Coronavirus & Your Health Care

  • LifeWise wants to help you get the care you need during the pandemic and for the coronavirus that causes COVID-19.

    Vaccines for COVID-19

    Oregon COVID-19 vaccination roll-out is in progress. The FDA and a national scientific safety work group has recommended approval of the vaccines currently in use.

    LifeWise follows the guidance of the state and federal governments, plus the FDA and CDC, on the COVID-19 vaccines and is ready to begin processing claims for the administrative fees. For up-to-date information, go to:

    Centers for Disease Control and Prevention (CDC)
    Oregon Department of Health COVID Information (ODOH)

    Who can get the vaccine?

    Vaccine availability is changing as more vaccines are being distributed to the states. If you aren’t a resident of Oregon, check every state’s vaccine plan. Further testing of the current approved vaccines is necessary before children under 16 can get the vaccine.

    How do Oregon’s vaccine phases and tiers work?

    Get Oregon’s phases and timing, which differs slightly from CDC.

    Here are resources for finding vaccines in your area:

    • Get Vaccinated Oregon: A new tool that answers basic questions about vaccine eligibility and vaccinations in your county.
    • Vaccine Information Chatbot: Residents of Clackamas, Columbia, Marion, Multnomah or Washington County may schedule vaccine appointments through the Vaccine Information chatbot.
    • 211: Text ORCOVID to 898211 (English and Spanish only) or email ORCOVID@211info.org for vaccine registration information. Or call 211 or 866-698-6155 (from 6 a.m. to 7 p.m. daily).
    • Licensed senior facilities: Residents and staff at most licensed facilities for older adults and people with disabilities are receiving on-site vaccinations through pharmacies enrolled in federal vaccination programs.
    • The Federal Retail Pharmacy Program: Eligible Oregonians can make vaccination appointments directly at these retailer websites:

    How much will it cost?

    The government has mandated that the cost of the vaccine will be $0 for everyone in the U.S. Cost for administering the vaccine will be covered by insurance (or waived for those without coverage). Providers may bill an insurance company for administrative costs.

    Do I need a doctor's prescription to get the vaccine?

    You might need a doctor to prescribe the vaccine for certain phases. Check with your provider.

    Most states are now requiring proof of residency for any COVID vaccination. That may include a driver’s license or utility bill showing your current address.

    How COVID-19 care is covered

    LifeWise will waive copays, deductibles, and coinsurance for the following COVID-19 related support.

    • COVID-19 testing. If your doctor recommends COVID-19 testing, you can get the FDA-approved test without pre-approval.
    • COVID-19 related treatment (both inpatient and outpatient)
    • COVID-19 vaccine

    See the section with important dates for when some of these benefits will end.

    Virtual care options

    If you have COVID-19 symptoms or need care for mental health, a cold, allergies, a rash or other non-emergency situations, please use virtual visits or care first to avoid possible exposure. Many doctors and providers offer virtual visits during the pandemic or you can contact the 24-Hour NurseLine. Find care now.

    NOTE: Only in-person clinics or providers can diagnose or test for COVID-19.

    Medications

    We understand the need to fill your prescriptions without going out. You have options.

    We’ve lifted our refill-too-soon policy to make sure you have necessary medications on hand. Just tell your pharmacist you need more. There are some exceptions to this, so ask your pharmacist.

    You can also use mail order to get a 90-day supply of many medications.

    Important dates

    We follow state and federal law. As such, our coverage policies will change on these dates.

    Details Dates
    Antibody tests covered when done in an inpatient setting, late illness onset, or outpatient inflammatory syndrome in children. Cost shares waived if criteria met. (CDC and EEOC guidelines) Policy effective July 1, 2020 Cost share criteria through 4/21/2021
    Cost share waivers for FDA-approved COVID-19 diagnostic testing other virus/respiratory testing tied to a COVID-19 diagnosis (Federal Families First Act and CARES mandate) April 21, 2021
    Cost share waivers for treatment related to COVID-19 diagnosis is waived June 30, 2021

    Additional resources

    How to stay safe at the workplace, schools, and home
    How to know if you're high-risk and what to do

    Other health care questions

    Can I get tested?

    We understand you want to know if you’ve had COVID-19. A doctor must determine that you meet the criteria for testing based on Centers for Disease Control and Prevention guidelines and order testing.

    To avoid possible spread, you should not go to a lab for testing without an order from your doctor.


    I wasn’t tested for COVID. Is my appointment still covered in full?

    If your doctor doesn’t determine that you met the CDC criteria for COVID-19 testing and/or diagnosis, your regular cost shares (copay, coinsurance, and/or deductible) will be applied to your visit.


    Is drive-through testing covered?

    Your test is covered the same whether you’re in the car or in a lab.


    Are masks and supplies covered?

    Masks are typically not covered by your health plan nor an eligible expense for your health savings account. They may be flexible spending account or health saving account eligible if you have a letter of medical necessity from your healthcare provider.


    Is other help available?

    Oregon Coronavirus Response includes resources for residents, such as financial, food, housing, and wellbeing services, among others.