COVID-19

What this means for COVID-19 coverage under Viva Health Medicare and employer (commercial) group health plans.

 

Vaccines and Boosters

COVID-19 vaccines and boosters will still be covered at 100% (no copay or coinsurance) after the end of the PHE, as long as members get them from an in-network provider (doctor’s office, pharmacy, etc.).

 

Testing/Treatment

• Cost sharing will apply for office visits when COVID-19 testing is performed just like it does for other office visits.
• Testing for COVID-19 will still be covered, but cost sharing may apply.
• Cost sharing for telehealth visits for COVID-19 will apply as it does for other conditions.
• Coverage of over-the-counter COVID-19 tests will end with the end of the PHE.
• Treatment for COVID-19 will still be covered, with usual member cost sharing. Members will still have access to drugs to treat COVID-19, such as oral antivirals like Paxlovid and Lagevrio and infusions of monoclonal antibodies. As long as drugs to treat COVID-19 are purchased by the federal government, cost sharing will only apply if there are costs to administer them (give you the shot). Cost sharing will apply to the drugs once the federal government uses all of its supply and Viva Health must start paying for the drugs.

 

Access to Telehealth Services

During the PHE, people with Medicare and employer-based health coverage had broader access to telehealth services, including in their homes, without geographic, location, or technology limitations.

Federal law will keep making access to telehealth more flexible for members through December 31, 2024, such as:

• People with Medicare can access telehealth services in any geographic area in the United States. This means members can keep using telehealth, even if they do not live in a rural area.
• People with Medicare can stay in their homes for telehealth visits paid for by Medicare, instead of having to travel to a health care facility.
• Certain telehealth visits can take place by audio only, using a telephone if a member is not able to use both audio and video with a smartphone or computer.

Viva Health will allow this flexibility for both its Medicare Advantage and employer group members through December 31, 2024. Cost sharing for telehealth visits will apply, as it does for in-person visits.

 

If you have additional questions about your coverage, call Viva Health at the numbers below:

Employer/Commercial Members
1-800-294-7780 (TTY: 711)
Monday through Friday, 8am to 5pm

Medicare Members
1-800-633-1542 (TTY: 711)
Monday through Friday, 8am to 8pm
(From October 1st – March 31st, 8am to 8pm, 7 days a week)