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COVID-19 update for members covered by Arkansas Blue Cross and Blue Shield and Health Advantage (fully insured health plans)

Arkansas Blue Cross and Blue Shield and Health Advantage are committed to the safety and well-being of our members. For more than a year, we have been working closely with the state and federal government during the coronavirus outbreak to help our fully insured members get access to the care they need during the coronavirus outbreak.

Status of COVID-19 expanded benefits

At the outset of the COVID-19 public health emergency, Arkansas Blue Cross and Health Advantage temporarily extended a number of voluntary, expanded COVID-19-related benefits and suspended some of our normal practices.

Now that vaccines are available, we are anticipating some changes in these temporary benefits and suspended practices. Some will remain in force awhile longer. Others will be discontinued. Of course, those measures covered under federal mandates will remain in force until federal officials advise that they may be discontinued, and we will make a decision on the future status of those components of our COVID-19 response at that time.

Please note: Decisions about coverage changes for members of self-funded health plans served by BlueAdvantage Administrators of Arkansas or Health Advantage are made by the employers or plan sponsors who fund those self-funded programs. If you have questions about coverage, please call the number on the back of the health plan member ID card.

Here is a rundown of the anticipated status of those COVID-19-related benefits and measures as of October 1, 2021:

  • Coverage (at no cost to our members) of COVID-19 diagnostic tests ordered by healthcare providers.
    This applies to diagnostic testing services that meet primary coverage criteria for COVID-19 as defined by the Centers for Disease Control & Prevention (CDC) and are ordered by a healthcare provider.

    Status: This measure will remain in force until the public health emergency declaration is terminated by the federal government. Application of copays, coinsurance, deductibles, etc., should be suspended until this benefit is discontinued.

  • Waiver of cost-sharing for medical services for our fully insured members whose primary diagnosis is COVID-19.
    This includes COVID-19-specific visits to an in-network medical clinic, urgent care center and/or emergency room and inpatient treatment for which COVID-19 is the primary diagnosis.

    Status: This measure will remain in force until the public health emergency declaration is terminated by the federal government. Application of copays, coinsurance, deductibles, etc., should be suspended until this benefit is discontinued.

  • Enhanced access to maintenance prescription medications and extension of prior authorizations on many medications for 90-day supplies.
    Our temporary prescription drug formulary flexibility was intended to address potential medication shortages or access issues.

    Status: This temporary enhancement will be discontinued after September 30, 2021. As of October 1, we will return to our usual parameters regarding prescription drug quantity limitations and prior authorization requirements.

  • Enhanced access to virtual health and nurse/provider hotlines.
    To promote safe access to primary care, the use of virtual health (including MDLIVE, the vendor serving our fully insured members) and nurse/provider hotlines has been promoted. This has included the temporary suspension of member cost-sharing (copays, coinsurance and deductibles) for virtual health visits (including wellness/preventative visits) with:
    • In-network physicians (M.D.s, D.O.s)
    • Advance practice nurse practitioners
    • Physician assistants

    Status: The waiver of usual member costs (copays, coinsurance and deductibles) will remain in force through September 30, 2021, but will be discontinued after that date. October 1, 2021, and thereafter, application of copays, coinsurance and deductibles should be resumed.

  • Enhanced access to teledentistry
    To promote safe access to dental assessment, the use of teledentistry was promoted, including the temporary suspension of member cost-sharing (copays, coinsurance and deductibles).

    Status: This temporary coverage of teledentistry will remain in force through September 30, 2021. October 1, 2021, and thereafter, teledentistry will not be covered.

  • Access a network of behavioral health professionals via telehealth (phone or video) – without member cost-sharing.
    This includes telehealth counseling from providers in our network, including:
    • Psychiatrists
    • Clinical psychologists
    • Advance practice nurse practitioners
    • Licensed clinical social workers
    • Licensed professional counselors

    Status: While coverage of in-network behavioral health services provided via telehealth will continue as a covered benefit, the suspension of member cost-sharing will remain in force through September 30, 2021. October 1, 2021, and thereafter, application of copays, coinsurance and deductibles should be resumed.

Resources for Health Advantage

Nurse24sm

24/7, free consultation with a registered nurse

  • Fully Insured, Arkansas Blue Cross Employees, AR State Police: 800-318-2384
  • Arkansas State Employees / Public School Employees: 866-458-0408

Virtual Health

Access to medical help through your smartphone, tablet, and/or computer when unable to see your primary care physician.

Chronic Care Advocacy Program

Enrollees can contact case managers 8 a.m. – 6:30 p.m.

Case Management

Enrollees can contact case managers 8 a.m. – 4:30 p.m. Members not enrolled in case management who would like to speak to a registered nurse about COVID-19 or any healthcare needs can call 800-225-1891.