COVID-19 Vaccines and Vaccine Boosters

The Episcopal Church Medical Trust (Medical Trust) COVID-19 vaccine and vaccine booster coverage:

• Members of the Episcopal Health Plan
• Members can present their Medical Trust health plan member ID card (Anthem, Cigna, or Kaiser) at the doctor’s office to ensure that Medical Trust benefits apply.
• Express Scripts members can present their Express Scripts benefit ID at the pharmacy to receive a COVID-19 vaccine or vaccine booster.
• There will be no out-of-pocket cost associated with receiving an FDA-approved COVID-19 vaccine or vaccine booster, or for its administration.
• If the cost of administering a COVID-19 vaccine or vaccine booster is billed, the Medical Trust will cover the cost.
• Members of the Episcopal Health Plan for Medicare Secondary Payer Small Employer Exception (MSP SEE)
• Original Medicare, which includes Part B, covers FDA-approved COVID-19 vaccines and vaccine boosters in full. The COVID-19 vaccine and vaccine booster are Medicare Part B vaccines.
• Members who have been approved by Medicare for the MSP SEE and are currently enrolled in both Medicare Parts A and B should present their Original Medicare ID card (red, white, and blue), if requested, to ensure that Medicare benefits apply.
• Every other member in an MSP SEE plan (that is, plan members enrolled in Medicare Part A only and plan members not enrolled in Medicare) should present their Medical Trust health plan member ID card, if requested, to ensure that Medical Trust benefits apply.
• Express Scripts members can present their Express Scripts benefit ID at the pharmacy to receive a COVID-19 vaccine or vaccine booster.
• Additional Information
• Members who have questions about COVID-19 vaccines, vaccine boosters, or the availability of COVID-19 vaccines and vaccine boosters should contact their local health department or their healthcare provider.

COVID-19 information and vaccination resources from our health plan carriers:

• Anthem BCBS
• Cigna
• Kaiser Permanente

 

Medical Trust Benefits & Services

Healthcare and benefits-related concerns – Active members of the Medical Trust can contact their health plan’s member services team using the number on the back of their member ID card or by visiting their health plan’s online member portal. More information about your healthcare benefits can be found in your plan’s Summary of Benefits and Coverage (SBC) and the Plan Document Handbook here.

Deductibles, copays, and coinsurance – The Medical Trust waives all copays, deductibles, and coinsurance for active members for healthcare services relating to the evaluation and testing for COVID-19. In addition, the Medical Trust also waives all copays, deductibles, and in-network coinsurance for its active members for healthcare services relating to the treatment of COVID-19 through at least December 31, 2022.¹

At-home COVID-19 Test Kit Update

The US government announced that every residential household is eligible to order four at-home COVID-19 tests for free at COVIDtests.gov. We encourage both active and retired members of the Medical Trust to order these free tests from the US government.

Effective January 15, 2022, Federal law requires active group health plans to cover the cost of certain FDA-approved at-home over-the-counter COVID-19 tests during the public health emergency. Medical Trust members enrolled in an Anthem or Cigna health plan can receive up to eight FDA-approved at-home OTC COVID-19 tests for free through their Express Scripts pharmacy benefit.

Medical Trust members enrolled in a Kaiser health plan can also receive up to eight FDA-approved at-home OTC COVID-19 tests for free. Kaiser members should contact member services at (866) 213-3062 or visit kp.org to learn more.

At this time, individuals enrolled in the UnitedHealthcare Group Medicare Advantage plans are not eligible for reimbursement of over-the-counter COVID-19 test kit purchases. However, as a reminder, COVID-19 testing and vaccinations performed through your healthcare provider are covered.

Pharmacy Benefits

Prescriptions and adequate supplies for Express Scripts members – Visit the Express Scripts Member Resources Center for information about Express Scripts’ response to COVID-19. If a member currently fills 30-day supplies of their medication at a retail pharmacy and would like the convenience of a longer-term supply, the member can ask their physician to write a prescription for a 90-day supply. Then the member should fill the prescription at Express Scripts Home Delivery. Express Scripts Member Services can help members get started. Should a member have any questions or concerns about his or her individual situation, Express Scripts pharmacists are available 24/7.

• Active Members: (800) 841-3361

Prescriptions and adequate supplies for Kaiser Permanente members – For information about Kaiser’s pharmacy benefits and their mail order options, Kaiser members should call the number on the back of their member ID card.

Telehealth and Virtual Visits

Telehealth platforms for Active Members² – You can access a medical professional through telehealth platforms offered by our carriers, Anthem, Cigna, and Kaiser, using your computer or mobile device. You will need high-speed internet access, a webcam or built-in camera, and audio capability. Please remember your personal healthcare provider may not participate on the carrier’s telehealth platform.

Carrier telehealth platform service coverage

• PPO members – Carrier telehealth platform services will continue to be covered with no deductible, copay, or coinsurance through December 31, 2022.
• HSA-qualified CDHP members – Effective January 1, 2022, CDHP members must meet their deductible before carrier telehealth platform services are covered at 100%, as required by the IRS.3 Once a CDHP member has met their deductible for the year, carrier telehealth platform services will continue to be covered with no coinsurance through December 31, 2022.

Carrier telehealth platforms

• Anthem Blue Cross Blue Shield – Access LiveHealthOnline.com or download the LiveHealth Online mobile app in the App Store® or Google Play™.
• Cigna – Access MDLiveforCigna.com on your computer, or download the MDLIVE mobile app by searching in the App Store® or Google Play™.
• Kaiser Permanente – Access Kaiser’s telehealth platform services by calling the number on the back of your member ID card.

More information about your health plan’s telehealth platforms can be found in the Plan Handbook here.

Virtual healthcare visits for Active Members – A virtual visit is an appointment with your personal healthcare provider carried out through an electronic medium of your provider’s choice (e.g., Zoom, Skype, telephonic) that is not offered through your health plan carrier’s telehealth platform (e.g., Anthem LiveHealth Online, Cigna MDLive).

• The Medical Trust will continue to allow claims for virtual visits with network and out-of-network providers that do not use a telehealth platform offered by Anthem or Cigna through December 31, 2022. Virtual visits are covered at standard levels of benefits and member cost shares.
• Note: Kaiser’s healthcare model requires its members to use the Kaiser telehealth platform for telehealth services.

Other Health Resources

Cigna Employee Assistance Program (EAP) is available to active members and retirees of The Episcopal Church Medical Trust (Medical Trust) plans, as well as members of their household. Cigna EAP offers an array of services designed to assist individuals with work, life, and family issues, including support for coping with stress, substance abuse issues, or assistance in identifying care for children/parents. The plan covers telephone consultations and up to 10 face-to-face counseling sessions per issue at no member cost. Cigna EAP is confidential and available 24/7 at (866) 395-7794.

The Cigna EAP now includes access to Talkspace^® virtual behavioral health!

• Connect with a licensed therapist or psychiatrist online, by video, or text using Talkspace, available for Cigna EAP members, ages 13 and up.
• Visit mycigna.com or download the getting started flyer to learn how to access Talkspace virtual behavioral health.

 

Your Finances

Whether or not you have a Fidelity NetBenefits® account, you can access the Fidelity COVID-19 Resource Center for information on navigating market volatility, recent legislation changes, market perspectives, budgeting, managing stress, and more.

CPG Financial Education Specialists – You are entitled to complimentary discussions with our financial education specialists. Call (888) 735-7114, Monday to Friday, 8:30 AM to 8:00 PM ET, or click here to schedule a complimentary discussion.

Social Security Administration has updates on Social Security benefits and available services during the pandemic, as well as information on COVID-19 scams and helpful links such as Coronavirus.gov, the CDC coronavirus webpage, and the US Government COVID-19 response site.

Federal Student Aid, a US government site, offers students, parents, and borrowers information on student loan forbearance during the pandemic.

US Department of Labor offers help with loss of employment with information on COVID-19 unemployment insurance relief and how to find your state’s unemployment website.

Consumer Financial Protection Bureau offers information on protecting your finances during COVID-19, including mortgage relief options and student loan forbearance.

Federal Trade Commission (FTC) reviews coronavirus scam tips that cover phishing emails, robocalls, relief check scams, and more. There’s even an FTC scam bingo game!

 

Church Publishing Free Resources

For the full list, please visit churchpublishing.org/freeresources.

 

COVID-19 Funeral Assistance

The COVID-19 pandemic has brought overwhelming grief to many families. Under the Coronavirus Response and Relief Supplemental Appropriations Act of 2021 and the American Rescue Plan Act of 2021, the Federal Emergency Management Agency (FEMA) is providing financial assistance for COVID-19 related funeral expenses incurred after January 20, 2020.⁴

Learn more.

US Government Response

US Department of the Treasury – Coronavirus Aid, Relief, and Economic Security (CARES) Act

US Department of Labor – Family First Coronavirus Response Act

Internal Revenue Service – Coronavirus Tax Relief and Economic Impact Payments for Individuals and Families

US Government response to the virus outbreak – USA.gov

Medicare – Medicare & Coronavirus

 

¹ This deductible waiver includes our HSA-qualified CDHPs as permitted byIRS Notice 2020-15.

² Please note, telehealth can help with minor, non-life-threatening conditions. During a medical emergency, individuals should visit the nearest hospital or call 911 for assistance.

3 The HSA-qualified CDHP deductible waiver was applied from January 1, 2020 through December 31, 2021, as permitted by IRS Notice 2020-29.

4 https://www.fema.gov/disaster/coronavirus/economic/funeral-assistance

 

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