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COVID-19 Resource Center

The past few months have been challenging for all of us — we hope you and your loved ones are taking care of yourselves and are doing well.

Because of the COVID-19 crisis, we’ve all made COVID heartsadjustments to our everyday lives. Work has come to a stop for many. And we’re making every effort to stay positive while still facing uncertainty around when and how we’ll open safely again for business as usual. 

We continue to monitor COVID-19’s impact on our participants’ health, as well as our Plan’s financial position. To stay informed, take time now to review the latest information listed below, and watch for additional updates over the next few months.

If You Need Medical Care

See the following topics:

•    If you suspect you have COVID-19
•    Coverage for COVID-19 screening and testing

•    Virtual visits with your healthcare provider – coverage continues
•    Healthcare providers begin to reopen for non-COVID-related care


If you suspect you have COVID-19 ... get tested!

 

Take action immediately. Contact a healthcare provider or make an appointment/drop into a test site in your community:

telehealth

Call your own doctor/provider.

Use LiveHealth Online, the SAG-AFTRA Health Plan’s telemedicine service, available 24/7.

Use Anthem’s COVID-19 Test Site Finder  to check your symptoms, search for test sites, and link with local resources in your community – then contact a healthcare provider.

Follow the links to find free COVID-19 testing sites (Los Angeles , New York , Georgia , Illinois , Tennessee).

What to do next:

Based on your provider’s assessment and test results, you’ll hear more about next steps (For example, self-quarantining for up to 14 days and seeking help if your symptoms worsen.)

 


Coverage for COVID-19 screenings and testing 

 

What to know:

You can get a free COVID-19 test in many communities. Check the Anthem link and state-based links above. Not sure where to go? Search Google (type in your state or city and “free COVID-19 test”). 

The SAG-AFTRA Health Plan covers COVID-19 related office visits (in-person and telehealth) and testing with no cost-sharing. 

Urgent care visits and emergency room visits to evaluate whether you need testing – and that result in testing – are covered at no cost to you. Coverage with no cost-sharing will continue in place until the end of the national COVID-19 emergency period.

What to do:

If you visit a doctor’s office, urgent care office, or emergency room, your COVID-19 test must be ordered by a properly licensed healthcare provider to ensure coverage at no cost to you.


Virtual visits with your healthcare provider – coverage continues

 

What to know:

The SAG-AFTRA Health Plan will continue to offer expanded telehealth benefits, by covering virtual office visits (by phone or online) with your doctor. This benefit also continues to apply to behavioral health providers as well.

You can also use LiveHealth Online, the SAG-AFTRA Health Plan’s telemedicine service, or MDLive for behavioral health services. Both LiveHealth Online  and MD Live are available 24/7. The SAG-AFTRA Health Plan’s regular cost-sharing (deductibles, copayments, and coinsurance) applies for non-COVID-related visits. This coverage will continue will be in place until the end of the national COVID-19 emergency period.

 

What to do:

Visit with your regular providers:  Call your regular provider and ask if they’ll visit with you over the phone or online by video.

LiveHealth Online and MD Live:  To use LiveHealth Online (medical) or MDLive  (behavioral health), you need to register first. Have your Plan ID card handy when calling, going online, or using the app for the first time.


Healthcare providers begin to reopen for non-COVID-related care

 

What to know:

Many healthcare providers are resuming preventive reopening doctorscare visits, diagnostic testing, imaging, and elective surgeries. 

What to do:

If your doctor’s office hasn’t contacted you to reschedule canceled appointments, give them a call. Or, to schedule new appointments, including preventive care visits, give your doctor’s office a call or contact LiveHealth Online


 

Managing Your Prescriptions

What to know:    

Staying home is one of the best things you can do to avoid COVID-19. To help make this easier for you to do and still fill any prescriptions you need, Express Scripts offers delivery of your medications.

express scripts

 

 

 

 

What to do:

For maintenance medications: Request that your doctor prescribe a 90-day supply and fill it through Express Scripts Home Delivery. Standard shipping is free. 

For other prescriptions: Ask your pharmacy if they offer home delivery — many Express Scripts network providers do during this time. Get more information through the Express Scripts coronavirus resource center.


 

Help When You Feel Stressed and Anxious

What to know:

If you’re feeling stressed and anxious, it may help to talk with someone. Beacon Health Options can point you to resources for help. This service is completely confidential.

beacon health

What to do:

Get a referral.  Contact Beacon Health Options at 866-277-5383 for a referral to an in-network behavioral health provider or to find immediate help if you’re in crisis.

Connect through a virtual visit.  Beacon Health Options works with MDLive  to offer virtual visits (via mobile app, video, and phone) for your mental health and emotional well-being needs. 

Access the myStrength tool.  You can use myStrength through September 30, 2020, at no cost. This online resource provides support to manage family needs, connect with others, and handle overwhelming emotions. You’ll also find mindfulness and meditation exercises.

Register online  or through the myStrength app (available in the App Store  or Google Play ). Use access code: beaconcovidsupport.


 

Loss of Eligibility for SAG-AFTRA Health Plan Coverage

alternate healthIf you lose eligibility for your SAG-AFTRA Health Plan coverage, you may be eligible for several alternatives for health insurance:

Option 1: Consider your spouse or domestic partner’s employer sponsored health insurance

Option 2: Enroll in Medicare if you’re eligible

Option 3: Find out if you’re eligible for Medicaid / Medi-Cal / Children’s Health Insurance Program

Option 4: Consider purchasing health insurance through your state Marketplace

Option 5: Continue SAG-AFTRA Health Plan coverage through COBRA


Take a little time to read about and understand your options. For personalized support in making the best decisions for your situation, contact:

 

Artists Health Insurance Resource Center — New York and East/Midwest Regions

 

Entertainment Health Insurance Solutions — Los Angeles and West Regions

 

SAG-AFTRA Foundation

•    Website: https://sagaftra.foundation/assistance/disasterrelief/ 
•    Please apply for assistance online
 


Option 1: Consider your spouse or domestic partner’s employer-sponsored health insurance

 

What to know:

Losing your SAG-AFTRA coverage may trigger a special enrollment period, which allows enrollment in your spouse/partner’s plan. 

 

What to do if this is the best choice for you: 

  1. Check with your spouse or domestic partner’s health plan or Human Resources/Benefits representative to confirm your eligibility.
  2. Enroll by the applicable deadline.

Option 2: Enroll in Medicare if you’re Medicare-eligible

 

What to know:

You should enroll in Medicare Part A (premium-free hospital coverage) at age 65. You should enroll in Medicare Part B as soon you become ineligible for SAG-AFTRA Health Plan coverage. You pay a premium for Medicare Part B, which covers doctor’s office visits, outpatient care, and additional healthcare services. 

Penalties will apply if you lose SAG-AFTRA Health Plan eligibility and elect COBRA continuation coverage instead of enrolling in Medicare. You may have to pay a higher Medicare Part B premium and have a gap in coverage when you decide to enroll in Part B later. Refer to the SAG-AFTRA Health Plan summary plan description  for details.

 

What to do if this is the best choice for you: 

Start your Medicare enrollment  right away (although you can do so within eight months of losing SAG-AFTRA Health Plan coverage). 


Option 3: Find out if you’re eligible for Medicaid / Medi-Cal / Children’s Health Insurance Program (CHIP)

 

What to know:

Your state’s Medicaid program (Medi-Cal in California) and Children’s Health Insurance Program (CHIP) provides low cost health insurance to eligible individuals and families, based on family size and income level. 

 

What to do if this is the best choice for you: healthcare gov

  1. Confirm whether you’re eligible  for Medicaid, Medi-Cal, or the Children’s Health Insurance Program. 
  2. Apply for coverage. You will find out if you qualify once you complete your Marketplace application, or you can contact your state’s Medicaid agency directly. 
  3. Once your application is approved, you can start your coverage immediately. There’s no special enrollment period or deadlines.

Option 4: Consider purchasing health insurance through your state Marketplace

 

What to know:

Your state Health Insurance Marketplace offers a platform for you to shop for an individual health insurance plan. You can compare options and costs (premiums, copays, deductibles, and coinsurance) and make an informed decision before you enroll.

Depending on where you live, you may have a wide variety of plans available. Also, based on your household income, you may be eligible for a tax credit that lowers your monthly premiums and cost-sharing for deductibles, copayments, and coinsurance. 

Example:

A 40 year old couple with a household income of $25,000 a year may be eligible d for a $642 per month tax credit. This sets their premium at $83 per month, and qualifies them for low cost-sharing when they need care ($5 doctor visits, 10% hospital coinsurance, and a $2,000 annual out-of-pocket maximum). 

 

What to do if this is the best choice for you: 

1.   To shop for insurance coverage, go to:

                               Covered California  (800-300-1506)

                               NY State of Health  (855-355-5777)

                               National Marketplace  (800-318-2596)

2.   Complete your Marketplace application.

3.    Enroll within 60 days of losing your SAG-AFTRA coverage. If you miss the deadline, your next chance to enroll is during the annual Marketplace enrollment period (in October). 


Option 5: Continue SAG-AFTRA Health Plan coverage through COBRA 

 

What to know:

Through COBRA, you can continue to receive your SAG-AFTRA Health Plan benefits. Your healthcare coverage will be the same — but it does not include life insurance or accidental death and dismemberment benefits. 

You’ll receive a COBRA enrollment offer from SAG-AFTRA Health Plan about a month before you become ineligible for your current coverage. COBRA premium rates are based on the actual cost of coverage and are based on family size (review current COBRA premiums). 

IMPORTANT: Participants living in New York may be eligible for a COBRA assistance program called the Continuation Assistance Demonstration Program for Entertainment Industry Employees. If your application is accepted, you may receive assistance equal to 50% of your COBRA premiums for up to 12 months (lifetime max).
 

 

What to do if COBRA is the best choice for you:

With the COVID-19 crisis, the federal government has temporarily changed the deadlines that normally apply to elect COBRA coverage. If your initial COBRA election window falls between March 1, 2020 and the end of the COVID-19 national emergency you have much more time to enroll and begin making premium payments. 

 

Take these steps to enroll:

1.    Watch for your COBRA enrollment offer in your home mail. The federal government has yet to determine the national emergency end date. However, when it’s set you’ll need to complete your COBRA enrollment within 60 days of that date. 

For example, if the national emergency ends on July 31, 2020 and you lose eligibility on July 1, 2020, your extended COBRA election window runs through September 30, 2020.

 

2.    Make your first COBRA premium payment. You’ll need to make your first premium payment within 45 days of the COBRA enrollment deadline. 

For example, if your COBRA enrollment deadline is September 30, 2020, your first COBRA premium payment is due on November 14, 2020. 

 

3.    Make any additional retroactive premium payments due. After you make your first premium payment, you’ll have a 30-day grace period to pay any additional monthly COBRA premiums due.

If you elect COBRA and pay your premiums by the deadlines that apply for you, the SAG-AFTRA Health Plan will pay its share of covered expenses retroactive to the date you lose eligibility, for the months you paid your premium. 

With this in mind, you may want to ask your doctor or other healthcare providers about the costs for routine care. It may make financial sense to pay the cost directly, and consider COBRA enrollment and paying retroactive premium payments if you have an unexpected health situation during your COBRA enrollment window.

Current COBRA participants: You have an extended period to pay premiums due between March 1, 2020 and the end of the COVID-19 national emergency, as well. Contact the SAG-AFTRA Health Plan at 800-777-4013 to learn more.  

 

IMPORTANT: While you have an extended time to enroll, the SAG-AFTRA Health Plan will not pay any claims until you return your COBRA enrollment form and submit your premium payment(s).


 

We’re Here to Help

Contact a SAG-AFTRA Health Plan representative at 800-777-4013 if you have questions about your benefits. 

If you’re losing eligibility for SAG-AFTRA Health Plan coverage, we also suggest working with our industry’s personalized insurance counselors  to decide what’s best for you.