Monkeypox (MPX) and Coronavirus (COVID-19)
Monkeypox (MPX)
On Aug. 4, 2022, the federal government declared a public health emergency in response to the monkeypox, also known as MPX, outbreak. Alignment Health Plan is monitoring the MPX outbreak closely and following CDC and local public health guidelines.
The key to containing the outbreak is to limit the spread – if you think you have symptoms of MPX, please contact your health care provider for advice, testing, and medical care. Until you receive your test result, wash your hands often, isolate yourself from others as much as possible and, if you must be around others, wear a mask.
We believe the virus is predominantly spread by close contact with skin lesions or contaminated linens but can also spread through droplets when someone infected sneezes or coughs.
For additional information on the current state of the monkeypox outbreak, please see the "Helpful Resources" below.
Helpful Resources:
2022 Monkeypox Outbreak
Monkeypox Signs and Symptoms
U.S. Department of Health and Human Services Monkeypox Response
Coronavirus (COVID-19)
If you have questions about the COVID-19 coronavirus, you're not alone. We want to make sure our members have the latest updates to stay safe and informed during this time.
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Information for members about COVID-19
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A The most common symptoms of patients with COVID-19 are fever, cough and shortness of breath, but occasionally symptoms are more severe. There is currently no cure for this virus. If you are an Alignment Health Plan member and develop these or any flu-like symptoms, please call Teladoc at 1-844-227-6955 or log in to your online member account. If you have not yet set up access to a virtual doctor, call our ACCESS On-Demand Concierge team 24 hours a day, seven days a week at 1-833-242-2223, TTY 711.
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A Alignment Health Plan is taking action to ensure that cost does not inhibit our members' access to medically necessary screening and testing for COVID-19. As such, Alignment Health Plan is waiving cost-sharing (including, but not limited to, copays, deductibles or coinsurance) to zero for medically necessary screening and testing for COVID-19. The Social Security Administration has also announced that Social Security and Supplemental Security Income (SSI) benefit payments will continue to be paid on time during the COVID-19 pandemic.
If you are an Alignment Health Plan member and are unable to access care from your doctors or other health care providers due to issues related to COVID-19, please know:
- You may receive medically necessary services from any available Medicare-certified provider or facility. This includes providers and facilities outside the medical group that you are assigned to with Alignment Health Plan.
- You do not need to obtain a prior authorization from your medical group or Alignment Health Plan in order to receive medically necessary services. Please be sure to use only Medicare-certified providers and facilities. You may do this by asking the provider or facility whether it participates in the Medicare program, which it must do to be Medicare-certified.
- You will pay the same amount as you would pay for receiving the same services through your regular medical group and/or doctor when receiving care from out-of-network Medicare-certified providers and facilities.
- We are waiving prescription refill limits so that you can receive the prescriptions you need when you need them.
- Some restrictions on home or mail delivery of prescription drugs are being relaxed.
- We are expanding access to certain telehealth services so you can connect with a doctor in the safety and comfort of your own home.
- If you are experiencing a medical emergency, please call 911 or go to your nearest hospital emergency room.
- For non-life-threatening care, please contact your primary care doctor (listed on your member ID card), contact Teladoc at 1-844-227-6955 or call our ACCESS On-Demand Concierge team at 1-833-242-2223, TTY 711, so we can help you get the care and services you need. ACCESS On-Demand Concierge services are available 24 hours a day, seven days a week
Once the declared State of Emergency has ended, the temporary changes stated above will also end. Please check our website regularly for updates during this time. For more information about Alignment Health Plan's disaster policy, please click here.
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A Many Alignment Health Plan benefits are available from the comfort of home.
- Have your prescriptions delivered - We can help set up mail-order delivery of your prescription drugs. To speak with a pharmacist, call 1-844-227-7616, TTY 711, 24 hours a day, 7 days a week
- Order over-the-counter (OTC) items by phone or online - Members who have a monthly OTC allowance can order their items for mail delivery by visiting https://nationsotc.com/alignment and using the 19-digit card number on the back of their black ACCESS On-Demand Concierge card. CalPlus (HMO) 009 members can also order their OTC items by calling 1-844-286-2857, TTY 711, Monday-Friday, 8 a.m.-8 p.m. Pacific Time.
- Stay fit at home - Peerfit Move offers a variety of at-home video workouts. Log in to your Peerfit Move account and select "Videos." If you have not activated your Peerfit Move account, you can create one by clicking "Sign Up"
- Transportation - We encourage all of our members to practice "social distancing," but curb-to-curb, door-to-door, and wheelchair-accessible vehicle services are still available through our transportation line at 1-866-327-2247, TTY 711, Monday-Friday, 8 a.m.-6 p.m. Pacific Time
- Enjoy virtual companion care at home - For Alignment members who qualify for our companion care benefit, our Grandkids-on-Demand can now call and assist with ordering groceries online, refilling prescriptions, staying connected with friends and family and more. For details, call our ACCESS On-Demand Concierge team at 1-833-242-2223, TTY 711, 24 hours a day, seven days a week
Testing for COVID-19
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A There are three categories of COVID-19 tests:
- Antibody or Serology Tests: This is a blood test that can tell if a person has had COVID-19 in the past
- NAAT or PCR Tests: Nucleic Acid Amplification Tests (NAATs), which include polymerase chain reaction (PCR) tests, collect fluids from the respiratory tract and are considered the best test to diagnose COVID-19, but results can take more than 24 hours
- Antigen or Rapid Tests: This diagnostic test uses a swab to collect fluids from the nose or back of the throat and results are available quickly, but it is less sensitive than NAAT
Your Alignment Health Plan provider can guide you to the best test for your situation.
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A You should get tested for COVID-19 if you have COVID-19 symptoms, have been exposed to someone that is confirmed or suspected to have COVID-19, or if you are asked to do so by a health care professional or public health official.
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A COVID-19 testing is available at:
- Health plan clinics
- In-network primary care provider offices and in-network hospitals
- Community health centers
- In-network pharmacies
Please contact your ACCESS On-Demand Concierge team at 1-833-242-2223, TTY 711, 24 hours a day, seven days a week if you need assistance finding a testing center near you.
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A Some COVID-19 tests may not be covered by Alignment Health Plan. Alignment Health Plan members may be eligible for a free COVID-19 antigen or NAAT test if they meet the following criteria:
- Test was ordered by a physician or other licensed health care professional AND
- Test has received FDA approval or Emergency Use Authorization AND
- Any of the following:
- You have symptoms of COVID-19, OR
- You are asymptomatic but have had a known exposure to someone with suspected or confirmed COVID-19, OR
- You need to test before hospital admission or before a medical procedureAlignment Health Plan members may be eligible for free antibody testing if they meet the following criteria:
- Test is ordered by a physician or other licensed health care professional AND
- Test has received FDA approval or Emergency Use Authorization
- You have complications of COVID-19 illness, such as multisystem inflammatory syndrome (MIS) or other post-COVID conditions that persist four or more weeks after initial infection
COVID-19 testing for any situation other than those listed above, may not be covered by your plan. These non-medically necessary situations include (but are not limited to) testing for:
- Employment, pre-employment or return to work
- School purposes and physicals
- Entertainment (e.g., prior to a concert or sporting event)
- General population or public hearing screening
- Travel purposes
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A As of April 4, 2022, Medicare beneficiaries can get up to eight free COVID-19 over-the-counter antigen tests each month from pharmacies at more than a dozen national and regional chain retailers. A partial list of participating pharmacies can be found at https://www.medicare.gov/medicare-coronavirus. These tests are paid for by Medicare so make sure you bring your red, white, and blue Medicare card to get your free tests at a pharmacy.
You can also order 16 free COVID-19 at-home tests for your household at https://www.covidtests.gov/.
For more information about benefits, Alignment Health Plan members can log in to their online member account, available 24 hours a day, seven days a week, or by calling our ACCESS On-Demand Concierge at 1-833-242-2223, TTY 711. Our phone lines may have longer wait times than usual. For your convenience, you can also send us a secure message via your online member account.
*For accommodations of persons with special needs, call 1-855-979-2247, TTY 711.