Last Updated | December 31, 2020

Measures we're taking to support Members

We are taking the following steps to ensure our members continue to receive the care they need during the COVID-19 pandemic.

Find COVID-19 information specific to our Blue Medicare Advantage members.

Topics

  • What to know about your Blue KC Coverage during COVID-19 outbreak
  • Accessing Blue KC Virtual Care
  • FAQs

Blue KC will cover certain COVID-19 tests with no cost share for Blue KC members.

You should contact your primary care physician or healthcare provider if you are experiencing COVID-19 like symptoms. Certain COVID-19 diagnostic tests will be covered with no cost share if your healthcare provider orders the test.

Important: In accordance with federal guidance, these tests will not be covered to screen for general workplace health and safety (such as employee ”return to work” program(s) or for public health surveillance for SARS-CoV-2 or for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-19.

In addition, effective March 18, 2020, covered services and items furnished during the office visit, urgent care visit or emergency room visit that results in the ordering or the administration of a covered COVID-19 test will also be covered with no cost sharing.

Important: Please note that for services provided prior to March 18, 2020, any cost sharing will apply for an office visit, urgent care or emergency room visit that resulted in ordering a COVID-19 test. In addition, other diagnostic tests during the office visit and those tests and services will also be subject to normal cost sharing.

Find an overview of current terms and information related to COVID-19 testing.

Learn more about the different types of COVID-19 tests.

Learn more about public health testing.

Blue KC will cover the COVID-19 Vaccine

Upon FDA approval, Blue KC will provide coverage for the administration of COVID-19 Vaccine. The Federal Government has funded the initial supply, and providers have been directed to bill the Government directly for the vaccine. However, fees for administering the vaccine will be billed to the insurance carrier and Blue KC will cover with no cost share to the member. We anticipate limited availability over the next several months. The CDC has prioritized healthcare workers and certain high-risk populations such as those in nursing homes to be the first to receive the vaccine.

Blue KC will eliminate prior authorizations for outpatient COVID-19 services.

Prior authorizations will be waived for diagnostic tests and for outpatient covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19. Blue KC will also make dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19. This policy will remain in place through March 31, 2021.

You can access care from home.

There’s no reason to leave home. You can access a video (face-to-face) visit right from your smartphone, tablet or computer with a virtual care doctor who's been trained to evaluate for COVID-19 via the Blue KC Virtual Care App. Urgent Care Visits and Behavioral Health Therapy visits provided in the Blue KC app are at no cost until March 31, 2021. Download the app on the Apple App Store and Google Play or go to www.BlueKCVirtualCare.com.

With increased use of virtual care, please understand the wait time may be longer.

In addition, until March 31, 2021, you can see your in-network providers, at no cost for virtual (face-to-face), telephone, e-mail or text visits for medical services or behavioral health therapy. Please call your provider to schedule a virtual visit.

Cost sharing* still applies to physical therapy, occupational therapy and speech therapy.

*Deductibles, co-payments and coinsurance

Blue KC will cover inpatient hospital admissions with no cost share to the member.

Effective April 1, 2020, Blue KC waived cost sharing and copayments for inpatient hospital admissions due to the diagnosis of COVID-19 for individuals fully insured by Blue KC. Some employers may have different contracts* with Blue KC which may affect your coverage levels. Please call the customer service number on the back of your Blue KC membership card with questions. This policy will remain in place through March 31, 2021.

*Minimum Premium/Cost-Plus, and ASO

Last Updated | December 31, 2020

FAQs

Blue KC will continue to monitor COVID-19 developments and update the following FAQ as additional information becomes available.

What is COVID-19?

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases (for example, SARS is a coronavirus). This novel (or new) coronavirus, or COVID-19, is a strain that has not been previously identified in humans. You may see "coronavirus" and "COVID-19" used interchangeably in news reports.

How can I protect myself and my family?

  1. Check the CDC website for up-to-date information.
  1. Practice good health habits. Everyday actions like handwashing can help to prevent the spread of respiratory viruses, including COVID-19.
    • Stay home when you're sick. That includes staying home from work, school, errands and travel.
    • Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer when washing isn't an option.
    • Cover your mouth and nose with a face mask when around others.
    • Avoid touching your eyes, nose and mouth.
    • Avoid close contact with people who are sick.
    • Put distance between yourself and other people outside of your home.
    • Cover a cough or sneeze with a tissue, then throw the tissue in the trash.
    • If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.
    • Clean and disinfect frequently touched objects and surfaces, such as phones, keyboards and doorknobs.
    • Get plenty of sleep, exercise, drink a lot of fluids and eat nutritious food.
    • Get a flu shot.

What are the symptoms?

According to the CDC, people with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

This list does not include all possible symptoms. Visit the CDC website to find updates.

What should I do if I’m experiencing symptoms of COVID-19?

Consider using the CDC’s Symptom Checker (located on this webpage) to help you make decisions and seek appropriate medical care.

If you are experiencing the above symptoms and you believe you may have been exposed to COVID-19 take the following action:

  1. Call your healthcare provider and share your symptoms and concerns of being exposed to COVID-19.
  1. Follow your provider’s guidance on next steps. They may:
    • Suggest you self-quarantine until you’re able to take a test.
    • Recommend you be tested for influenza or other illnesses first.
    • Provide self-care tips.
  2. Do your best to avoid close contact with others and practice safe disinfecting and cleaning behaviors including:
    • Cover your mouth
    • Wash your hands
    • Disinfect surfaces you use (kitchen and bathroom counters, tables, drawers, etc.)
  3. Monitor your symptoms and keep your healthcare provider informed of any changes.

I believe that I am sick with COVID-19. How should I be treated?

If you believe you may have been exposed to COVID-19, the CDC recommends that you get lots of rest and stay hydrated. If you are not sick enough to be hospitalized, you can recover at home. Follow CDC additional instructions for how to take care of yourself at home. If your symptoms worsen, contact your healthcare provider immediately to coordinate necessary care.

I believe that I am sick with COVID-19. What can I do to prevent spreading the illness to others?

The CDC recommends the following precautions to help prevent the disease from spreading to people in your home and community:

  • Isolate yourself at home. You should restrict activities outside your home, except for getting medical care. If you must go out, avoid using any kind of public transportation, ridesharing, or taxis.
  • Cover your cough and sneezes.
  • As much as possible, stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available. You should also restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus.
  • Avoid sharing personal items with other people in your household, like dishes, towels, and bedding.
  • Clean all surfaces that are touched often, like counters, tabletops, and doorknobs. Use household cleaning sprays or wipes according to the label instructions.

What telehealth services are available to me?

Blue KC Virtual Care is available today to all members 24/7 through Amwell, our virtual care provider. We highly recommend members take advantage of this service as another form of protection to avoid close contact with others who may be sick.

You can also access urgent care visits and BH Therapy via the Blue KC Virtual Care app at no cost to you until March 31, 2021. The Blue KC Virtual Care app is available on the Apple App Store and Google Play or at www.BlueKCVirtualCare.com. For instructions on how to use Blue KC Virtual Care see the "Accessing Blue KC Virtual Care" section of this website.

I don’t have a primary care doctor. Who can I call if I’m experiencing symptoms?

Unless an emergency, consider alternatives to in-person ER visits:

  • Use Blue KC Virtual Care. The 24/7 app is available to you and all your covered family members.
  • Call your local Urgent Care Center.

Healthcare facilities and virtual care platforms may be experiencing an influx of calls from their patients during this time. You may experience longer than normal wait times when contacting your provider.

What should I know about COVID-19 testing?

Information is changing by the hour and science is evolving daily to bring us a better understanding of the behavior of this virus, how we can most effectively test for it and react to the results of those tests.

Here is a helpful breakdown of current terms and information related to COVID-19 testing:

  • Diagnostic testing for COVID-19 is intended to identify current infection in individuals and is performed when a person has signs or symptoms of COVID-19, or when a person is asymptomatic but has recent known or suspected exposure to COVID-19. Diagnostic tests are medically necessary to guide clinical decision-making for individuals. Current diagnostic tests are PCR tests or antigen tests—find more information about testing types in the question below on this page.
  • Public health screening for COVID-19 is intended to identify infected people who are not showing symptoms and don’t know or think they’ve been exposed to COVID-19. Public health screenings are performed to identify people who may be contagious so that measures can be taken to prevent further transmission. Scientists are still studying which type of COVID-19 test is most appropriate as a public health screening. Public health departments are charged with making this decision for their respective communities.
    • Find more information from the CDC.
    • Learn more about public health testing in our area in the question below on this page.
  • The positivity rate is increasingly being used as a marker to guide community decisions like school openings. The positivity rate is defined as the percentage of COVID-19 tests performed that are positive in a given population. Many public health experts believe that our communities should aim for a positivity rate of 5 percent in order to consider resuming “normal” activity. The positivity rate gives us an idea of how well we are controlling the spread of the virus AND how many people are being tested.
  • Testing accuracy is also important to consider. COVID-19 testing results are not 100 percent accurate and there are many false negative test results—meaning you may get a negative result when you do, in fact, have COVID-19. False negative test results are especially common with antigen testing, though this testing option is increasingly being used by healthcare providers because of its results can be determined more quickly. To make matters even more complicated, the accuracy of COVID-19 test results is impacted by when in the course of a person’s illness or exposure the test is performed—for example, PCR tests appear to be most accurate 5-7 days after exposure.
  • Symptoms may help guide your doctor’s recommendations more than test results due to questions of testing accuracy. For example, when flu season arrives each year and patients show key symptoms of influenza, medical providers are likely to treat the illness as the flu, regardless of the results of the flu test—the same is true with COVID-19.
  • Testing capacity is something healthcare professionals continue to focus on as well. At any given time, our communities have different capacity to conduct an appropriate number of diagnostic and public health screening tests to properly manage the pandemic. In an ideal scenario, testing would be available for all members of a community on a regular basis, offering the ability to identify those who should isolate from others to prevent transmission of the virus. In the absence of an ideal testing scenario, the importance of social distancing and wearing masks cannot be over-emphasized.

What are the different types of COVID-19 tests?

Here is a breakdown of the three main categories of current COVID-19 tests. Again, Blue KC recommends you contact your primary care physician or healthcare provider if you are experiencing COVID-19 like symptoms or to discuss testing options.

  • PCR (Polymerase Chain Reaction) testing, a form of diagnostic testing, is designed to capture the DNA of the virus and amplify it so that it can be identified. Due to its high level of accuracy and low level of false negative results, PCR testing is the most effective way to determine if a person has COVID-19. Unfortunately, turnaround times for PCR testing results have been slow in some areas, making it very difficult to use in making medical decisions. Blue KC is hopeful that these turnaround times will improve in our service area.
  • Antigen tests, another form of diagnostic testing, aim to identify small proteins that sit on the outer layer of the virus. Antigen tests produce rapid results but suffer from accuracy problems and a high rate of false negative results—meaning a significant number of test results will come back as negative when, in fact, an individual is infected with COVID-19. Scientists are working to improve the accuracy of antigen tests.
  • Antibody testing for COVID-19 looks for the presence of antibodies, which are specific proteins the immune system manufactures in response to infections like COVID-19 and can tell you if you had a previous infection. Antibody test results are affected by many things, including the health of a person’s immune system. For these reasons, most experts believe we cannot rely on antibody testing in day-to-day medical practice. We do not know if the antibodies that result from a COVID-19 infection will provide someone with protection (immunity) from getting infected again. If antibodies do provide immunity, we don’t know how what antibody level is needed to provide protection or how long that protection may last. CDC scientists are currently conducting studies to answer these questions in this rapidly evolving set of circumstances. Early in the pandemic, some healthcare providers were using antibody tests in an attempt to learn as much as possible about the virus and its behavior. Some providers may still have medical reasons to order antibody testing, but this practice is becoming more infrequent. Find more information about antibody testing from the CDC.

What should I know about public health testing that may be available?

Some local public health departments are beginning to offer COVID-19 testing to their residents whether or not they are showing COVID-19 symptoms. Check with your county’s health officials to learn more about public health testing they may be currently offering.

Can I still visit my healthcare provider for preventive or scheduled care?

The Centers for Medicare and Medicaid Services (CMS) has issued this guidance about seeking healthcare services during these times, including some of the following:

  • Do not postpone necessary care.
  • Talk with your healthcare provider about the precautions they are putting in place to keep patients safe.
  • Consider telehealth or virtual visits when possible.

How can I get a COVID-19 vaccine?

Please visit our Vaccine Info page to learn more.

How is Blue KC prepared to continue serving members?

Blue KC is actively monitoring the development of COVID-19, especially in the Kansas City metro area. We want you to know that we have already put measures in place to ensure our business operates as usual and members get the care they need should the situation escalate.

Measures will remain in effect until further notice.

most of all, take care.

Certain Information for Uncertain Times

From news and guidelines from the CDC to timely updates from Kansas City’s Department of Health, Blue KC is here to connect you to useful and trusted information.

By staying informed, we can all stay safe and healthy.

Letter from our CEO

Dear Kansas City Community,

The recent coronavirus developments have been a whirlwind for our community and our country at large. The rapid changes with COVID-19 have made it difficult to keep up with the news and latest developments. Many of you are feeling the direct impact with changes at work, home, school and other communities. These are extraordinary times, and Blue KC is here to help. We are committed to keeping our members informed and providing support during this national public health pandemic.

The physical and mental health of our employees, members and community is always our top priority. Blue KC has already put measures in place to protect our workforce while ensuring our business operates as usual and members get the critical care they need. This includes taking precautions to prevent the spread of the virus. Blue KC has facilitated remote workspaces for our employees and has waived fees for 24/7 access to virtual care for our members. By taking these steps, we are helping our members stay home with the goal of keeping them and others well.

We are in communication with many of our partners across the healthcare industry. In times like these, collaboration across the healthcare community is critical to providing better information and care for the people who live and work in our region.

If you are a Blue KC member and worry you might have COVID-19, you should contact your primary care physician or healthcare provider to discuss criteria and availability of COVID-19 testing before visiting a healthcare facility. Members should also reference the CDC website for best practices if they are experiencing symptoms.

I encourage you and your families to do what is necessary to safeguard your own health and the health of others. We know, for some, drastic changes especially in a short amount of time can be unsettling. It’s important everyone be mindful of their mental health and take steps to reduce stress and anxiety.

We will continue to actively monitor the development of COVID-19, especially in the Kansas City metro area. For information about symptoms, precautions and testing, please visit https://www.bluekc.com/consumer/covid-19.html.

Sincerely,

Erin Stucky Signature

Erin Stucky
President and CEO, Blue KC

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COVID-19 (Coronavirus) and What You Need to Know About It

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most of all, take care.

Last Updated | December 28, 2020

COVID-19 Vaccines

Blue KC will continue to monitor COVID-19 vaccine developments and update the following FAQ as additional information becomes available.

Topics

  • FAQs

FAQS

Is there a vaccine for COVID-19?

Two FDA-approved vaccines (Pfizer and Moderna) are now available in limited quantities. Additional vaccines are also being developed and tested and will go through the FDA approval process when appropriate.

When will a vaccine be available?

Limited numbers of doses of COVID-19 vaccines are available now but only for targeted populations such as healthcare workers and those most at risk. Vaccines will be more widely available later in 2021. COVID-19 vaccines currently have been approved for older teens and adults only. More studies will need to be completed before a COVID-19 vaccine will be available for children.

When will Blue KC members be able to get the vaccine?

Due to the unprecedented circumstances of the pandemic and vaccine supply not yet able to meet the high demand, many states are prioritizing healthcare workers who are most at risk of contracting COVID-19 and residents of nursing homes and other long-term care facilities be the first groups to receive vaccines. In general, we expect essential workers and those who fall into high-risk categories due to age or underlying conditions will be next. Younger and healthier groups will likely be eligible to get the vaccine following those with higher priority.

Please note that states are expected to develop their own prioritization plans, so eligible groups may vary somewhat from state to state. To learn more about the Kansas COVID-19 Vaccination Plan, please click HERE. To learn more about the Missouri COVID-19 Vaccination Plan, please click HERE.

Will I have to pay for the vaccine?

COVID-19 vaccinations will be free for all individuals, including the uninsured.

Vaccine coverage involves two charges — the vaccines themselves and the costs for the administration of the vaccines. The cost of a COVID-19 vaccine itself is currently covered by the government through agreements with the developers. The cost of vaccine administration will be covered by the government for Medicare Advantage members, but health plans will be responsible for developing coverage for the cost of vaccine administration for commercial members. For most of our commercial members, the cost of vaccine administration will be covered. There are a limited number of grandfathered groups and individual short-term plans that come under different requirements. Look for additional information coming soon about coverage for these groups.

Can I choose which vaccination I receive?

In the short-term, given supply constraints, it is unlikely that individuals will be able to select which vaccine they receive. But in the long-term, maybe. As different types of vaccines arrive on the market, there may be additional recommendations coming from the CDC, healthcare providers and public health departments regarding which vaccine products are best suited to individuals or populations. Some vaccines require two doses and it is important that both doses are the same brand.

Will there be side effects to taking the vaccine?

Similar to most vaccines, experts expect that the majority of individuals will experience mild side effects.

Does the vaccine infect me with COVID-19? Am I contagious to others?

No. While the vaccine will make an immune response against COVID-19, it does not contain the active virus. Because recipients are not infectious, doctors are not recommending they quarantine after receiving the vaccine.

How can I learn more about COVID-19 vaccines?

For the latest information about COVID-19 vaccines, please visit the CDC’s website.