As we navigate these challenging times brought on by the emergence of the coronavirus (COVID-19), AMT continues to monitor developments related to COVID 19 and its effects on our local communities. We are focussed the well-being of our communities and health of our member employers, their employees and dependents. Your Association Master Trust (AMT) Trustees have recognized the potential financial impact to our covered members as a result of COVID-19 and have moved in a positive way to decrease the financial burden of potential testing for the virus. Accordingly, the AMT Trustees have approved the waiver of any cost sharing requirements and have lessened certain plan requirements for the testing of coronavirus in conjunction with the recommendations made by the NJ Department of Banking and Insurance.
In cooperation with Horizon Blue Cross Blue Shield of NJ, AMT will:
Waive Prior Authorization for diagnosis of COVID-19
- Waiving prior authorizations for a visit to a primary care physician, urgent care center, or emergency room for evaluation of upper respiratory symptoms, fever, shortness of breath or other conditions that may represent COVID-19.
- Waiving prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
- Waiving prior authorization for lab studies or diagnostic testing required during an ER evaluation or inpatient hospital stay.
Cover the full cost of the COVID-19 test
- We will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19 including any emergency room visit to an in-network or out of network hospital, any in-network doctor office visit, or any in-network urgent care center visit when the purpose of the visit is to be tested for COVID-19. Additionally, any cost sharing for medically necessary COVID-19 laboratory tests performed by either an in-network or out of network laboratory will be waived.
Increase access to prescription medications
- Waive early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encourage members to use 90-day mail order Horizon will also ensure formulary flexibility if there are shortages or access issues and not hold patients liable for additional charges stemming from obtaining a non-preferred medication resulting from shortages or access issues.
Offer Telehealth and Nurse Advice Hotlines
- AMT-Horizon members will have no cost, 24/7 access to licensed nurses who can assess and assist members with symptoms that are consistent with suspected COVID-19 infection. Those service are available through the www.HorizonBlue.com on line portal, or by phone at 1-888-624-3096 or the “Horizon Blue” app. Members may also use those services to consult with a nurse about other health concerns and potentially avoid a visit to a physician office or urgent care facility.
You can make this notice available to your employees through email, paper copy or as a post to your web site. Additionally, you can direct your employees to the AMT website at amt-nj.com for access to this notice as well as an informational graphic designed to offer some basic information about COVID-19.
While it is impossible to predict the impact that coronavirus will have, our focus continues to be providing you the best service possible. If you have any questions on any of the expanded COVID-19 coverage please feel free to contact your administrative services representative.
