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Coronavirus Information for Medicare Members

Information Specific to Medicare Members

Below you will find useful information about the virus specific to Medicare members.

If you have any questions feel free to reach out using the contact information listed throughout this page. You can also contact our member experience team.

Our coronavirus vaccine page has more information about the coronavirus vaccine.

 Medical Plan Information About the Coronavirus

Yes, the coronavirus test is covered by your Network Health Medicare Advantage Plan, in accordance with the Families First Coronavirus Response Act.

You will pay $0 out-of-pocket to receive this test at in- and out-of-network facilities. 

You can contact your personal doctor, Wisconsin Department of Health Services at dhs.wisconsin.gov/outbreaks/index.htm, Ascension, Froedtert or visit the CDC’s website at cdc.gov/coronavirus/2019-ncov/index.html.

If you are feeling mildly ill, call your doctor before seeking medical treatment.

  • He or she may be able to give you advice on how to treat your symptoms at home, which would reduce the number of people you expose.
  • If you or someone you’re caring for is short of breath, minimally responsive, looks blue or ashen call 911.
Providers will prioritize who is tested. Here is some of the criteria that will be used.
  • Patients with signs and symptoms of the coronavirus (such as fever, cough and difficulty breathing) and no other explanation for symptoms.
  • High risk patients (individuals with underlying health conditions such as asthma, diabetes, cancer or heart disease, age = 65, residing in a long-term care facilities, etc.).
  • Patients with known or suspected contact (direct contact with a known case of the coronavirus, travel history to a high-risk geographic area or healthcare worker with known exposure) within the past 14 days.
If your provider determines you need a test, they will work with you on what to do next. Typically, that means your doctor will collect a sample via swabbing the nose and throat before sending to a state-regulated lab.
At this time, no changes are anticipated to member medical or pharmacy benefits. We are monitoring the situation closely and will update our information and policy if the situation changes.

Telehealth Services

To give our members access to the care they need, effective March 20, 2020, Network Health will cover all coronavirus telehealth services for a $0 copayment, including MDLIVE® virtual visits and telephone and virtual face-to-face visits with in-network providers. This coverage will end on July 17, 2022.

Currently, all coronavirus telehealth services will be covered at a $0 copayment until July 17, 2022.

All telehealth services for CMS-approved providers and covered services are covered at a $0 copayment, including MDLIVE, until July 17, 2022.

We will not cover Medicare telehealth visits for providers who are not allowed to bill for telehealth services for Medicare members.

No. To increase access to appropriate care, all coronavirus telehealth visits will be covered at $0 per visit until July 17, 2022 even before members have met their deductible.

No, primary care telehealth services are not subject to your plan’s deductible, copayment and/or coinsurance until July 17, 2022.

Virtual visits limit your exposure to illness from others and limit the spread of any illness you may have. Getting medical advice using a virtual visit provides many benefits if you are experiencing non-emergency symptoms. For more information on MDLIVE, including the illnesses they treat and instructions for logging in, visit our Getting Care Quickly page.

Please note, due to increased activity, MDLIVE wait times are longer than usual. If you prefer not to wait on hold, MDLIVE gives you the option to receive a call back.

Yes, all telehealth services for CMS-approved providers and covered services are covered at a $0 copayment until July 17, 2022. This applies to all telehealth providers for preferred provider organization (PPO) plans and in-network providers for health maintenance organization (HMO) plans. HMO plans do not cover telehealth services with out-of-network providers.

We will not cover Medicare telehealth visits for providers who are not allowed to bill for telehealth services for Medicare members.

Below is a list of providers that have telehealth services available online.

Yes, see the list below.

  • Froedtert 414-805-2000
  • Ascension 833-978-0649
  • Agnesian 844-225-0147
  • Bellin Health 888-330-3524
  • Bellin Telehealth 920-445-7313
  • Holy Family 920-320-3333
  • Primary Care Associates of Appleton 920-996-1000
  • ProHealth 262-928-4499

That is at the discretion of the provider. Typically, providers will only see existing patients virtually.

No, the coronavirus must be diagnosed through a lab test. Telehealth providers can let their patient know whether a lab test is warranted.

Medicare is allowing coverage of some tests with no member responsibility when the purpose of the visit was to evaluate for possible coronavirus infection.


Network Health
1570 Midway Place
Menasha, WI 54952
Hours
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Tuesday: 8 a.m. to 4 p.m.

COVID-19 Information for Network Health Members

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