COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
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Yes Maybe Later NeverFor any drug that you are currently taking that is not on our formulary, or that requires additional authorization, we will cover a temporary 30‐day supply (unless you have a prescription written for fewer days, in which case multiple fills will be allowed to provide up to a total of a month’s supply of medication) when you fill the prescription at a network pharmacy. If you are given this temporary supply, please speak to your doctor before you use the entire supply so you and your doctor can select a formulary alternative or request an exception. We will not pay for this drug beyond your first 30‐day supply unless you have been approved for a formulary exception.
If you are a resident of a long‐term care facility, we will cover a temporary transition supply up to 31 days. If you need a drug that is not on our formulary, or is subject to additional authorization, but you are past the first 90 days of membership in our plan, we will cover up to a 31‐day emergency supply of that drug (unless you have a prescription for fewer days, in which case multiple fills will be allowed to provide up to total of a month’s supply of medication) while you pursue a formulary exception or work with your physician to select a formulary alternative.
If your level of care changes (e.g., entering a long term‐care facility or going home after a stay in a long‐term care facility), Indiana University Health Plans provides transitional supplies of non‐formulary or otherwise restricted medications. For the first month after being discharged from a long‐term care facility, you can get at least a 31‐day supply of your current medications to allow time for you and your physician to switch to a formulary alternative or request an exception.
Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Enrollment in Indiana University Health Plans depends on contract renewal. Other pharmacies/physicians/providers are available in our network. Product types include HMO and HMO-POS. H7220_IUHMA19511 Accepted 11/17/2018