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Information from your health plan about COVID-19 (coronavirus disease)

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Information for providers

CMS and Wisconsin ForwardHealth have provided waivers and updates that allow medical providers to focus on treating patients with COVID-19 more efficiently. In line with these waivers and updates, Security Health Plan’s COVID-19 Provider FAQ  details our revised processes. This Provider FAQ will be updated continuously as new information is received from CMS and Wisconsin DHS.

COVID-19 benefit information

Security Health Plan will cover many testing, testing-related and treatment services related with COVID-19. Use the table below to see which benefits are covered for the different plan types listed in the left column of the table below.

Security Health Plan members who need to get care from an out-of-network provider during the COVID-19 health emergency should contact a Security Health Plan Nurse Navigator at 1-800-472-2363.

  Active COVID-19 testing and testing-related services Serological or antibody testing and testing-related services Inpatient and observation treatment related to COVID-19 Out-of-network coverage  Telehealth
Medicare Advantage HMO-POS
Covered at 100%  Covered at 100%  Covered at 100% 

Services at out-of-network facilities will have the same cost share as in network.

All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services
Secure Saver MSA
Covered subject to plan deductible Covered subject to plan deductible Covered subject to plan deductible  MSA plan members may use any provider that accepts Medicare.  All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services
Ally Rx D-SNP Covered at 100%  Covered at 100%  Your Security Health Plan and Medicaid coverage will coordinate to cover at 100%   Services at out-of-network facilities will have the same cost share as in network.

 

 All Medicare-covered, medically-necessary telehealth services will be covered.   Your Security Health Plan and Medicaid coverage will coordinate to cover at 100% without member cost share. You have free, unlimited coverage for Care My Way  services.
Medicare  Supplement Covered at 100%  Covered at 100%  Covered at 100%   Medicare Supplement members may use any provider that accepts Medicare.  All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have free, unlimited coverage for Care My Way services
Medicare Select: Senior Security  Covered at 100%  Covered at 100%  Covered at 100%  If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network.  All Medicare-covered, medically necessary telehealth services will be covered the same as if the visit was in the office. You have  free, unlimited coverage for Care My Way services
Large employer group  Covered at 100%   Covered at 100%   Covered at 100%  If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network.  An expanded list of services* may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services
 Small employer group  Covered at 100%   Covered at 100%   Covered at 100%  If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network.   An expanded list of services* may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way  services
 Individual and Family Plan (IFP)  Covered at 100%   Covered at 100%   Covered at 100%  If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network.  An expanded list of services* may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office.  Includes free, unlimited coverage for Care My Way services
 BadgerCare Plus (Medicaid)  Covered at 100%   Covered at 100%   Covered at 100%  COVID-19 testing and treatment received at out of network facilities will be covered the same as in network. All covered services may be provided via telehealth at no cost to you. You have free, unlimited coverage for Care My Way services
 Marshfield Clinic Health System employees (self-funded non-governmental employer)  Covered at 100%   Covered at 100%   Covered at 100%   Please call Security Administrative Services at 1-800-570-8760 for details.  An expanded list of services* may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free, unlimited coverage for Care My Way services
Marshfield Clinic Health System-Beaver Dam employees (self-funded non-governmental employer)  Covered at 100%   Covered at 100%   Covered at 100%   Please call Security Administrative Services at 1-800-570-8760 for details.  An expanded list of services* may be provided via telehealth and will be subject to the same copay or coinsurance as if the visit were in office. Includes free,  unlimited coverage for   Care My Way services
 Governmental self-funded groups  Covered at 100%   Covered at 100%   Please call Security Administrative Services at 1-800-570-8760 for details. If a network provider is not available due to the COVID-19 emergency, COVID-19 services, supplies and treatment by out-of-network providers will be covered the same as in network.  Please call Security Administrative Services at 1-800-570-8760 for details.
 Non governmental self-funded groups  Covered at 100%   Covered at 100%   Please call Security Administrative Services at 1-800-570-8760 for details.  Please call Security Administrative Services at 1-800-570-8760 for details.  Please call Security Administrative Services at 1-800-570-8760 for details.

*The expanded list of services available via telehealth includes, but is not limited to behavioral health, office visits/consultations, care management and outpatient therapy.

Providers working at additional locations to help with altered workflow during COVID-19

Security Health Plan understands the situations that may arise during the COVID-19 pandemic that may require providers to work at health care locations where they normally do not practice. Security Health Plan created guidelines for our provider affiliates to report health care facility changes to Security Health Plan to facilitate payment for services during this time and into the future. Please check this page for any updates as COVID-19 evolves.

To report provider location changes please fill in the Excel spreadsheet    “COVID-19 Additional Provider Locations”  and email it to both of the following addresses shp.dsc.netmgmt@securityhealth.org and shpprd@securityhealth.org.

Coronavirus (COVID-19) Interim Policy Coverage for Telehealth Services

Effective immediately, Security Health Plan will cover telehealth services as outlined in its updated Telehealth Medical Policy through July 31, 2020. View Telehealth Medical Policy

Security Health Plan will be re-assessing and updating this policy as necessary as situations change during the coronavirus (COVID-19) pandemic.

The coverage outlined in the Telehealth Medical Policy will cover providers who are credentialed and affiliated with Security Health Plan. Telehealth visits will be reimbursed according to the provider’s current Security Health Plan contracted rate and the member’s plan cost sharing will apply.

Commercial and Security Administrative Services Products: Providers should bill telehealth services with POS 02 and modifiers GQ, GT, or 95 if applicable.
BadgerCare/Medicaid plans:  Providers should follow Forward Health guidance for billing telehealth services.
Medicare plans:  Providers should follow CMS guidance for billing telehealth services.

 

Last updated:  May 19, 2020