For coronavirus relief benefits click here for Medicare or click here for Commercial and Individual and Family Plan members.

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Coronavirus Information for Medicare Members

Information Specific to Medicare Members

Below you will find useful information about the virus specifc 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 customer service team.

Coronavirus Relief Benefit Enhancements

As your health and wellness partner, Network Health is launching new, safe ways to help you improve or maintain your health.

Members of Network Health Medicare Advantage Plans have access to these mid-year benefits in 2020.

Information about the $200 Benefits Card*

*Members of Network Health’s PPO, HMO and PPO SNP Medicare Advantage Plans receive a $200 Benefits card to use for qualified health care expenses in 2020.

Here are some ways to use your card.

  • Pay your office visit copayments
  • Pay your coinsurance expense
  • Pay for prescription medications
  • Purchase over-the-counter products (For a list of eligible products click here)
  • Purchase prepared meals from Mom's Meals
  • Out-of-pocket dental expenses
    • Dental x-rays, exams/teeth cleanings, gum treatments, fillings, crowns, bridges, oral surgery, extractions, dentures
  • Out-of-pocket vision expenses
    • Contact lens solution and cleaners
    • When purchased through a vision provider: contact lenses, eye examinations,  eyeglasses, reading glasses, prescription sunglasses

These items cannot be purchased with your Benefits Card.

  • Vitamins
  • Spa treatments
  • Dinner at a restaurant
  • Any other items not on the list

 Additional Benefit Enhancements

Network Health, in partnership with the YMCA, is offering expanded access to special virtual and in-person health and social programs as a result of the ongoing coronavirus concerns.

These special progams are available until December 31, 2020 and are designed to keep you physically and mentally healthy, fit and engaged as we enter this colder season and see an increase in coronavirus cases throughout our communities.

To register and learn more about the programs, click here

*Available on plans with the SilverSneakers fitness benefit.

Enjoy a live, full-length yoga class from the comfort of your home. SilverSneakers is offering virtual yoga sessions via Zoom meeting beginning on July 15, 2020.

These classes are available every Wednesday from 9:30 a.m. to 10:15 a.m. CST

Please sign up for classes using this link.

*Available on plans with the SilverSneakers fitness benefit.

Beginning in July, Simpli Hearing, LLC, is offering an expanded hearing aid discount program. You can find quality brand name hearing aids discounted to $795-$2,370 (a savings of up to $1,050 per hearing aid). The discount includes a three-year warranty, three-year loss and damage insurance, up to six hearing aid follow up visits within three years and 16 batteries. You can contact Simpli Hearing at 888-374-6754, Monday–Friday from 8 a.m. to 8 p.m.

To ensure you get the care you need, Network Health covers all telehealth services with in-network providers for a $0 copayment through December 31, 2020. Call your personal doctor today to find out if a telehealth visit is right for you.

Recovering after an inpatient hospital stay can be difficult. That’s why Network Health's PPO and HMO Plan* members receive 14 delicious meals delivered right to your home, after a qualifying inpatient hospital stay. To take advantage of this benefit, contact the Network Health Care Management Department at 866-709-0019 (TTY 800-947-3529), Monday-Friday from 8 a.m. to 5 p.m. (Please note, you will have to submit a notification of discharge within seven days of your hospital release.)
Need a ride to the dentist or to the doctor? We can help. Our partnership with Aryv helps you get where you need to be, safely. Members of Network Health’s PPO, HMO and PPO SNP Medicare Advantage Plans* have expanded benefits which includes unlimited non-emergent transportation within the Network Health service area. To set up transportation, call Aryv at 855-923-1113 (TTY 711) or visit the Aryv website at aryv.com/network-health.

 Medical Plan Information About the Coronavirus

Network Health will waive out-of-pocket costs for the lab test and any primary care, urgent care or emergency room visits related to obtaining the coronavirus test, in accordance with the Families First Coronavirus Response Act.

In addition, if you are outside the Network Health service area and you receive the lab test, we are not requiring a prior authorization (prior approval) for the lab test.

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.
Yes, all Network Health members can get a 90-day supply of their medications if the following conditions are met.
  • The prescription order has sufficient refills remaining. If needed, ask the pharmacist to request additional refills from your prescriber.
  • The requirements for taking these medications imposed by the medication prescriber are met.
  • This applies to our entire pharmacy network, including states outside Wisconsin.

Medicare members can get their refills via retail location or mail order.

During the coronavirus health crisis, members may reach out to their pharmacy to ask about delivery options. Many pharmacies are delivering free of charge while Wisconsin is under the safer at home order.

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.
Yes, hydroxycholorquine is on our drug list. Our pharmacy benefits manager is putting an anti-hoarding algorithm into their system to monitor supplies because we understand how important this drug is for chronic disease management.

Medicare Plans with Supplemental Benefits

During the coronavirus pandemic, many medical providers have stopped offering non-essential services to reduce the risk of spreading the coronavirus among their patients. Several Network Health plans offer supplemental benefits. To determine if your Network Health plan offers these benefits, review your plan documents. Below you will find each benefit and the updates we've received from our partners.
Many dental providers are only offering essential services during this time. If you want to use your benefit, you may be unable to find a provider that is willing to perform routine, covered services.

Because of the high rate of provider closures during this time, the online provider locator may not be fully up to date. We recommend calling your provider directly to verify business hours and service availability.

Medicare Advantage plans – Delta Dental

  • Delta Dental has reduced their customer service hours to Monday–Friday from 7 a.m. to 4 p.m. CST, until April 1.
  • Delta Dental can be reached at 866-548-0292 (TTY 711) and additional information is available online at medicareadvantage.deltadentalwi.com.

Many vision providers are only offering essential services during this time. If you want to use your benefit, you may be unable to find a provider that is willing to perform routine, covered services.

Because of the high rate of provider closures during this time, the online provider locator may not be fully up to date. We recommend calling your provider directly to verify business hours and service availability.

EyeMed contact information for each line of business is as follows.

Medicare

  • 833-279-4359 (TTY 711), Monday–Saturday from 6:30 a.m. to 10 p.m., and Sunday from 10 a.m. to 7 p.m. CST.

Medicare (D-SNP)

  • 833-279-4361 (TTY 711), Monday–Saturday from 6:30 a.m. to 10 p.m., and Sunday from 10 a.m. to 7 p.m. CST.

Many fitness centers are temporarily closing during this time due to restrictions on large
gatherings and to protect their clients. If your Network Health plan has a fitness benefit, you have access to other resources so you can continue to exercise from the comfort of your home.

SilverSneakers® offers the following options for members.

  • SilverSneakers Livestream classes via video conferencing technology.
  • SilverSneakers Go provides digitally-led activities such as guided walks.
  • SilverSneakers instructors and fitness network locations are hosting live broadcast events.
  • OnDemand classes and workshops available 24/7 through the SilverSneakers member portal. Members must create an online account to view the OnDemand classes.
If your Network Health Medicare Advantage Plan offers the OTC benefit, your service is currently uninterrupted. You can continue to place orders and receive their orders through the mail.
  • Some high-demand OTC items such as hand sanitizer are currently out of stock and  may not be ordered.
  • The OTC center (available through Express Scripts, Inc.) can be reached at 855-435-5164 (TTY 711), Monday–Friday from 7 a.m. to 10 p.m. CST.
  • To determine if your plan offers the OTC benefit, visit networkhealth.com/medicare/additional-benefits.
  • Your service for home-delivered meals following an inpatient hospital stay is currently uninterrupted. Network Health will continue to closely monitor this benefit to ensure we are providing a safe and reliable experience for you.
  • Please contact your care manager with additional questions.

Your service for non-emergency transportation is currently uninterrupted. Network Health will continue to closely monitor this benefit to ensure we are providing a safe and reliable experience for you.

  • Drivers have been provided education on enhanced hygiene and sanitation practices
    during this time.
  • Aryv can reached at 855-923-1113 (TTY 711), seven days a week from 4 a.m. to 10 p.m. CST.
  • You may contact their care manager with additional questions.

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.

Currently, all coronavirus telehealth services will be covered at a $0 copayment through December 31, 2020 but we will continue to evaluate that date based on guidance provided by CMS.

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

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 December 31, 2020, 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 December 31, 2020.

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. 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. This list will continue to grow as we get more information.

Yes, this list will continue to grow as we get more information.

  • 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.

This depends on the pharmacy, so the member will want to call the pharmacy to confirm. During the coronavirus health crisis, many pharmacies are delivering free of charge while Wisconsin is under the safer at home order.

In addition, many pharmacies have drive-up windows that customers can use, if they don't want to enter the store.


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