Medica Prime Solution (COST) and Medica Advantage Solution (HMO, HMO-POS, PPO)
Including Medica Advantage Solution PartnerCare (HMO I-SNP)
Testing Coverage (effective 02/04/2020 – 10/31/2021)
Medica Prime Solution and Advantage Solution will cover the cost of medically necessary COVID-19 diagnostic testing. Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets guidelines from Centers for Disease Control and the Food and Drug Administration (FDA), and is ordered by an appropriate medical professional.* Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. This means the member's share of the cost will be waived for COVID-19 testing in office visits, urgent care, walk-in retail health clinics, emergency room and outpatient facilities if the member is being tested for COVID-19.
Medica will also cover the cost for FDA-approved antibody tests after a suspected (not confirmed) COVID-19 diagnosis. Tests must be ordered by a medical professional and considered medically necessary.* Coverage for the antibody test will extend to office visits and other charges related to the antibody test when performed in-network. This new coverage will extend through October 31, 2021.
*Not covered as part of a return to work requirement, public surveillance program or travel requirement.
Treatment Coverage (effective 03/01/2020 – 09/30/2021)
Medica Prime Solution and Advantage Solution individual plans will cover the cost of COVID-19 treatment at no cost to members in these situations: in a hospital participating with their Medica network, when accessing extended absence and travel benefits, or in an emergency (i.e. admission through an emergency room), if the provider/hospital is Medicare eligible.
Medica Advantage Solution group retiree plans will cover the cost of COVID-19 treatment if the provider/hospital is Medicare eligible, at no cost to members.
Medica Medicare Supplement (Medigap)
Testing Coverage (effective 02/04/2020 – 10/31/2021)
Medica Medicare Supplement (Signature Solution) will cover the cost of medically necessary COVID-19 diagnostic testing (COVID-19 infection). Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets guidelines from Centers for Disease Control and the Food and Drug Administration (FDA), and is ordered by an appropriate medical professional.* Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. This means the member's share of the cost will be waived for office visits, urgent care, walk-in retail health clinics, emergency room and outpatient facilities when the member is being tested for COVID-19.
Medica will also cover the cost for FDA-approved antibody tests after a suspected (not confirmed) COVID-19 diagnosis. Tests must be ordered by a medical professional and considered medically necessary.* Coverage for the antibody test will extend to office visits and other charges related to the antibody test when performed in-network. This coverage will extend through October 31, 2021.
*Not covered as part of a return to work requirement, public surveillance program or travel requirement.
Medica Medicare Supplement (Select Solution) will cover the cost of medically necessary COVID-19 diagnostic testing. Medica covers rapid diagnostic tests and standard nasal and saliva diagnostic tests. This applies to testing that meets guidelines from Centers for Disease Control and the Food and Drug Administration (FDA), and is ordered by an appropriate medical professional.* Provider services for that testing will also be covered at no cost to members if they see a provider who is Medicare eligible. This means the member’s share of the cost will be waived for COVID-19 testing in office visits, urgent care, walk-in retail health clinics, emergency room and outpatient facilities if member is being tested for COVID-19.
Medica will also cover the cost for FDA-approved antibody tests after a suspected (not confirmed) COVID-19 diagnosis. Tests must be ordered by a medical professional and considered medically necessary.* Coverage for the antibody will extend to office visits and other charges related to the antibody test when performed in-network. This coverage will extend through October 31, 2021.
*Not covered as part of a return to work requirement, public surveillance program or travel requirement.
Treatment Coverage (effective 03/01/2020 – 09/30/2021)
Medica Medicare Supplement (Signature Solution) will cover the cost of COVID-19 treatment in a hospital setting, as long as the provider/hospital is Medicare eligible, at no cost to members.
Medica Medicare Supplement (Select Solution) will cover the cost of COVID-19 treatment in a hospital that is participating with their Medica contracted network, at no cost to members.