News
Coronavirus Disease 2019 (COVID-19): We are here to support our members in getting the care they need.
Diagnostic Testing | Office Visits | Telehealth/Virtual Visits | TeleMental/Virtual Visits | Prescription Benefits
The NALC HEALTH BENEFIT PLAN is here to support our members in getting the care they need.
As a result of the rapidly evolving COVID-19 pandemic, the Plan has made it a priority to remove any barriers that would prevent our members from getting the necessary testing.
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Diagnostic Testing for COVID-19
For PPO claims, we will cover physician ordered diagnostic testing at 100% of the PPO network negotiated rate. For physician ordered diagnostic testing that is billed as non-PPO, we will cover 100% of the Plan allowance. If there is a difference between the charged amount and the Plan allowance for a non-PPO claim, you are responsible for the difference.
We will also cover the associated office visit at 100% of the Plan allowance if tested on that day.
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High Option members: If you use a PPO provider, your office visit copayment will be waived. If you use a non-PPO provider, we will pay 100% of the Plan allowance for the office visit. If there is a difference between the charged amount and the Plan allowance for a non-PPO office visit, you are responsible for the difference.
CDHP/VO Members: If you use a PPO provider, your office visit coinsurance of 20% will be waived. If you use a non-PPO provider, we will pay 100% of the Plan allowance for the office visit. If there is a difference between the charged amount and the Plan allowance for a non-PPO office visit, you are responsible for the difference.
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In addition to the virtual doctor visits available through NALCHBP Telehealth, the Plan will now cover medically necessary online Telehealth Office Visits. This will be effective March 1, 2020 until further notice.
High Option Members:
- Cigna PPO Providers – Members have a $20.00 copayment
- Non-PPO Providers – Members have a 30% coinsurance of Plan allowance after satisfying their annual deductible
- NALCHBP Telehealth Providers – Members will still have only a $10 copayment
CDHP/VO Members:
- Cigna PPO Providers – Members have a 20% coinsurance of Plan allowance after satisfying their annual deductible
- Non-PPO Providers – Members have a 50% coinsurance of Plan allowance after satisfying their annual deductible
- NALCHBP Telehealth Providers – Members will still have a 10% coinsurance of Plan allowance after satisfying their annual deductible.
To locate a provider in the telehealth network, contact the following:
NALCHBP Telehealth (medical) High Option Members visit www.nalchbptelehealth.org or call 888-541-7706
Telehealth (medical CDHP/Value Option Members visit www.MDLIVEforCigna.com or call 888-726-3171
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To ensure that our health plan members affected by COVID-19 have the mental health support and resources they need, you can access TeleMental or Virtual visits rendered by providers such as psychiatrists, psychologists or clinical social workers.
High Option Members:
- Optum Network Providers – Members have a $10.00 copayment
- Optum Non-Network Providers – Members have a 30% coinsurance of Plan allowance after satisfying their annual deductible
CDHP/VO Members:
- Optum Network Providers - Members have a 10% coinsurance of Plan allowance after satisfying their annual deductible.
- Optum Non-Network Providers - Members have a 50% coinsurance of Plan allowance after satisfying their annual deductible
To locate a provider in theTeleMental health network, contact the following:
TeleMental/Virtual Visits for High Option Members visit liveandworkwell.com (Access code 877-468- 1016) or call 877-468-1016
TeleMental/Virtual Visits for CDHP/Value Option Members visit MyCigna.com or call 855-511-1893
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CVS Pharmacy is now offering the option of home delivery, where available, of all prescription medications at no charge. We are also waiving early refill limits on 30-day prescriptions for maintenance medication prescriptions ahead of their normal fill schedule. Please take advantage of our 90-day prescription benefit for maintenance medications and be sure to refill any eligible 90-day maintenance medications to be sure that you stay adherent during this pandemic.
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As long as COVID-19 continues to pose a threat, the Plan will maintain focus on how to best serve our members.
For the latest information about COVID-19 from the CDC visit https://www.cdc.gov/coronavirus/2019-ncov/index.html.