Updated Feb. 4, 2022
Does my insurance cover COVID-19 testing, treatment, and vaccine?
Wellfleet will cover the following COVID-19 tests at no cost to the member under the following conditions:
To detect active COVID-19 disease:
Antigen test (on-site rapid screening and in-lab test) OR
PCR (Polymerase Chain Reaction) test (in-lab test)
Either of the above tests will be covered under the following conditions:
An FDA-approved test is utilized as ordered by a qualified provider (“Provider”) to diagnose and/or treat a COVID-19 disease, AND the member meets CDC/state requirements for testing. The testing is performed on asymptomatic members as a result of an individualized clinical assessment, and not part of a surveillance testing program for groups of asymptomatic members.
State regulations mandate coverage of testing without the above requirements being met.
To detect late active or past COVID-19 disease:
Antibody (serology) test (in-lab test)
The above test will be covered under the following conditions:
The test is medically necessary AND
The member meets CDC/state requirements for testing AND
An FDA approved test is utilized as ordered by a qualified provider (“Provider”)
State regulations mandate coverage of testing without the above requirements being met.
Please note that “surveillance” testing is not covered – this would be any testing done for any purpose other than diagnosing someone for COVID-19 (employment, public health surveillance, groups of asymptomatic members).
If requesting personal reimbursement, please supply a copy of the receipt.
Over-the-Counter (OTC) Testing Reimbursement
Effective for tests purchased on or after 1/15/2022, Wellfleet will cover over the counter (OTC) COVID-19 tests without a doctor order limited to eight (8) tests per calendar month per covered member with no member cost share.
The test must be purchased for personal use, not for employment purposes, has not been (and will not be) reimbursed by another source, and is not for resale. This federal regulation applies to both fully-insured and self-funded ACA compliant plans.
The following documentation must be submitted for reimbursement:
- Completed COVID-19 OTC Test Reimbursement Form | Download »
- Receipt from seller, documenting date of purchase and price
- UPC label from COVID-19 test box
Where can I get a free test?
Every home in the U.S. is eligible to order four free at-home COVID-19 tests completely free. Orders will usually ship in 7-12 days. Order your tests by visiting www.covidtests.gov.
Wellfleet is waiving out-of-pocket costs for all COVID-19 treatment until further notice. We’ll waive all co-pays, deductibles and co-insurance. Similar to a preventative visit, like your annual physical, you’ll have no out-of-pocket costs for your treatment.
For additional coverage information specific to your school, visit your school’s page on WellfleetStudent.com or call our dedicated Coronavirus hotline – (833) 343-5338. Hours of operation are Monday – Friday 8:30 a.m. – 5:00 p.m.
Wellfleet Student members should contact their student health care centers or visit their school’s page on WellfleetStudent.com to find a provider. When contacting, be sure to advise them of your recent travel and symptoms and try to avoid contact with others.
This applies to plans underwritten by Wellfleet Insurance carriers.
Wellfleet will waive all out-of-pocket costs for the COVID-19 vaccine. Student members will not be responsible for co-pays, deductibles and co-insurance regardless of which FDA approved vaccine they receive.
For distribution information, please check the U.S. Department of Human Services site, your state or city website. For more information on the dosing, administration, and possible side effects of approved COVID-19 vaccines, please visit https://www.cdc.gov/vaccines/covid-19/info-by-product/index.html.
Wellfleet Rx members will have no cost-share for Pfizer’s PaxlovidTM and Merck’s molnupiravir for the treatment of mild-to-moderate coronavirus disease (COVID-19), when prescribed by a licensed health care provider. The FDA recommends initiating as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.
Prescriptions can be filled at participating pharmacies. Wellfleet Rx members can find participating pharmacies by visiting wellfleetrx.com/students/pharmacy-network/.
For additional coverage information specific to your plan, visit your school’s page on WellfleetStudent.com or call our dedicated Coronavirus hotline – (833) 343-5338. Hours of operation are Monday – Friday 8:30 a.m. – 5:00 p.m.
I believe I may have contracted COVID-19, what tests should I be asking for?
If you believe you’re exhibiting signs of COVID-19, you should contact your Provider to set up a COVID-19 test. You’ll have no out-of-pocket costs for your testing, or treatment costs related to COVID-19.
How do I file a claim for payment?
If you receive treatment, please submit a completed claim form along with a copy of the bill to Wellfleet. Claims forms are located at Wellfleetstudent.com/forms or you can download the form by clicking here. Please call (833) 343-5338 for assistance.
What if I need a prescription refill?
Wellfleet will continue to assess recommendations, guidance and requirements and may amend standard protocol based on state-specific regulations. Plans in certain states may allow for greater days supplies to be covered.
Any pharmacy copays for COVID-19 treatment should be submitted to Wellfleet for reimbursement.
Please call 833-343-5338 for assistance.
My campus and/or Student Health Center is closed. Where can I go to get tested or treatment for COVID-19?
For student members who are typically required to report to their Student Health Center for care or referrals, this requirement is waived. They can seek testing or treatment for the Coronavirus COVID-19 at any local medical facility. This includes emergency room, urgent care and office visits. There is no need for referral and there will not be any applicable out-of-pocket fees for testing or treatment related to COVID-19.
Wellfleet is waiving out-of-pocket costs for all COVID-19 testing, treatment, and vaccination until further notice. We’ll waive all co-pays, deductibles and co-insurance. Similar to a preventative visit, like your annual physical, you’ll have no out-of-pocket costs for your treatment. This applies to plans underwritten by Wellfleet Insurance carriers.
For more information call our dedicated Coronavirus hotline – (833) 343-5338. Hours of operation are Monday – Friday 8:30 a.m. – 5:00 p.m.
Can I utilize telehealth options?
Yes. If you believe you are sick or have the Coronavirus COVID-19, this is a great option to reduce your exposure to others.
You can find the services offered by visiting your school’s page on Wellfleetstudent.com. The options available will vary by school. To locate your services, once on your school’s page, click on the “Find health professionals” button. Available options can include:
- Locating an in-network provider
- Locating an in-network pharmacy
- 24/7 Nurseline: Talk to a registered nurse
If you’re unsure of your coverage options or have any questions, simply call or dedicated Coronavirus hotline – (833) 343-5338 or contact your school’s student health center.
I have questions about Coronavirus. What number should I call?
We’ve set up a dedicated Coronavirus hotline – (833) 343-5338. Hours of operation are Monday – Friday 8:30 a.m. – 5:00 p.m.
What is Coronavirus COVID-19?
Coronavirus COVID-19 is a respiratory illness that can spread from person to person. A novel coronavirus called SARS-CoV2 is the cause of COVID-19 and the outbreak first recognized in China in December 2019.
How long is the incubation period?
The incubation period is estimated at approximately 4-7 days. Data for human infection with other coronaviruses (e.g., MERSCoV, SARS-CoV) suggest that the incubation period may range from 2-14 days.
How is Coronavirus COVID-19 spread?
Based on what is currently known about Coronavirus COVID-19 and what is known about other coronaviruses, spread was thought to occur mostly from person-to-person via respiratory droplets among close contacts. Additionally, studies have shown spread can happen through fecal contamination.
What are the symptoms of Coronavirus COVID -19
The clinical spectrum of Coronavirus COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness to severe pneumonia with respiratory failure and septic shock. Frequently reported signs and symptoms include:
- Myalgia or fatigue
- Shortness of breath
- Loss of smell or taste
There have been reports of asymptomatic infection with COVID-19.
How many cases of Coronavirus -COVID-19 are reported worldwide?
For the latest information, view the World Health Organizations Situation report. It is updated daily and includes information on total number or confirmed cases by country.
What is the best way to prevent the spread of the Coronavirus COVID-19?
- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Cover your mouth and nose when you cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces.
- Avoid close contact with people who are sick.
- Stay home when you’re sick.
- See your doctor if you think you’re ill.
I’m symptomatic. Should I stay home?
Yes, except to seek medical care, when telehealth options are not available. If you’re sick with COVID-19 or believe you might have COVID-19, it’s important that you stay home and contact your doctor or local medical facility immediately for assistance. They can advise you how to get testing and treatment, as well as how to prevent spreading the virus with those around you. The Centers for Disease Control and Prevention also offers a guide on what to do if your sick.
What is the best way to stay updated?
Because this is an evolving situation, we’ll keep our communications updated, and encourage you to check back often.
We also recommend visiting your school’s student health center page and The Centers for Disease Control website for the most up-to-date information.