PEBB Insurance Providers Information About Seeking Care for COVID-19 - Coronavirus:

  • PEBB has put into place a temporary rule to assist qualifying employees with benefit eligibility challenges related to not meeting related hours requirements during the COVID-19 Pandemic. This temporary rule provides protection to PEBB members in the event they fall below the minimum number of working hours in a month to maintain core health benefit coverage and who are not in a current stability period under the Affordable Care Act or on approved FMLA, CBIW or any other protected leave. This rulemaking is effective April 9, 2020 – October 5, 2020. Update 9/1/20: A PEBB temporary rule can only be effective for a maximum of 6 months. Since the Pandemic emergency continues PEBB began the rulemaking process to make the COVID rules permanent.  This proposal is currently in process. Once we are no longer in an emergency situation PEBB will repeal the rules.  The proposed and temporary rules are posted to the PEBB website.
  • PEBB Plan Announcement: Governor Kate Brown announced that the State of Oregon has reached an agreement with health insurance companies to waive cost-sharing for customers who need Coronavirus (COVID-19) testing. This agreement means PEBB members will not be responsible for co-payment, co-insurance or deductible related to the COVID-19 for certain services such as testing, labs and in-network office visit (including urgent care or emergency room visit). For more information see the full press release.
    • Through PEBB, you have access to programs, tools and resources to help you take on these uncertain and changing times. PEBB has grouped all their partner resources on the PEBB website under COVID-19 Resources. Employees will find links to deal with “the new normal” in a healthy and positive way.  The topics include:
      • Emotional health resources
      • Physical health resources
      • Free mobile apps
      • Upcoming webinars, and
      • Recordings of past webinars
    • Telemedicine is available to all PEBB members at no cost.  Go to www.PEBBInfo.com for links to carrier’s telehealth information.
    • Assistance with loss of coverage for eligible dependents due to employment or school provided benefit changes may be available.  If coverage is lost mid-month for students there is an option to have coverage start that month or following month.
    • WW (formally Weight Watchers) has moved to a virtual platform https://www.weightwatchers.com/us/PEBB to learn more about how WW is adapting in-person workshops for our membership.
    • ASI Flex has made several COVID-19 changes for Flexible Spending Accounts:
      • Medical/Dependent Care
        • June 30th is the NEW deadline for ASI to receive claims for the 2019 plan year (Claims can still only be incurred through March 15, 2020).
        • Additionally, members may now have the need to adjust their 2020 Dependent Care FSA due to a change in childcare arrangements.  PEBB is ready to assist with those requests.  We ask that members please submit the following FSA Midyear Change Form to e-mail to employee.benefits@oregonstate.edu within 30 days of a childcare change.
      • Parking or Transportation Accounts or Commuter Accounts - Members may also need to change these accounts due to COVID-19. Please complete 2020 Commuter Form to make these changes and e-mail to employee.benefits@oregonstate.edu
  • Moda Health
    • Members can find up-to-date information on Moda's website here: https://www.modahealth.com/pebb/
    • Moda Health members can access OHSU virtual visits at a $0 cost share.  To schedule a visit members can use this link: https://www.ohsu.edu/virtual-care
    • Telemedicine (such as synchronous video, telephonic, skype, email) for in-network mental health providers are covered at the standard cost sharing for PEBB ($10 copay, deductible waived). For Out of Network providers, only the 2-way synchronous video interactive virtual care is covered at the standard cost sharing (30% coinsurance, subject to deductibles). In addition Moda PEBB members have access to eDoc through their myModa at no cost share to the member. This is a virtual email platform available to members to ask non-emergent questions to physicians and behavioral health providers, among others.
  • Providence
    • Providence has created FAQs and instructions. Benefit coverage is determined by the type of service received.  Providence also encourages employees to use the Providence Nurse advice line.
    • Providence members can see a participating provider and there is no charge for virtual or telephonic visits.  Historically, Providence did not allow telehealth visits with non-participating providers, but that is changing due to COVID-19.  If a member sees an out of plan provider for virtual visits or telehealth, the out of plan benefit applies.  This includes the deductible + a 30% coinsurance. Please note the following have not been approved for this use:  Facebook Live, Twitch, Snapchat, TikTok, and similar video communication applications that are public facing.
  • Kaiser
    • Kaiser is asking everyone follow the recommendations of the CDC.  If you have a fever, cough, and shortness of breath, we’re here to help. Beginning right away, members will be encouraged to use telehealth/e-visits rather than calling their clinician. 
    • If you are 18 or older, complete an E-visit to get online care and advice for cold cough and flu, be screened for coronavirus, and get treatment for your symptoms if necessary. To get started, click the link above, log into the Kaiser Permanente app or kp.org
    • Call 1-800-813-2000 (TTY 711) to talk to an Advice Nurse 24/7.
    • It’s important that members call us before they come in. Calling ahead helps us direct members to the most appropriate care, and take precautions to protect other members, patients and employees.
    • Testing and costs: We have the ability to have our patients tested for COVID-19. If testing is warranted, we will make the appropriate arrangements. As a member of Kaiser Permanente, you will not have to pay for costs related to COVID-19 screening or testing. We believe that cost should not be a barrier to screening or testing for our members who may have been affected by this virus. Kaiser Permanente will not charge member cost-sharing (including, but not limited to, co-pays, deductibles, and coinsurance) for all medically necessary screening and testing for COVID-19. This policy applies to the cost of the visit, associated lab tests, and radiology services at our hospital, emergency department, urgent care, and provider offices where the purpose of the visit is to be screened and/or tested for COVID-19.  In the event you are diagnosed with COVID-19, additional services, including hospital admission (if applicable) will be covered and charged according to your normal plan coverage rules.  We have a dedicated webpage that is updated frequently: https://healthy.kaiserpermanente.org/alerts/p1/2019-novel-coronavirus-feb-2020
    • Vaccine Coverage: There is currently no vaccine to protect against the new coronavirus. The best way to prevent infection is to wash your hands frequently and avoid being exposed to this virus. And while there is no specific antiviral treatment, people with coronavirus can seek medical care to help relieve symptoms.
    • Where can you find more information about COVID-19: Members my find information on their KP.org account, the CDC’s website https://www.cdc.gov/coronavirus, or for general information and updates about coronavirus, you can call 211 to learn more from the Oregon Health Authority.
    • Kaiser covers telehealth for mental health appointments without copays when members use an in network provider. They also have a tool for helping members practice self-care called the myStrength app.  Self-care during this difficult time is important. Available at no cost to our members 18 and older, the myStrength app offers a personalized program with interactive activities, in-the-moment coping tools, inspirational resources, and community support. It has new features specifically designed to help cope with fear or anxiety about the coronavirus.  Find more information here.

PacificSource Provider Information About Care for COVID-19 – Coronavirus

  • PacificSource COVID-19 Updates
  • PacificSource is keeping in close contact with healthcare providers, state coronavirus response teams, and health agencies in preparation to provide members with responsive access to care.
  • No-cost coronavirus testing and treatment
    • PacificSource is waiving copays and deductibles for members testing and treatment for COVID-19.
    • Summary of PacificSource COVID-19 provisions:
      • PacificSource will eliminate out-of-pocket costs for COVID-19 testing and testing-related visits for our members.
      • We will waive all copays for Teladoc visits for members who have that as a plan option.
      • PacificSource will allow members a one-time early refill for prescription drugs. (Additionally- Vaccination—when it becomes available—will also be offered at no cost to members.)
      • PacificSource providers have been instructed to not collect copay/coinsurance or deductibles for testing and testing related services.
  • Telemed services include coverage for mental health. Telemed services are covered with a $10 copay in network. Teladoc is also available for acute care and mental health. PacificSource is temporarily waiving all cost share for members when they use Teladoc.
  • New video helps share up-to-date information
    • Because awareness is key to prevention, PacificSource has a link to a new video where their Chief Medical Officer highlights COVID-19 facts and preventive tips. When you get a chance, please take a moment to watch.
  • Routine habits help prevent the spread of disease.
    • The same preventive habits are recommended for coronavirus that are recommended to reduce the spread of flu. These routine habits include:
      • Washing your hands often throughout the day for at least 20 seconds with warm water and soap (or alcohol-based hand gel).
      • When coughing or sneezing, cover your mouth and nose with a tissue (or into your elbow).
      • Avoid touching your eyes, nose, and mouth.
  • Feeling ill? Help yourself and those around you by...
    • Staying home if you’re feeling flu-like symptoms.
    • Waiting at least 24 hours after a fever has subsided before returning to work or leaving home.
    • Seeking medical care if symptoms are persistent or turn severe.
  • It's important to know the facts.

Mental Health Resources

Moda

Kaiser

Providence

  • Using virtual visits, clinicians can evaluate and treat general mental health conditions, such as depression and anxiety. When appropriate, they can prescribe medications.* Treatment is provided by psychiatrists and therapists who are part of the Optum behavioral health network.
  • Members can call the behavioral health team at (800) 711-4577 to find a list of providers
  • Providence has self-help tools and interactive resources called Live and Work well
  • Apps that Providence recommends include: Headspace, Shine, Calm and Nod for Digital Health and Wellbeing Tools
  • Resources

PacificSource

  • PacificSource offers behavior health appointments through Teladoc. Cost share is waived for all Teladoc appointments through 12/31/20.
  • If a person needs help finding a mental health provider, they can call the Customer service team at can call 1-888-977-9299. If a person is struggling and feels they are more of in crisis mode, they can contact a Member Support Specialist (MSS). This team is not medical professions/clinicians, but they help identify and remove barriers to accessing mental health care.
  • PacificSource has a video library section of short mental health videos,
  • Members have access to a Teledoc app to ask questions and get answers, 24 hours a day, 7 days a week for mental health support
  • Members have access to Cafewell their Health Engagement portal which has mental health resources here:  https://pacificsource.com/members/individuals/healthy-resources/cafewell.  It is also a place members can find:
    • Personalized health resources and action plans
    • Activities, wellness challenges, and expert health coaching 
    • Communities of health experts
    • Helpful tips and articles on a variety of health and wellness topics
  • Resources