CORONAVIRUS (COVID-19) COVERAGE

Over the last several days we have had numerous inquiries on what the coverage is for Coronavirus related medical benefits. We would like to resend this update, concerning benefits and other useful tools to combat COVID-19. The health and well being of our members remain our highest priority during this challenging time, and we are committed to help prevent the spread of Coronavirus. We will cover COVID-19 related visits, the diagnostic test, and treatment when not covered for free by Public Health. Group health plans are not required to cover tests for employment purposes or public health surveillance. Below is a summary of the coverage provided to our symptomatic members during this emergency.

COVID-19 Vaccines Guam has received allocations of the COVID vaccine and Public Health has created a protocol list for the vaccination order. Here are some key points on the coverage of the vaccine: The federal government has purchased and provides the vaccine to Guam for prioritized distribution, vaccine cost is free. We will cover the administration costs with no cost share to the member and will reimburse according to Medicare rates. We will continue to keep you updated on any changes.

Diagnostic Testing for COVID-19 Diagnostic testing will be covered with no cost share to our members (deductibles, co-payments, and co-insurance waived) and without prior authorization if the tests meet these criteria: Approved by the U.S. FDA Ordered by a licensed healthcare provider Medically necessary and ordered in accordance with the U.S. CDC recommendations Not provided by Public Health for free Coverage for tests applies only for tests intended for individualized diagnosis or treatment of COVID-19, as determined by an attending health care provider.

Clinic Visits for COVID-19 Clinic visits that are primarily for COVID-19 will be covered with no cost-share to our members. Deductibles, co-payments, and co-insurance will be waived.

COVID-19 Treatment Treatment will be covered based on your health plan benefits. Deductibles, co-payments, and co-insurance will apply. Please refer to your schedule of benefits for more information.

We encourage our members to continue observing the safety protocols outlined by our government and health officials, as we work together to keep our island healthy and safe.

For any questions, please contact us: 671-477-9808 | service@calvos.com | www.calvos.net

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