Benefits Update
03/06/2020
Communication to DC Health Link Customers
CONNECT WITH OUR HEALTH INSURANCE COMPANIES
(855) 885-3289
(855) 444-3121
(800) 777-7902
(877) 856-2430
CORONAVIRUS (COVID-19) BENEFITS FROM DC HEALTH LINK INSURERS
This information was updated on January 19, 2021. This applies to all DC Health Link individual and small group health insurance options at all coverage levels. DC Health Link plans are continuing to update information about COVID-19 on their websites. This is not a complete list of all your benefits related to Coronavirus. Please check plan websites for additional information on plan benefits and how your benefits work.
| Benefit |
Aetna
Website |
CareFirst BlueCross BlueShield
Website |
Kaiser Permanente
Website |
UnitedHealthcare
Website |
|---|---|---|---|---|
| NEW Is the COVID vaccine free to me? |
Yes | Yes | Yes | Yes |
| NEW Is the administering of a COVID vaccine free to me? |
Yes | Yes | Yes | Yes |
| Will my insurance pay for the COVID-19 test if my doctor recommends that I get tested? | Yes | Yes | Yes | Yes |
| If my doctor recommends that I get tested, is my insurance plan waiving my deductible, copay and coinsurance for the COVID-19 laboratory test? | Yes | Yes | Yes | Yes |
| If my doctor recommends that I get tested, is my insurance plan waiving my deductible, copay and coinsurance for the physician, urgent care, or hospital portion of the visit? | Yes | Yes | Yes | Yes |
| Is my insurance plan waiving prior authorization for getting a COVID-19 test if my doctor recommends that I get tested? | Yes | Yes | Yes | Yes* |
| Is treatment for COVID-19 a covered benefit under my plan? | Yes | Yes | Yes | Yes |
| Is my insurance plan waiving my deductible, copay and coinsurance for physician, urgent care, and hospital treatment for COVID-19? | Yes* | Yes | Yes* | Yes* |
| Is my insurance plan waiving prior authorization for getting COVID-19 treatment if my doctor recommends treatment? | Yes* | Yes | Yes* | Yes* |
| Is my insurance plan waiving my deductible, copay and coinsurance for diagnosis, testing, and treatment for COVID-19 if I see an out-of-network provider? |
Yes* If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing) |
Yes* If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing) |
Yes* If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing) |
Yes* If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing) |
| Can I get an early refill on my prescription medication even though it hasn’t been 30 days from when I last filled it? |
Yes Rx cost-sharing continues to apply. If your prescription is delivered, the delivery charge is waived. |
Yes Rx cost-sharing continues to apply. If your prescription is delivered, the delivery charge is waived. |
Updated Yes* Not Automatic. Patient must request. Rx cost-sharing continues to apply. |
Yes Rx cost-sharing continues to apply. Call member services. Phone number on the back of your medical card. |
| Is there a free nurse advice line? |
Yes 24-Hour Nurse Advice Line (800) 556-1555 |
Yes 24-Hour Nurse Advice Line (800) 535-9700 |
Yes 24-Hour line and talk with a licensed care provider (nurse or doctor) (800) 777-7904 |
Yes Call member services to be directed. Phone number on the back of your medical card. |
| What telehealth/telemedicine services are available? |
Updated FREE video-conferencing and Teladoc® through January 31, 2021. No cost sharing for behavioral/ mental health related telehealth services through January 31, 2021. All other telehealth services subject to cost-sharing. |
Updated Free in-network member-initiated telephone consultations for all provider specialties. Member cost sharing for in-network or out-of-network visits to a provider’s office, including through telehealth, related to diagnosis and treatment of COVID-19 will continue to be waived. Free in-network member-initiated telephone consultations: in-network primary care, general practice, internal medicine, pediatrics, OBGYN and associated nurse practitioners through September 30, 2020. No cost sharing for all telehealth from in-network providers for medically appropriate services through July 24, 2020. FREE CareFirst Video Visit through July 24, 2020. |
FREE Telephone, Video Visit, and Email with your Kaiser Permanente provider for all services. These telehealth services are always free. No cost sharing for new E-visit for Coronavirus. |
FREE*
Virtual Visit No cost-sharing for in-network telehealth services for medical and outpatient behavioral services, and physical, occupational, and speech therapy services. No cost-sharing for in-network or out-of-network for COVID-19 testing related telehealth services including both interactive audio/video and audio only. FREE 24-Hour Optum’s Emotional-Support Help Line COVID-19. (866) 342-6892 Emotional-Support Help Line is open to members and the public. FREE premium access to tele-mental health services and tools from Sanvello Health. |
| Are there other COVID-19 related services that are available? |
Yes Aetna website for more information |
Yes Outreach calls to most vulnerable and at-risk members to help them navigate the COVID-19 pandemic. CareFirst website for more information |
Yes New FREE Calm and myStrength apps. Calm is an app focused on mindfulness, meditation, and improving sleep. myStrength is a digital behavioral health app that offers a personalized interactive program to help improve awareness and change behaviors. New FREE ClassPass app. ClassPass app has on-demand workouts including cardio, Yoga, and strength training. Kaiser Permanente website for more information |
Yes UnitedHealthcare website for more information |
Insurance Carriers
Aetna
CareFirst BlueCross BlueShield
Kaiser Permanente
UnitedHealthcare
NEW
Is the COVID vaccine free to me?
Is the COVID vaccine free to me?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
NEW
Is the administering of a COVID vaccine free to me?
Is the administering of a COVID vaccine free to me?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
Will my insurance pay for the COVID-19 test if my doctor recommends that I get tested?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
If my doctor recommends that I get tested, is my insurance plan waiving my deductible, copay and coinsurance for the COVID-19 laboratory test?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
If my doctor recommends that I get tested, is my insurance plan waiving my deductible, copay and coinsurance for the physician, urgent care, or hospital portion of the visit?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
Is my insurance plan waiving prior authorization for getting a COVID-19 test if my doctor recommends that I get tested?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes*
Is treatment for COVID-19 a covered benefit under my plan?
Aetna
Yes
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes
UnitedHealthcare
Yes
Is my insurance plan waiving my deductible, copay and coinsurance for physician, urgent care, and hospital treatment for COVID-19?
Aetna
Yes*
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes*
UnitedHealthcare
Yes*
Is my insurance plan waiving prior authorization for getting COVID-19 treatment if my doctor recommends treatment?
Aetna
Yes*
CareFirst BlueCross BlueShield
Yes
Kaiser Permanente
Yes*
UnitedHealthcare
Yes*
Is my insurance plan waiving my deductible, copay and coinsurance for diagnosis, testing, and treatment for COVID-19 if I see an out-of-network provider?
Aetna
Yes*
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
CareFirst BlueCross BlueShield
Yes*
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
Kaiser Permanente
Yes*
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
UnitedHealthcare
Yes*
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
If there is an unreasonable delay for in-network providers, then your plan will cover out-of-network charges including cost sharing and surprise billing (also called balance billing)
Can I get an early refill on my prescription medication even though it hasn’t been 30 days from when I last filled it?
Aetna
Yes
Rx cost-sharing continues to apply.
If your prescription is delivered, the delivery charge is waived.
Rx cost-sharing continues to apply.
If your prescription is delivered, the delivery charge is waived.
CareFirst BlueCross BlueShield
Yes
Rx cost-sharing continues to apply.
If your prescription is delivered, the delivery charge is waived.
Rx cost-sharing continues to apply.
If your prescription is delivered, the delivery charge is waived.
Kaiser Permanente
Updated
Yes*
Not Automatic. Patient must request.
Rx cost-sharing continues to apply.
Yes*
Not Automatic. Patient must request.
Rx cost-sharing continues to apply.
UnitedHealthcare
Yes
Rx cost-sharing continues to apply.
Call member services. Phone number on the back of your medical card.
Rx cost-sharing continues to apply.
Call member services. Phone number on the back of your medical card.
Is there a free nurse advice line?
Aetna
Yes
24-Hour Nurse Advice Line
(800) 556-1555
24-Hour Nurse Advice Line
(800) 556-1555
CareFirst BlueCross BlueShield
Yes
24-Hour Nurse Advice Line
(800) 535-9700
24-Hour Nurse Advice Line
(800) 535-9700
Kaiser Permanente
Yes
24-Hour line and talk with a licensed care provider (nurse or doctor)
(800) 777-7904
24-Hour line and talk with a licensed care provider (nurse or doctor)
(800) 777-7904
UnitedHealthcare
Yes
Call member services to be directed. Phone number on the back of your medical card.
Call member services to be directed. Phone number on the back of your medical card.
What telehealth/telemedicine services are available?
Aetna
Updated
FREE video-conferencing and Teladoc®
through January 31, 2021.
No cost sharing for behavioral/ mental health related telehealth services through January 31, 2021.
All other telehealth services subject to cost-sharing.
FREE video-conferencing and Teladoc®
through January 31, 2021.
No cost sharing for behavioral/ mental health related telehealth services through January 31, 2021.
All other telehealth services subject to cost-sharing.
CareFirst BlueCross BlueShield
Updated
Free in-network member-initiated telephone consultations for all provider specialties.
Member cost sharing for in-network or out-of-network visits to a provider’s office, including through telehealth, related to diagnosis and treatment of COVID-19 will continue to be waived.
Free in-network member-initiated telephone consultations: in-network primary care, general practice, internal medicine, pediatrics, OBGYN and associated nurse practitioners through September 30, 2020.
No cost sharing for all telehealth from in-network providers for medically appropriate services through July 24, 2020.
FREE CareFirst Video Visit through July 24, 2020.
Free in-network member-initiated telephone consultations for all provider specialties.
Member cost sharing for in-network or out-of-network visits to a provider’s office, including through telehealth, related to diagnosis and treatment of COVID-19 will continue to be waived.
Free in-network member-initiated telephone consultations: in-network primary care, general practice, internal medicine, pediatrics, OBGYN and associated nurse practitioners through September 30, 2020.
No cost sharing for all telehealth from in-network providers for medically appropriate services through July 24, 2020.
FREE CareFirst Video Visit through July 24, 2020.
Kaiser Permanente
FREE Telephone, Video Visit, and Email with your Kaiser Permanente provider for all services. These telehealth services are always free.
No cost sharing for new E-visit for Coronavirus.
No cost sharing for new E-visit for Coronavirus.
UnitedHealthcare
FREE*
Virtual Visit
No cost-sharing for in-network telehealth services for medical and outpatient behavioral services, and physical, occupational, and speech therapy services.
No cost-sharing for in-network or out-of-network for COVID-19 testing related telehealth services including both interactive audio/video and audio only.
FREE 24-Hour Optum’s Emotional-Support Help Line COVID-19.
(866) 342-6892
Emotional-Support Help Line is open to members and the public.
FREE premium access to tele-mental health services and tools from Sanvello Health.
No cost-sharing for in-network telehealth services for medical and outpatient behavioral services, and physical, occupational, and speech therapy services.
No cost-sharing for in-network or out-of-network for COVID-19 testing related telehealth services including both interactive audio/video and audio only.
FREE 24-Hour Optum’s Emotional-Support Help Line COVID-19.
(866) 342-6892
Emotional-Support Help Line is open to members and the public.
FREE premium access to tele-mental health services and tools from Sanvello Health.
Are there other COVID-19 related services that are available?
Aetna
CareFirst BlueCross BlueShield
Yes
Outreach calls to most vulnerable and at-risk members to help them navigate the COVID-19 pandemic.
CareFirst website for more information
Outreach calls to most vulnerable and at-risk members to help them navigate the COVID-19 pandemic.
CareFirst website for more information
Kaiser Permanente
Yes
New FREE Calm and myStrength apps. Calm is an app focused on mindfulness, meditation, and improving sleep. myStrength is a digital behavioral health app that offers a personalized interactive program to help improve awareness and change behaviors.
New FREE ClassPass app. ClassPass app has on-demand workouts including cardio, Yoga, and strength training.
Kaiser Permanente website for more information
New FREE Calm and myStrength apps. Calm is an app focused on mindfulness, meditation, and improving sleep. myStrength is a digital behavioral health app that offers a personalized interactive program to help improve awareness and change behaviors.
New FREE ClassPass app. ClassPass app has on-demand workouts including cardio, Yoga, and strength training.
Kaiser Permanente website for more information
UnitedHealthcare
Note that (*) indicates a requirement for health insurers issued by Commissioner Karima Woods, Department of Insurance, Securities and Banking on March 20, 2020.