Coronavirus (COVID-19) is a contagious respiratory illness caused by a virus first identified in China, and has symptoms similar to the flu. These can range from mild (fever, cough, shortness of breath) to severe (serious illness such as pneumonia). In extreme cases, it can result in death. Like many of you, we at AFSPA have been following the news of the outbreak of Coronavirus (COVID-19) around the globe.
The Foreign Service Benefit Plan (FSBP) continues to support you wherever you are. To ensure you have access to the care you need, FSBP has implemented the following to support members’ care for COVID-19:
COVID-19 TestingFSBP will cover all FDA-approved Coronavirus (COVID-19) testing at 100% for US-based members. FSBP will cover all locally approved Coronavirus (COVID-19) testing at 100% for members overseas. Coverage includes testing for both active (antigen) infections as well as for antibodies. |
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FSBP will provide coverage at 100% - no deductible or other member cost sharing – for provider visits, medications, and other treatments related to the testing and treatment of Coronavirus (COVID-19), in accordance with guidance from the Office of Personnel Management (OPM)
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COVID-19 VaccinesAdministered by a pharmacy in the U.S. Participating Pharmacy Vaccines obtained at a participating network pharmacy are covered at 100% per Section 5(f) of the 2021 FSBP Brochure. The network pharmacy should submit a claim for payment directly to the Plan with no cost sharing from the member. Click here to find your nearest network pharmacy. Non-Participating Pharmacy COVID-19 vaccines obtained at pharmacies not participating in the network also will be covered at 100% of the billed charges. Members will have to file a paper claim to obtain reimbursement for the cost of the vaccine. No letter of explanation is needed for a claim for a COVID-19 vaccine obtained at a non-network pharmacy. The claims submitted to FSBP must contain all the elements outlined in Section 7 of the 2021 FSBP Brochure for processing. Administered in a doctor’s office or other setting in the U.S. COVID-19 vaccines obtained from non-pharmacy provider will be covered at 100% of the billed charges for both adults and children, per Section 5(a) of the 2021 FSBP Brochure. The coverage for this vaccine will be the same for both in network and out of network providers according to the current regulations. If you required by the provider to pay for the vaccine at the time of service, you can submit a claim to the Plan for reimbursement. Please make sure your claim submission includes all the elements outlined in Section 7 of the 2021 FSBP Brochure.
Administered by a pharmacy Overseas Vaccines obtained outside the United States will be reimbursed at 100%. |
Telehealth Services for Members in the U.S.FSBP members in the U.S. can access care 24/7 through our telehealth vendor, Teladoc, covered at 100%. This coverage will continue in 2021. You can find coverage details and information to access these services in Section 5(a) and 5(e) of the 2021 FSPB Brochure. Additional Behavioral Health Televideo Services Behavioral Health Televideo Services is a rapidly growing and evolving form of treatment. Licensed health care professionals provide services using real-time video conferencing. With this state-of-the-art communications technology, health care professionals can provide services to members who may not have been able to access services in the past. Health care professionals who provide Behavioral Health Televideo Services comply with all relevant laws in the jurisdiction where they and the member getting services are located. We expect health care professionals providing Behavioral Health Televideo Services to comply with the Clinical, Technical and Administrative Guidelines of the American Telemedicine Association. The following Behavioral Health Televideo Providers are available to you depending on which state you live in. MDLive
Array AtHome Care (formerly Inpathy)
Telemynd (formerly Arcadian Telepsychiatry)
Please note: Members located overseas cannot access services through FSBP’s stateside telehealth vendor, Teladoc. Overseas members must use vHealth (Worldwide) for general medicine telehealth consultations (see below). |
Telehealth Service for Overseas membersFSBP members with an overseas address (including APO, DPO, Embassy, and Consulate addresses) and members with a stateside address who are traveling outside the U.S., can access general telehealth consultations overseas through vHealth (Worldwide), covered at 100%. This coverage will continue in 2021. You can find coverage details and information to access these services in Section 5(a) and 5(e) of the 2021 FSPB Brochure. Even if you visit the U.S., but maintain your overseas address, you still will access vHealth for any telehealth needs. At this time telehealth consultations from vHealth are only available for general/primary medicine. This may include preventive care as well as treatment for acute and chronic illnesses. A provider may also give referrals and prescribe medications, when appropriate. |
Telemedicine Services for U.S. and Overseas membersTo help members avoid wait times and potential exposure to Coronavirus (COVID-19) at doctor’s offices and other settings both stateside and overseas, FSBP will pay all telemedicine visits at 100%, waive usual restrictions, the calendar year deductible and other cost sharing provisions only until December 31, 2020. Effective January 1, 2021, telemedicine visits (virtual visits with an established provider or PCP) will no longer be covered at 100%, but will be covered like in-person office visits: subject to the calendar year deductible and paid at 90% of the Plan allowance for in network providers and 70% of the Plan allowance for out of network providers. Providers should employ a HIPAA-compliant platform for such visits. What's the difference between telehealth and telemedicine? When you are utilizing services from Teladoc or vHealth, we refer to this as a "telehealth" visit. When you consult with an established provider or primary care physician (PCP) for clinical services on a virtual/remote level (via video conference or by telephone) we refer to this as a "telemedicine" visit.
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FSBP has removed the restrictions for all stateside members to obtain an early refills of non-specialty medications by visiting their network retail pharmacy. Maintenance medications can be obtained in 90-day supplies from participating Smart90 pharmacies or through home delivery at www.express-scripts.com. Staff at the Plan’s specialty pharmacy Accredo stand ready to guide members who typically receive infusion treatments at infusion centers or hospitals. You can reach out to Accredo at 800-922-8279 to learn about alternatives to facility care and ensure that you continue receiving your treatment. FSBP has removed the restrictions for overseas members to obtain an early refill of their prescription drugs by home delivery. Overseas members needing support should contact the dedicated Expat Team at Express Scripts via email at [email protected] or call 877-846-3630 to order a refill. Members should include their member ID and/or date of birth when they contact the Expat Team to ensure timelier service. For locations in which a state of emergency is declared (for Stateside members), FSBP will work with our partners at Aetna and Express Scripts to ensure you have access to necessary prescription drugs. |
Stay Updated
For more information, please see the links below in addition to guidelines and updates distributed by local media:
- U.S. Centers for Disease Control and Prevention – www.cdc.gov
- State Department Travel Advisories - https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
- State Department’s Smart Traveler Enrollment Program (to receive country updates while traveling) - https://step.state.gov/STEP/Pages/Common/Subscribe.aspx
- World Health Organization – www.who.int
A Focus on Our Kids
Below are available resources that offer guidance to help our kids cope with current mental health challenges:
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Coronavirus (COVID-19) is a contagious respiratory illness caused by a virus first identified in China, and has symptoms similar to the flu. These can range from mild (fever, cough, shortness of breath) to severe (serious illness such as pneumonia). In extreme cases, it can result in death. Like many of you, we at AFSPA have been following the news of the outbreak of Coronavirus (COVID-19) around the globe.
The Foreign Service Benefit Plan (FSBP) continues to support you wherever you are. To ensure you have access to the care you need, FSBP has implemented the following to support members’ care for COVID-19:
COVID-19 TestingFSBP will cover all FDA-approved Coronavirus (COVID-19) testing at 100% for US-based members. FSBP will cover all locally approved Coronavirus (COVID-19) testing at 100% for members overseas. Coverage includes testing for both active (antigen) infections as well as for antibodies. |
|
FSBP will provide coverage at 100% - no deductible or other member cost sharing – for provider visits, medications, and other treatments related to the testing and treatment of Coronavirus (COVID-19), in accordance with guidance from the Office of Personnel Management (OPM)
|
COVID-19 VaccinesAdministered by a pharmacy in the U.S. Participating Pharmacy Vaccines obtained at a participating network pharmacy are covered at 100% per Section 5(f) of the 2021 FSBP Brochure. The network pharmacy should submit a claim for payment directly to the Plan with no cost sharing from the member. Click here to find your nearest network pharmacy. Non-Participating Pharmacy COVID-19 vaccines obtained at pharmacies not participating in the network also will be covered at 100% of the billed charges. Members will have to file a paper claim to obtain reimbursement for the cost of the vaccine. No letter of explanation is needed for a claim for a COVID-19 vaccine obtained at a non-network pharmacy. The claims submitted to FSBP must contain all the elements outlined in Section 7 of the 2021 FSBP Brochure for processing. Administered in a doctor’s office or other setting in the U.S. COVID-19 vaccines obtained from non-pharmacy provider will be covered at 100% of the billed charges for both adults and children, per Section 5(a) of the 2021 FSBP Brochure. The coverage for this vaccine will be the same for both in network and out of network providers according to the current regulations. If you required by the provider to pay for the vaccine at the time of service, you can submit a claim to the Plan for reimbursement. Please make sure your claim submission includes all the elements outlined in Section 7 of the 2021 FSBP Brochure.
Administered by a pharmacy Overseas Vaccines obtained outside the United States will be reimbursed at 100%. |
Telehealth Services for Members in the U.S.FSBP members in the U.S. can access care 24/7 through our telehealth vendor, Teladoc, covered at 100%. This coverage will continue in 2021. You can find coverage details and information to access these services in Section 5(a) and 5(e) of the 2021 FSPB Brochure. Additional Behavioral Health Televideo Services Behavioral Health Televideo Services is a rapidly growing and evolving form of treatment. Licensed health care professionals provide services using real-time video conferencing. With this state-of-the-art communications technology, health care professionals can provide services to members who may not have been able to access services in the past. Health care professionals who provide Behavioral Health Televideo Services comply with all relevant laws in the jurisdiction where they and the member getting services are located. We expect health care professionals providing Behavioral Health Televideo Services to comply with the Clinical, Technical and Administrative Guidelines of the American Telemedicine Association. The following Behavioral Health Televideo Providers are available to you depending on which state you live in. MDLive
Array AtHome Care (formerly Inpathy)
Telemynd (formerly Arcadian Telepsychiatry)
Please note: Members located overseas cannot access services through FSBP’s stateside telehealth vendor, Teladoc. Overseas members must use vHealth (Worldwide) for general medicine telehealth consultations (see below). |
Telehealth Service for Overseas membersFSBP members with an overseas address (including APO, DPO, Embassy, and Consulate addresses) and members with a stateside address who are traveling outside the U.S., can access general telehealth consultations overseas through vHealth (Worldwide), covered at 100%. This coverage will continue in 2021. You can find coverage details and information to access these services in Section 5(a) and 5(e) of the 2021 FSPB Brochure. Even if you visit the U.S., but maintain your overseas address, you still will access vHealth for any telehealth needs. At this time telehealth consultations from vHealth are only available for general/primary medicine. This may include preventive care as well as treatment for acute and chronic illnesses. A provider may also give referrals and prescribe medications, when appropriate. |
Telemedicine Services for U.S. and Overseas membersTo help members avoid wait times and potential exposure to Coronavirus (COVID-19) at doctor’s offices and other settings both stateside and overseas, FSBP will pay all telemedicine visits at 100%, waive usual restrictions, the calendar year deductible and other cost sharing provisions only until December 31, 2020. Effective January 1, 2021, telemedicine visits (virtual visits with an established provider or PCP) will no longer be covered at 100%, but will be covered like in-person office visits: subject to the calendar year deductible and paid at 90% of the Plan allowance for in network providers and 70% of the Plan allowance for out of network providers. Providers should employ a HIPAA-compliant platform for such visits. What's the difference between telehealth and telemedicine? When you are utilizing services from Teladoc or vHealth, we refer to this as a "telehealth" visit. When you consult with an established provider or primary care physician (PCP) for clinical services on a virtual/remote level (via video conference or by telephone) we refer to this as a "telemedicine" visit.
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FSBP has removed the restrictions for all stateside members to obtain an early refills of non-specialty medications by visiting their network retail pharmacy. Maintenance medications can be obtained in 90-day supplies from participating Smart90 pharmacies or through home delivery at www.express-scripts.com. Staff at the Plan’s specialty pharmacy Accredo stand ready to guide members who typically receive infusion treatments at infusion centers or hospitals. You can reach out to Accredo at 800-922-8279 to learn about alternatives to facility care and ensure that you continue receiving your treatment. FSBP has removed the restrictions for overseas members to obtain an early refill of their prescription drugs by home delivery. Overseas members needing support should contact the dedicated Expat Team at Express Scripts via email at [email protected] or call 877-846-3630 to order a refill. Members should include their member ID and/or date of birth when they contact the Expat Team to ensure timelier service. For locations in which a state of emergency is declared (for Stateside members), FSBP will work with our partners at Aetna and Express Scripts to ensure you have access to necessary prescription drugs. |
Stay Updated
For more information, please see the links below in addition to guidelines and updates distributed by local media:
- U.S. Centers for Disease Control and Prevention – www.cdc.gov
- State Department Travel Advisories - https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories.html/
- State Department’s Smart Traveler Enrollment Program (to receive country updates while traveling) - https://step.state.gov/STEP/Pages/Common/Subscribe.aspx
- World Health Organization – www.who.int
A Focus on Our Kids
Below are available resources that offer guidance to help our kids cope with current mental health challenges:
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