Firemen’s Relief Association FAQ for COVID-19, Benefit Coverage
TESTING FOR COVID-19
Does LAFRA cover the test for COVID-19?
LAFRA will waive cost sharing (copayment, coinsurance, and deductible) for COVID-19 testing during this national emergency. We are also waiving cost sharing for COVID-19 testing related visits during this same time, whether the testing related visit is received in a health care provider’s office, an urgent care center, an emergency department or through a telehealth visit.
Other costs beyond the test and test-related physician office, urgent care, emergency room, and telehealth visit and items and services related to the visit will be covered based on terms in the medical plan and applicable state and federal mandates. Therefore, deductibles, copayments and coinsurance would apply to care, and certain services or supplies beyond the test itself and test-related provider visit.
TELEHEALTH SERVICES
Is there a Telehealth option for members?
Yes. Members may contact a medical provider through LAFRA’S Telehealth vendor – LiveHealth Online. Telehealth visits to a provider outside of LiveHealth Online will not be covered unless, it is for the screening of COVID-19.
Will LAFRA waive cost share for Telehealth visits?
To increase flexibility when it is needed most, we are expanding our telehealth policies to make it easier for Members to connect with a healthcare provider.
DESIGNATED LIVEHEALTH ONLINE TELEHEALTH
LAFRA will waive the upfront collection of cost-share for medical telehealth visits through LiveHealth Online. until June 14, 2020. You can visit with a board-certified doctor from the comfort of home, minimizing the risk of exposure to yourself and others. Doctors are available 24/7.
COVID-19 SCREENING
LAFRA is waiving cost-sharing for in-network and out-of-network telehealth screening-related visits for COVID-19. Telehealth screenings for COVID-19 are not limited to LiveHealth Online providers.
Can telehealth providers evaluate symptoms and send the individual for a COVID-19 test?
A telehealth provider may determine whether the individual should be sent to a CDC approved location for a COVID-19 test. The COVID-19 test and test-related telehealth visit is paid at no cost share.
PRESCRIPTION BENEFITS
Have any changes been made to the prior authorization program for medications covered through the pharmacy benefit? Are you extending authorizations?
Yes, we have identified prior authorizations expiring for select medications between March 1 and July 1st and are extending these for 90 days. Opioid medications are excluded from the automatic extension.