Coronavirus (COVID-19)

Message from the CEO

In these uncertain and somewhat scary times, reminiscent of the H1N1 virus of the early 2000’s, where over 700 million people worldwide contracted the virus, it is important to exercise caution with the Coronavirus and to maintain proper habits.  While we are not anywhere near those totals yet, please find valuable information at the below links on the subject.

Brief History

It is an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and has now been detected in more than 100 locations internationally, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”).  On January 30, 2020, the International Health Regulations Emergency Committee of the World Health Organization declared the outbreak a public health emergency of international concern external. On January 31, 2020, Health and Human Services Secretary, Alex M. Azar II, declared a public health emergency (PHE) for the United States to aid the nation’s healthcare community in responding to COVID-19. On March 11, 2020, COVID-19 was characterized as a pandemic. The origin of the virus is still “officially” undetermined, though there are some very salient thoughts as to its nexus.

The complete clinical picture with regard to COVID-19 is not fully known. Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death. While information so far suggests that most COVID-19 illness is mild, reporting out of China though suggests serious illness occurs in 16% of cases. Older people and people of all ages with severe underlying health conditions — like heart disease, lung disease and diabetes, for example — seem to be at higher risk of developing serious COVID-19 illness. This is the first pandemic known to be caused by the emergence of a new coronavirus.  Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic.

Current Status

The outbreak has since spread to every province of mainland China as well as 114 other countries and regions, with more than 138 000 confirmed cases globally as of March 13, 2020. Of those cases there has been a little over 5,000 deaths. The positive news is nearly 70,000 people have been treated and recovered, the remaining cases from the tally above are in a pending recovery stage, as the protocol for recovery is 14 days. Though the World Health Organization has labeled it a pandemic, that does not necessarily mean it is lethal to all; it is not. Those with respiratory problems and those older people (with or with-out a medical issue) need to be cautious about interaction with others, as they are the most susceptible to this virus.

We have links to assist our members and visitors to gain more knowledge. You can find references and advice from the Missouri Department of Health & Social Services, along with a message from Director Randall Williams, MD; the Centers for Disease Control (CDC); a John’s Hopkins University “up to the minute” dashboard and much more. You will find our COVID-19 page under “COVID-19” in the menu bar next to “Home”.

We are working with our members, state government, Federal government and other health care associations to bring you the latest news and to do our best to keep all of the more than 22 million patients who have connected with MHC as safe as possible. Together we will get through this crisis as American always rallies in the face of adversity.

Sincerely,

Angie Bass, President and CEO

MO Dept. of Health and Senior Services

Update: New Criteria to Guide Evaluation and Laboratory Testing for COVID-19 at the Missouri State Public Health Laboratory

Read more at the MO DHSS Website

MO Department of Health and Senior Services updates on COVID-19 in Missouri. Check their website to stay informed about the virus in Missouri.

COVID-19 FAQs

What is COVID-19?

COVID-19 is a virus strain, first identified in Wuhan, Hubei Province, China, that has only spread in people since December 2019. Health experts are closely monitoring the situation because little is known about this new virus and it has the potential to cause severe illness and pneumonia in some people.

What are COVID-19 symptoms and how is it spread?

Symptoms of COVID-19 appear within two to 14 days after exposure and include

  • fever,
  • cough,
  • runny nose
  • difficulty breathing

Or at least two of these symptoms:

  • fever
  • chills
  • repeated shaking with chills
  • muscle pain
  • headache
  • sore throat
  • new loss of taste or smell

This virus is primarily spread through respiratory droplets, which means to become infected, people generally must be within six feet of someone who is contagious and come into contact with these droplets. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

How is COVID-19 treated?

Currently, there is no FDA approved medication for COVID-19. People infected with this virus should receive supportive care such as rest, fluids and fever control, to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions.

How can I best protect myself and family?

  • Wash your hands often with soap and water for at least 15-20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact (within 6 feet) with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Standard household cleansers and wipes are effective in cleaning and disinfecting frequently touched objects and surfaces.
  • It’s currently flu and respiratory disease season and CDC recommends getting vaccinated, taking everyday preventive actions to stop the spread of germs, and taking flu antivirals if prescribed.

Who is at higher risk of serious illness from COVID-19?

Early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness including older adults, and people who have serious chronic medical conditions like heart disease, diabetes, and lung disease.

Essential Health Benefit Coverage FAQs

Do the Essential Health Benefits (EHB) currently include coverage for the diagnosis and treatment of COVID-19?

Yes. EHB generally includes coverage for the diagnosis and treatment of COVID-19. However, the exact coverage details and cost-sharing amounts for individual services may vary by plan, and some plans may require prior authorization before these services are covered. Nongrandfathered health insurance plans purchased by individuals and small employers, including qualified health plans purchased on the Exchanges, must provide coverage for ten categories of EHB.1 These ten categories of benefits include, among other things, hospitalization and laboratory services. Under current regulation, each state and the District of Columbia generally determines the specific benefits that plans in that state must cover within the ten EHB categories. This standard set of benefits determined by the state is called the EHB-benchmark plan. All 51 EHB-benchmark plans currently provide coverage for the diagnosis and treatment of COVID19.2

Many health plans have publicly announced that COVID-19 diagnostic tests are covered benefits and will be waiving any cost-sharing that would otherwise apply to the test. Furthermore, many states are encouraging their issuers to cover a variety of COVID-19 related services, including testing and treatment, without cost-sharing, while several states have announced that health plans in the state must cover the diagnostic testing of COVID-19 without cost-sharing and waive any prior authorization requirements for such testing.

Is isolation and quarantine for the diagnosis of COVID-19 covered as EHB?

All EHB-benchmark plans cover medically necessary hospitalizations. Medically necessary isolation and quarantine required by and under the supervision of a medical provider during a hospital admission are generally covered as EHB. The cost-sharing and specific coverage limitations associated with these services may vary by plan. For example, some plans may require prior authorization before these services are covered or may apply other limitations. Quarantine outside of a hospital setting, such as a home, is not a medical benefit, nor is it required as EHB. However, other medical benefits that occur in the home that are required by and under the supervision of a medical provider, such as home health care or telemedicine, may be covered as EHB, but may require prior authorization or be subject to cost-sharing or other limitations.

When a COVID-19 vaccine is available, will it be covered as EHB, and will issuers be permitted to require cost-sharing?

A COVID-19 vaccine does not currently exist. However, current law and regulations require specific vaccines to be covered as EHB without cost-sharing, and before meeting any applicable deductible, when the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommends them. Under current regulations, if ACIP recommends a new vaccine, plans are not required to cover the vaccine until the beginning of the plan year that is 12 months after ACIP issues the recommendation. However, plans may voluntarily choose to cover a vaccine for COVID-19, with or without cost-sharing, prior to that date.

In addition, as part of a plan’s responsibility to cover prescription drugs as EHB, as described above to cover ACIP-recommended vaccines, if a plan does not provide coverage of a vaccine (or other prescription drugs) on the plan’s formulary enrollees may use the plan’s drug exceptions process to request that the vaccine be covered under their plan, pursuant to 45 CFR 156.122(c).

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