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WPS is actively monitoring the current international and domestic environment for COVID-19 as well as the related risks so we can prepare accordingly. On this page, you’ll find links to information about COVID-19, related news, and information on what WPS is doing to help our customers.
Note: The content below is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
To help slow the spread of COVID-19, the federal government recently passed guidelines making at-home testing more accessible.
If you have Medicare:
Effective April 2022, people who have Medicare Part B will be able to get up to eight (8) COVID-19 over-the-counter (OTC) tests each calendar month until the end of the COVID-19 public health emergency.
This new initiative enables payment from Medicare directly to participating eligible pharmacies and other health care providers to allow Medicare beneficiaries to receive tests at no cost. This is in addition to the two sets of four free at-home COVID-19 tests Americans can continue to order from COVIDTests.gov.
Please use the following link to find participating pharmacies: medicare.gov/medicare-coronavirus.
National pharmacy chains participating in this initiative include:
This coverage will apply until the end of the public health emergency. In accordance with new requirements, WPS Health Insurance and WPS Health Plan will cover the costs of certain OTC home testing kits for individual and group customers (excluding Medicare supplement customers). See the chart below for the list of covered home testing kits.
When the tests are ordered or administered by a health care provider following an individualized clinical assessment, there is no limit on the number of tests—including at-home tests—that are covered. This includes people who need testing due to underlying medical conditions. Without a doctor’s prescription, we will cover up to eight OTC tests per individual per rolling 30 days.
To find an in-network pharmacy, log into the Express Scripts member portal and search for in-network pharmacies. The cost of the test will run through your pharmacy benefit like any prescription drug. There is no cost-sharing (copay or out-of-pocket expense).
If you get your test kits at an out-of-network pharmacy or purchase them at a retail register at an in-network pharmacy, you will need to submit a claim form for reimbursement (up to $12/test). Note that the reimbursement is based on number of tests and kits may come with a varied number of tests in them.
If you have a pharmacy benefits administrator other than Express Scripts, please contact them for questions on reimbursement.
| National Drug Code (NDC) | Brand Name | Package Size Quantity |
|---|---|---|
| 11877001140 | BINAXNOW COVID-19 AG SELF TEST (KIT) | 2 |
| 00111070752 | COVID-19 AT-HOME TEST (KIT) | 1 |
| 00111070772 | COVID-19 AT-HOME TEST (KIT) | 4 |
| 56964000000 | ELLUME COVID-19 HOME TEST (KIT) | 1 |
| 82607066026 | FLOWFLEX COVID-19 AG HOME TEST (KIT) | 1 |
| 82607066027 | FLOWFLEX COVID-19 AG HOME TEST (KIT) | 2 |
| 82607066028 | FLOWFLEX COVID-19 AG HOME TEST (KIT) | 5 |
| 56362000589 | IHEALTH COVID-19 AG HOME TEST (KIT) | 2 |
| 56362000590 | IHEALTH COVID-19 AG HOME TEST (KIT) | 5 |
| 08337000158 | INTELISWAB COVID-19 HOME TEST (KIT) | 2 |
| 60006019166 | ON-GO COVID-19 AG AT HOME TEST (KIT) | 2 |
| 14613033968 | QUICKVUE AT-HOME COVID-19 TEST (KIT) | 5 |
| 14613033972 | QUICKVUE AT-HOME COVID-19 TEST (KIT) | 2 |
It’s a new coronavirus strain that causes respiratory illness. Originating in Wuhan City, China, the virus has infected thousands of people worldwide and caused deaths. Cases have now been reported around the world. The World Health Organization named the disease caused by the new coronavirus on Feb. 11, 2020. The new name is COVID-19, short for “coronavirus disease 2019.”
Common signs of infection include:
In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and death.
People with heart and lung disease or weakened immune systems, as well as infants and older adults, are at higher risk for lower respiratory tract illness.
Human coronaviruses are usually spread from an infected person to others through the air by coughing and sneezing and through close personal contact, such as touching or shaking hands.
The Department of Health and Human Services (HHS) is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program here.
HHS also has established free community-based pharmacy testing sites around the country. The Biden-Harris Administration is purchasing 500 million at-home, over-the-counter tests to be distributed for free to Americans who want them, with the initial delivery starting in January 2022. There is a website where all Americans can request at-home tests for home delivery—for free.
For people covered by original fee-for-service Medicare, Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People with Medicare can access one lab performed test without cost-sharing per patient per year without an order. Effective April 2022, people who have Medicare Part B will be able to get up to eight (8) COVID-19 over-the-counter (OTC) tests each calendar month until the end of the COVID-19 public health emergency.
Medicare covers all medically necessary hospitalizations.
You can call the number on the back of your ID card for answers.
Vaccines are an essential and highly effective way to prevent infectious disease in large populations. WPS will cover immunizations as directed.
Most of these supplies are not currently covered by Medicare or insurance plans in general.
Due to recent guidance from the Centers for Medicare & Medicaid Services, Medicare and our WPS Medicare supplement insurance plans will cover telehealth benefits through a medical provider (not Teladoc® at this time) for as long as it is covered by Medicare.
Your health coverage has been boosted with new benefits! Check out the list below and feel free to call Customer Service using the phone number on your customer ID card if you have any questions.
Note: Self-funded group health plans have the option to select these benefits. If you are enrolled under a self-funded employer plan, check with your group leader to see if these benefits are covered. If you are a group leader, you can contact your WPS account manager with questions.
To help slow the spread of COVID-19, the federal government recently passed guidelines making at-home testing more accessible. WPS Health Insurance and WPS Health Plan will cover the costs of home testing kits in accordance with the new requirements.
If you have health coverage through WPS, you can buy at-home tests—online or at a store—and be reimbursed according to the regulation. Everyone enrolled in group (fully insured and self-insured), individual, short-term, or family health plans is eligible for this program beginning Jan. 15, 2022. For people who have Medicare Part B, Medicare will cover up to eight (8) COVID-19 over-the-counter (OTC) tests each calendar month. The Department of Health and Human Services also has free community testing programs.
This coverage will apply until the end of the public health emergency.
Starting on January 28, 2022, for everyone enrolled in group (fully insured and self-insured), individual, short-term, or family health plans, tests are available through ExpressScripts at participating network pharmacies. You can use this reimbursement form or purchase the tests through the in-network pharmacy with your insurance card.
Starting on Jan. 19, 2022, the website COVIDTests.gov will provide tests at no cost, including no shipping fee.
WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers. This enhanced benefit will apply through October 13, 2022 or through the federal health emergency, whichever is later.
In most cases, telehealth services are available to WPS customers and their dependents to answer questions about the virus, evaluate their risk, and provide support by phone or video call if they develop symptoms. While self-funded groups with our Freedom Essentials plan will be able to opt out of this coverage, all other self-funded group health plans must opt in to this coverage change. Self-funded groups should get in touch with us right away to ensure they have the telehealth benefit they want for their employees.
This benefit enhancement will go through the federal public health emergency or July 15, 2022, whichever is later.
For telehealth services not related to COVID-19 testing, Teladoc® is our preferred provider. For customers with health plans that are not HSA-qualified High-Deductible Health Plans (HDHP), WPS will waive copays for telehealth services for any condition provided by Teladoc providers. If a customer has an HSA-qualified HDHP, deductibles and coinsurance will still apply. While self-funded groups with our WPS Freedom Essentials plan will be able to opt out of this coverage, all other self-funded group health plans must opt in to this coverage change. Self-funded groups should get in touch with us right away to ensure they have the telehealth benefit they want for their employees. This benefit enhancement will go through Dec. 31, 2021.
Starting Jan. 1, 2022, the Teladoc copay for short-term plans is $55. Fees billed by our approved telehealth provider are subject to change.
There is no change in the way prescription drug coverage is administered. However, we encourage the use of home delivery for medications when available to help maintain social distancing. Early refills are also available. WPS will allow early refills for both 30-day supplies and 90-day supplies of retail and home delivery prescriptions. Note that not all medications are approved for extended supplies and the amount of the refill will vary depending on the number of refills remaining on the prescription.
Your WPS health plan covers all medically necessary services based on the terms of your policy. There is no coverage for housing, food, and other items.
Hospitalizations are covered under the terms of your health plan.
You can call our Customer Support team using the number on your customer ID card.
Vaccines are an essential and highly effective way to prevent infectious disease in large populations. WPS will cover immunizations as directed.
Most of these supplies are not currently covered by insurance plans in general.
WPS coverage has been boosted with new benefits! Check out the list below and refer your clients to our Customer Service if they have questions. They can call the phone number on their WPS ID card.
Note: Self-funded group health plans have the option to select these benefits. Group members should check with their group leader to see if these benefits are covered. Group leaders who have questions can contact their WPS account manager.
WPS will waive any cost-sharing for federally approved in vitro diagnostic tests which are used for the detection or diagnosis of the virus that causes COVID-19, including antibody testing. For some employers, WPS is only the claims administrator for their self-funded health plan, not the insurer. In these situations, it is the decision of the employer to determine how this will be covered. Self-funded clients will be able to opt in to coverage changes and will be contacted by the WPS Account Management team. This benefit enhancement ends the later of the end of the federal public health emergency or July 15, 2022, whichever is later.
The IRS has indicated that a health plan that otherwise satisfies the requirements to be an HSA qualified High-Deductible Health Plan (HDHP) may provide health benefits associated with the testing of COVID-19 without a deductible, or with a deductible below the minimum deductible (self-only or family) for an HDHP. An individual covered by the HDHP will not be disqualified from being an eligible individual because they received COVID-19 testing. This will apply to in-vitro diagnostic testing and related services on or after Jan. 1, 2020, with respect to plan years beginning on or before Dec. 31, 2021.
WPS customers can buy at-home tests—online or at a store—and be reimbursed according to the regulation. Everyone enrolled in group (fully insured and self-insured), individual, short-term, or family health plans is eligible for this program beginning Jan. 15, 2022. For people who have Medicare Part B, Medicare will cover up to eight (8) COVID-19 over-the-counter (OTC) tests each calendar month. The Department of Health and Human Services also has free community testing programs.
Starting on January 28, 2022, for everyone enrolled in group (fully insured and self-insured), individual, short-term, or family health plans, tests are available through ExpressScripts at participating network pharmacies. You can use this reimbursement form or purchase the tests through the in-network pharmacy with your insurance card.
Starting on Jan. 19, 2022, the website COVIDTests.gov will provide tests at no cost, including no shipping fee.
For people who have Medicare Part B, Medicare will cover up to eight (8) COVID-19 over-the-counter (OTC) tests each calendar month.
The Department of Health and Human Services (HHS) is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. You can learn more about this program here.
HHS also has established free community-based pharmacy testing sites around the country. The Biden-Harris Administration is purchasing 500 million at-home, over-the-counter tests to be distributed for free to Americans who want them, with the initial delivery starting in January 2022. There is a website where all Americans can request at-home tests for home delivery—for free.
For people covered by original fee-for-service Medicare, Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People with Medicare can access one lab performed test without cost-sharing per patient per year without an order. The Department of Health and Human Services also has free community testing programs.
WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers. This enhanced benefit will apply through October 13, 2022 or through the federal health emergency, whichever is later.
Medicare covers all medically necessary hospitalizations.
There is no change in the way prescription drug coverage is administered. However, we encourage the use of home delivery for medications when available to help maintain social distancing. Early refills are also available. WPS will allow early refills for both 30-day supplies and 90-day supplies of retail and home delivery prescriptions for both fully insured and self-funded groups. Note that not all medications are approved for extended supplies and the amount of the refill will vary depending on the number of refills remaining on the prescription.
Each WPS health plan covers all medically necessary services based on the terms of the policy. There is no coverage for housing, food, and other items.
Hospitalizations are covered under the terms of the health plan.
WPS individual and group health plan customers can call our Customer Support team using the number on their customer ID card. WPS Medicare supplement insurance customers can call the number on the back of their ID card.
Vaccines are an essential and highly effective way to prevent infectious disease in large populations. WPS will cover immunizations as directed.
Most of these supplies are not currently covered by insurance plans in general.
WPS coverage has been boosted with new benefits! Check out the list below and refer your patients to our Customer Service if they have questions. They can call the phone number on their WPS ID card.
Note: Self-funded group health plans have the option to select these benefits. Group members should check with their group leader to see if these benefits are covered. Group leaders who have questions can contact their WPS account manager.
Each Provider Agreement contains provisions related to the timely filing of claims and appeals. In order to allow our Provider partners to focus their efforts on responding to the national health crisis and caring for their patients and our customers, WPS will waive the enforcement of certain Provider Obligations:
We have temporarily expanded our coverage of telehealth and telemedicine services to allow providers to render important health care services while protecting both patients and caregiving staff from avoidable exposure to COVID-19. Review our temporary telehealth policy.
Fully insured groups: No. On March 11, 2020, the IRS released a notice that allows insurers to provide health benefits associated with the testing for COVID-19 (Coronavirus Disease 2019) without first applying the HDHP's applicable deductible. As stated in the notice, this is true until further guidance is issued.
Self-funded groups: WPS will make this change to self-funded groups upon receipt of written confirmation.
Many providers have asked for flexibility in moving practitioners between service locations during the crisis. We have temporarily modified our process to allow practitioners to provide care at any location within the same entity (as defined by a single tax ID), even if that practitioner was not previously registered to that address. Please continue to provide roster updates as normal.
We acknowledge the CMS 1135 waiver for state licensing, which temporarily allows out-of-state practitioners to provide services if they are licensed in another state. In the State of Wisconsin, organizations must follow the provisions outlined in the Wisconsin Department of Health Services Emergency Orders #16 and #20, found at evers.wi.gov/Documents/COVID19/EMO16-DSPSCredentialingHealthCareProviders.pdf and dsps.wi.gov/Documents/EmergencyOrder20.pdf.
The Internal Revenue Service urges taxpayers to be on the lookout for a surge of scam phone calls and email phishing attempts about the coronavirus, or COVID-19. The schemes are related to the economic impact payments being issued by the U.S. government.
Beware of solicitors who try to sell you a coronavirus disease (COVID-19) test kit.
If you are called by anyone other than your attending physician, please do not provide personal or health-related information. Never give your bank or credit card information to any solicitor over the phone.
Vaccines are an essential and highly effective way to prevent infectious disease in large populations. WPS will cover immunizations as directed.
Given the rapidly evolving nature of this disease, the above guidance is subject to change.