Last Updated 4/12/2023
Health New England continues to monitor the spread of coronavirus (COVID-19) on behalf of our members. We will update this page as more details develop.
COVID-19 Testing Information
Effective May 12, 2023 - Changes to Over-the-Counter COVID-19 Test Kit Coverage: Health New England covered the costs of FDA-authorized, rapid, at-home COVID-19 tests and will continue to cover until the end of the public health emergency (PHE), which will end on May 11, 2023. Any reimbursement requests for test kits purchased before May 12, 2023, must be submitted by November 11, 2023. Any cost sharing waived due to the PHE (i.e., for COVID-19 testing) will return to normal cost sharing effective May 12, 2023.
Effective January 15, 2022 - At-Home Tests:
Health New England is reviewing all state and federal guidance related to coverage for over-the-counter at-home COVID-19 tests starting January 15, 2022. We are working on how to implement this requirement and more information will follow. Please continue to check this page for updates about member reimbursements. Read the Biden-Harris administration announcement here.
COVID-19 Vaccine & Booster News
For the most up-to-date information about the COVID-19 vaccine and booster shots, visit our page.
CEO Message
Read a message from our President and CEO, Richard Swift.
Attention: Health New England is not accepting walk-ins at this time.
Our Member Services representatives are available to assist you over the phone. Learn how to Contact Us.
NEW: Cost Share For Non-COVID Telehealth Services Resumes
Effective July 1, 2021, Health New England will reinstate member cost share for non-COVID-19 related telehealth services, including care provided by telephone or video communications.
Because of last year’s COVID-19 shutdowns, Health New England temporarily waived cost share for non-COVID telehealth services to maintain member access to health care and to help prevent infection and illness. As vaccines roll out and states and businesses reopen, this waiver of cost share for non-COVID related telehealth services will end on June 30, 2021. Standard cost share for non-COVID telehealth services will apply.*
Health New England is expanding the types of services that are eligible for telehealth coverage. Details are below.
Continued member cost share waivers include:
- COVID-19 related telehealth services
- In-person COVID-19 related services when performed in an outpatient setting
- Inpatient COVID-19 services for both fully insured and self funded accounts that have opted in
*This update applies to fully funded commercial members, and only to employer groups that participated in the telehealth cost share waiver during the COVID State of Emergency. Please check your plan materials for additional information. Health New England’s Medicare Advantage members may be limited to cost share waivers only during the declared state of emergency based on guidance from CMS.
Extension of COBRA Continuation of Coverage, Special Enrollment, Claim Filing and Appeal Deadlines
On April 28, 2020, the U.S. Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) issued guidance around deadline extensions and other relief to assist health plans, members, employers and other service providers impacted by the COVID-19 outbreak. This allows members additional time to meet certain deadlines for COBRA continuation coverage, special enrollment, filing claims for benefits, appeals of denied claims, and external review of certain claims.
In most cases, this means the normal deadline is extended so that it starts at the end of the “Outbreak Period End Date” and goes for the same number of days in the normal deadline. The Outbreak Period End Date is “60 days after the announced end of the national emergency or such other date announced by the DOL in a future notice.”
All guidance is retroactive to March 1, 2020. More details can be found in the
DOL's EBSA COVID-19 FAQs. If you have additional questions, please call our Member Services team at (800) 310-2835 (TTY:711), Monday – Friday, 8:00 a.m. – 6:00 p.m.
*These COBRA extensions apply to employers with 20 or more employees.
Is Health New England considered an “essential" business?
On Monday, March 23, Massachusetts Governor Charlie Baker issued an emergency order requiring all businesses that do not provide “COVID-19 essential services” to close their physical workplaces for a two-week period starting Tuesday, March 24, at noon. Health New England is considered an essential business. We will continue to serve our members, providers, employers and brokers without disruption.
Residents of Massachusetts and Connecticut are urged to stay home during this period and practice social distancing when necessary. To learn more about businesses that will remain open in Massachusetts and Connecticut, visit the following pages:
Is Health New England covering coronavirus testing and treatment for members?
Health New England is making policy changes according to the Massachusetts Division of Insurance mandates that support our priority of focusing on the health and safety of our community and our members.
Learn more about coverage and cost sharing related to testing and treatment for coronavirus (COVID-19).
Will I be able to get refills on my prescriptions early?
Health New England is ensuring access to prescription medications by allowing early refills consistent with guidance from federal, state and local governments. In addition, Health New England has a 90-day maintenance medication benefit available to members for both retail and mail-order. We will have formulary flexibility if there are shortages or access issues, or if new treatment options become available.
Learn more about other coverage information.
(Applies to members who have prescription coverage through Health New England.)
If I don’t have health insurance or lose my insurance coverage through my employer because of COVID-19, what can I do?
If you or your company is impacted by COVID-19, you may qualify for state or federal health insurance programs including Health New England plans through the Health Connector (the Massachusetts Exchange), an intermediary (HSA Insurance), or MassHealth (Massachusetts Medicaid).
Massachusetts Health Connector continues Open Enrollment through July 23 providing additional time for state residents to access affordable, quality health insurance, particularly those hurt by the economic impacts of COVID-19.
Massachusetts Health Connector and MassHealth
https://mahealthconnector.optum.com/individual/
Call Center: 1-877-MA-ENROLL (1-877-623-6765)
TTY: (877) 623-7773 for people who are deaf, hard of hearing, or speech disabled
HSA Insurance (intermediary)
https://www.hsainsurance.com
Customer Service: (781) 228-2222
Toll-Free: (877) 777-4414
Sales@hsainsurance.com
What is coronavirus and COVID-19?
Coronaviruses are a large family of viruses that may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections. The most recently discovered coronavirus causes coronavirus disease COVID-19, which is a highly infectious respiratory disease.
Since its discovery in December 2019, COVID-19 has spread to 185 countries worldwide, including more than 850,000 confirmed cases in the United States. According to the CDC, person-to-person transmission of COVID-19 is currently widespread across the U.S.
On March 23, Governor Charlie Baker issued an emergency order requiring all businesses not offering "COVID-19 Essential Services" to close their facilities and, on March 24, issued a statewide Stay-at-Home Advisory. One week later, on March 31, Governor Baker extended both advisories through May 4.
For up-to-date information about the coronavirus, visit the CDC website.
Free Coronavirus Symptom Checker Available:
Massachusetts recently announced a statewide resource called Buoy, a free web-based symptom checker and triage tool. Buoy is available at no cost to all Health New England members. Read these
Frequently Asked Questions to learn more, and to access Buoy, go to buoy.com/mass or mass.gov/online-health-tool.
Do you need to talk to a doctor?
Members should call their primary care provider (PCP) first. PCPs may have the ability to evaluate members over the phone (telehealth) in order to limit potential exposure in physician offices. If a PCP isn’t available, most Health New England members* have access to Teladoc® for non-emergency medical issues. Our 24/7 Nurse Advice Line at (866) 389-7613 is available for free to all members as well.
*Some self-funded employer groups do not participate in Health New England’s Teladoc benefit, and/or have decided to not waive member cost sharing for telehealth services. Please check your plan materials for additional information.
What can you do if you are experiencing mental health challenges with the COVID-19 situation?
In just a few weeks, the world has changed dramatically due to coronavirus (COVID-19). It can be difficult to face both personal and professional changes. If you are experiencing mental health challenges due to this pandemic, you are not alone.
As your local health plan, we would like to remind you of some resources that may be able to provide assistance:
- Ask your employer or human resources department if they offer an Employee Assistance Program (EAP), which can provide confidential assistance with a variety of challenges, including mental health.
- Access behavioral health care services from one of our in-network providers. Search for behavioral health providers or call our Member Services team for assistance finding a provider at (800) 310-2835.
- Contact Teladoc® for behavioral health care services.* For more information, visit https://healthnewengland.org/bhteladoc or call 1-800-Teladoc (835-2362).
*Teladoc Behavioral Health Services apply to fully funded groups and Health Connector members. Not all employer groups participate in this benefit. Please check your plan materials for details.
- Call the Disaster Distress Helpline at (800) 985-5990, which is a 24/7, 365-day-a-year, national hotline dedicated to providing immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster, including disease outbreaks like COVID-19. This toll-free, multilingual, and confidential crisis support service is available to all residents in the United States and its territories.
How do you prevent the spread of coronavirus and other illnesses?
Coronavirus is spread through coughing and sneezing. The CDC recommends taking a number of preventive measures that help prevent the spread of germs:
- Wash your hands with soap and water for at least 20 seconds.
- If unable to use soap and water, use a hand sanitizer with at least 60% alcohol content.
- Wash your hands before eating and after blowing your nose or sneezing.
- Avoid contact with people who appear to be sick.
- Avoid touching your mouth, eyes and nose.
- Clean and disinfect surfaces and objects that are frequently used.
What should you do if you suspect you’ve been infected with coronavirus?
If you suspect that you’ve been infected, the CDC urges you take the following steps:
- People with COVID-19 or with other flu-like symptoms should stay home and follow all quarantine procedures.
- Avoid public areas and public transportation.
- Distance yourself from people and animals in your home.
- Avoid sharing household items.
- Wear a facemask when around other people.
If you have more significant symptoms, contact your health care provider, urgent care or the emergency room and follow their instructions.
Will a flu shot prevent coronavirus?
No, the flu shot does not prevent you from getting coronavirus. The flu shot does prevent the common flu, which causes thousands of deaths and hospital admissions each year. It can also help prevent serious complications if you do get the flu, like pneumonia.
What is Health New England’s business continuity plan?
We are prepared to operate effectively under conditions of increased absenteeism or quarantine by utilizing our technological capabilities for associates to work from home, if necessary.
Although the precautions to avoid the spread of COVID-19 may impact where staff works, we will still maintain full infrastructure capacity. This means we do not have to reduce critical functions because our day-to-day member and provider operations capabilities can be operated remotely minimizing impact to services and needed care.
If I am a Health New England member, where can I get information about premium assistance or the hardship process?
- For Commercial members who get their health coverage through their employers, you should work directly with your employer if you have a hardship.
- For Connector members who get their health coverage through the Exchange (Massachusetts Health Connector) or through HSA Insurance (intermediary), you should contact the Connector or HSA directly if you have a hardship. (Contact information is listed on this page above.)
- For COBRA, Medicare Advantage or Medicare Supplement members who pay premiums directly to Health New England, please view our FAQs about our COVID-19 Premiums/Hardship process.