PEIA Policy for COVID-19

March 11, 2020

Coronavirus 2019 (COVID-19) is a respiratory illness caused by a novel coronavirus designated SARS-CoV-2. The outbreak of COVID-19 originated in Wuhan City, Hubei Province, China. With thousands of confirmed cases being reported in a rapidly growing number of countries worldwide and the number of national cases growing, the West Virginia Public Employees Insurance Agency (PEIA) is establishing a policy to define the benefit and reimbursement regarding COVID-19 testing and treatment.

Effective March 1, 2020, PEIA will cover COVID-19 testing at 100% of the contracted allowance, at a network provider, for members who meet CDC guidelines for testing. This will apply to PEIA PPB Plans A, B, C and D. This means that members will have no out-of-pocket expense for the actual test. Deductibles, copayments, and coinsurance will also be waived for any physician or facility services incurred in the process of being tested.

Treatment of any members, who test positive for the virus, will be covered at normal benefit levels.

The CDC is periodically updating who should be tested. Please refer to the following link for the latest updates. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html

If you believe you have been exposed to or have symptoms consistent with COVID-19, please call your local health department, primary care provider or iSelectMD 844-433-8123 for further instructions.

West Virginia has set up a hotline for its citizens and providers for up to date and accurate information regarding COVID-19. The hotline is toll-free, and operators are available 24/7 at 800-887-4304.

In addition, Optum, part of UnitedHealth Group, is opening its Emotional-Support Help Line. Professionally trained, mental health staff are there to support people who may be suffering from fear or stress created by COVID-19. Optum’s Emotional-Support Help Line number is 866-342-6892 and will be open 24 hours a day, seven days a week. The service is free of charge and open to all PEIA members.