Coronavirus (COVID-19)
If you are concerned you may have COVID-19, call your doctor (PCP) to discuss. Keep track of your symptoms and if you have an emergency warning sign (such as trouble breathing), get medical attention right away.
The U.S. declared the end of the pandemic health emergency (PHE) on May 11, 2023. In California, most mandates under the current COVID-19 PHE continue to apply.
WHA members will continue to be covered at no cost share when they go to an in-network pharmacy or their PCP for COVID-19 vaccines, testing, and therapeutics. The requirement to waive cost-sharing for certain testing, screening, or therapeutic services by an out-of-network provider ends on 11/11/2023.
NOTE: This means if a WHA member elects to obtain any of these above services from an out-of-network provider starting on 11/12/2023, then they will incur a copayment and/or charges under the deductible.
Vaccines Now Available
Updated vaccines are designed to target the variants currently circulating among the population.
-
During the week of September 11, 2023, both the FDA and CDC approved an updated Pfizer-BioNTech and Moderna mRNA COVID-19 vaccine for anyone 6 months and older for protection against the COVID-19 variant XBB.1.5 (fall/winter 2023).
-
WHA members may check local network retail pharmacies in their neighborhood to see if they have the most recent COVID-19 vaccine, but please note that it must be administered by the pharmacy staff to be covered by your WHA plan. Search our online provider directory for network pharmacies near you.
-
WHA members who get the vaccine will continue to have a $0 cost at a network pharmacy or at their PCP. Check with your PCP if you have questions about what's right for you/your family. Also, members (children ages 3+ years) may get a COVID-19 vaccine (and flu shot) at no cost at a WHA network pharmacy.
WHA's network includes multiple medical groups (where you see your doctor) and they are good resources for vaccine information and are linked below:
COVID-19 Medication
Medication is available through your PCP, WHA's network pharmacies, and health clinics. If obtained at a network pharmacy, members are eligible for $0 cost share. Standard cost-shares apply when obtained outside of WHA’s standard pharmacy network and members will be required to submit for reimbursement at <this link > or send a printed claims form to OptumRx.
If you have COVID-19 symptoms and test positive, contact your doctor immediately to determine if the medication is right for you. Do not wait to get treated as you may need to take an oral COVID-19 medication within 5-7 days of your first symptoms. If for some reason you are not able to access prescription medication, call WHA Member Services.
Note: CalPERS members should contact OptumRx at 855.505.8110 for pharmacy orders/refills.
At-home Test Kits
The at-home COVID test kits are available at the pharmacy counter. WHA will reimburse the cost of up to eight (8) FDA-approved at-home COVID-19 test kits per month at a maximum reimbursement of $12 per kit (including tax and shipping if applicable) when obtained at a network pharmacy.
Members who purchased an FDA-approved COVID-19 diagnostic test on or after January 15, 2022, may submit a reimbursement request form. Standard cost-shares apply when obtained at a pharmacy outside of WHA’s standard network. Members must save receipts and attest/sign that tests are for personal use (not employment purposes and not be resold). Reimbursement is only for FDA-approved, at-home test kits (see a full list here).
A Claim Reimbursement webpage is available through WHA Pharmacy partner OptumRx <here> and will accept receipts dated on or after January 15, 2022. A printed claims form may also be submitted.
Note: CalPERS members should check details on the CalPERS webpage.
MyCare Medicare Advantage Members
Effective May 11, 2023, WHA MyCare Medicare Advantage members will continue to have coverage without cost sharing for laboratory-conducted COVID-19 tests when ordered by their PCP/clinical provider. However, access to free over-the-counter COVID-19 tests will end through Medicare. WHA members may purchase COVID-19 Antigen self-tests through Optum Personal Care Benefits, WHA’s over-the-counter (OTC) health and wellness products benefit (using their quarterly allowance in their MyCare plan). Each test kit contains 2 tests per box and costs $25 per box, which would be credited to your account. Go to ShopFirstLineBenefits.com for more information.
General Testing
WHA will cover the cost of the test to determine if you currently have COVID-19. If you believe you have been exposed and want to get tested, contact your doctor. WHA does not cover testing for a specific workplace testing program required by your employer. WHA continues to follow state and federal guidance on benefit coverage of COVID-19 by health plans, which clearly outlines that health plans are not required to pay for monitoring and screening required for employment purposes.
Looking for Health Coverage?
We are here to help you stay healthy and facilitate the care you need when you need it. Let us help you find the plan that's right for you.
Virtual Visits with Your Doctor
Many physicians, health professionals, clinics, and facilities also offer telehealth options. Get care without leaving the comfort of your home or your office. Learn more about the telehealth services available through our provider partners.
Urgent Care from Teladoc®
WHA members also have access to virtual urgent care with Teladoc. Connect with an urgent care healthcare professional for minor injuries and illnesses such as cold or flu, minor cuts or burns, muscle strains or sprains, upset stomach or skin rashes, without having to go to an urgent care facility.
*When receiving urgent care telehealth services through Teladoc, all services shall be provided consistent with existing appointment standards and access requirements. If your plan has out-of-area benefits, members can access services either via telehealth or on an in-person basis. Certain conditions apply. Review your plan documents for details on cost-sharing and balance billing protections.
Nurse Advice Available by Phone
You have 24/7 access to a nurse advice line staffed with registered nurses. You can speak directly with a nurse at 877.793.3655, and they can answer any health concern, help you with treatment or refer you to the nearest urgent care or network hospital. They are available anytime day or night, so don't hesitate to call at no cost to WHA members!
Connect With Your Doctor
Your medical group may offer an online service to email your doctor, request prescription refills, schedule an appointment, view lab test results, or access your medical record.
Chat with or Send a Message to WHA Member Services
Have a question about your benefits or coverage? During business hours, you can chat online with a WHA member service representative. You can also send a secure message 24/7. Both are available by logging into your MyWHA account and visiting the website's Contact Us page below.
Printable Resources
Handouts and posters created by the Centers for Disease Control and Prevention (CDC):
- Personal Action Plan (for COVID-19)
- What to do if you are sick or caring for someone else
Frequently Asked Questions
What is the novel coronavirus?
The novel coronavirus is a new coronavirus never identified before now. Referred to as the coronavirus disease 2019 (COVID-19), it is very different than the common coronavirus seen in humans that cause the common cold and other mild illnesses. COVID-19 was identified first in Wuhan, China, and has spread globally.
How does COVID-19 spread?
COVID-19 virus is thought to spread mainly from person to person. Between people who are in close contact with one another (within about 6 feet), generally, when respiratory droplets are produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Learn more about what is known about the spread of COVID-19.
How can I help protect myself?
The best way to prevent infection is to avoid being exposed to the virus that causes COVID-19, and take these preventive measures:
- Get vaccinated and stay up to date on your COVID-19 vaccines and booster shots. Vaccines are widely available for everyone ages 6 months and up.
- Use a mask or face covering to protect yourself and prevent the spread of the virus to others.
- Remember to continue practicing these preventive measures, and stay safe.
- Stay home, especially if you are sick, except to get medical care. Learn what to do if you are sick. Leave only when necessary to restock essential supplies (food, medications, toilet paper, etc.)
- Maintain social distancing
- Avoid becoming in contact with those who are sick. Keep at least six (6) feet between you and those around you. This is especially important for people who are at higher risk of getting very sick.
- Wash hands frequently for at least 20 seconds
- Wash your hands often with soap and warm (preferred) water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
- Avoid touching your eyes, nose, and mouth
- Cover coughs and sneezes
- Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash.
- Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
- Clean and disinfect
- Clean and disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
- If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.
Continue to monitor publicly available information, as well as that from your PCP, medical group, and WHA’s website on any public health issue/concern.
Resources
Learn about the latest updates at the California Department of Public Health.
Center for Disease Control and Prevention (CDC) - https://www.cdc.gov/vaccines/covid-19/index.html
Food and Drug Administration (FDA) - https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines
Did You Know: that hand sanitizers are regulated as over-the-counter (OTC, or nonprescription) drug? Hand sanitizers are a convenient alternative when handwashing with soap and water isn’t possible and help protect yourself and your family from diseases with simple hygiene. For more information, visit: Q&A for Consumers: Hand Sanitizers and COVID-19.
Last review date: April 14, 2023