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Access to care and coverage

AllWays Health Partners is committed to ensuring timely access to critical health care services for COVID-19 that our members may need during this public health emergency.

We have put in place coverage policies for COVID-19 vaccines, testing and treatment, based on public health recommendations and industry guidelines that are informed by the best data and medical evidence available.

To expedite access to critical health care services for COVID-19 in accordance with guidelines from state and federal agencies, our coverage criteria--which may be updated in response to an evolving situation--includes:

  • Removing cost-sharing (copayments, deductibles, or coinsurance) for medically necessary outpatient and inpatient COVID-19 testing and treatment at in-network or out-of-network providers, urgent care centers, emergency departments, hospitals, and other facilities for the duration of the public health emergency.


Note
: Employers that are self-insured may have different cost sharing for these services. Please visit the AllWays Health Partners member portal or call the Customer Service number on the back of your member ID card if you have questions about your plan.

COVID-19 vaccines

AllWays will covers the administration of COVID-19 vaccines at no cost to our members. The COVID-19 vaccines that are being administered have received Emergency Use Authorization (EUA) or full approval from the Food and Drug Administration (FDA).

Learn about the safety and effectiveness of the vaccines, the truth behind several common vaccine myths, and where you can schedule a vaccine appointment in our guide to common COVID-19 vaccine questions.

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COVID-19 testing

Testing is an important way to prevent the spread of COVID-19. AllWays Health Partners has ensured timely access to critical health care services for our members throughout the pandemic and remains committed to providing a variety of options to make COVID-19 testing available. Visit our FAQs on testing to learn more about these options and our coverage policies.

Frequently asked questions

COVID-19 vaccines

People ages 5 and older who live, work, or study in Massachusetts are eligible to receive a COVID-19 vaccine. People ages 5-17 can receive the Pfizer vaccine and people age 18 and older can receive any vaccine. You can find a vaccine location near you on Mass.gov/covid-19-vaccine.

The CDC also recommends a booster shot for individuals age 12 and older. Individuals who are 12-17 years old can get a Pfizer booster. Individuals 18 and older can get any booster. Additionally, individuals ages 50 or older can now get a second booster at least 4 months after their first booster. For the latest guidance on booster shots and eligibility, please visit Mass.gov.

To see the latest COVID-19 vaccination sites and schedule an appointment please visit Vaxfinder.mass.gov. Walk in or same-day appointments are also available at local pharmacies such as CVSWalmart, and Walgreens.

For members who require in-home vaccinations because they are unable to leave their home to get to a vaccination site, please visit the state’s COVID-19 Homebound Vaccination Program page at Mass.gov/covidvaccine.

Ahead of your appointment, the latest clinical guidelines and what to expect at your vaccination appointment is available from the CDC.

Children ages 5 to 17 who live or go to school in Massachusetts are now eligible to get the Pfizer vaccine. Appointments for children ages 5-17 at hundreds of sites across the Commonwealth can be found on VaxFinder.mass.gov. For medical questions about vaccinating your child, we encourage you to contact your child’s health care provider. You can also learn more about the latest guidance on the COVID-19 vaccine for children and teens from the CDC.

AllWays Health Partners will cover the administration of COVID-19 vaccines at no cost to our members.

The COVID-19 vaccines that are being administered have received Emergency Use Authorization (EUA) or full approval from the Food and Drug Administration (FDA). EUA is a designation issued by the FDA to facilitate the availability and use of medical actions, including vaccines, during public health emergencies.

The COVID-19 vaccines that are being administered have proven to be extremely effective. Clinical trials were conducted to evaluate the safety of these vaccines, with thousands of participants across gender, age, race, and ethnicity. Visit the CDC to learn more about the safety and benefits of the COVID-19 vaccines.

The CDC has shared guidance on how to protect yourself and others for people who are fully vaccinated.

COVID-19 testing

Yes, AllWays Health Partners covers all medically necessary COVID-19 testing for the duration of the public health emergency.

We also offer access to at-home COVID-19 tests at no cost to members. More information is below.

Beginning January 15, 2022, members of AllWays Health Partners have access to up to 8 FDA-approved at-home COVID-19 tests per member per month in accordance with federal guidance. This policy will remain in effect for the duration of the federal public health emergency.

  • Commercial members* can obtain these tests at the pharmacy counter of all participating retail pharmacies at no cost at the time of purchase. We offer members thousands of participating pharmacies nationwide, including CVS Pharmacy®, independent pharmacies, and chains like Walgreens® and Rite Aid®. There are several online ordering options through CVS Pharmacy®. Many pharmacies also offer delivery or shipping direct to homes. Commercial members who pay out-of-pocket can also submit for reimbursement through caremark.com. Please note that reimbursements will be up to $12 per individual test ($24 for box of 2 tests). Remember to save a copy of your receipt.
  • My Care Family members can obtain these tests at all participating Massachusetts retail pharmacies at no cost at the time of purchase. My Care Family members should visit the pharmacy counter for more information on obtaining a MassHealth covered test at no cost.

*Employers whose pharmacy benefit is not covered through AllWays Health Partners may have different processes in place for their members. Please consult with your pharmacy benefits manager.

COVID-19 testing sites are located across the state. These sites include rapid antigen tests and PCR tests. Visit Get Tested MA on Mass.gov for the latest guidance on COVID-19 testing and to find a testing location near you.

COVID-19 care and coverage

If you have questions about insurance coverage for COVID-19, please call the number on the back of your ID card for a prompt that will take you to a dedicated phone line. For medical questions about testing, treatment, or vaccines, we recommend that you contact your doctor or another health care professional.

My Care Family coverage policies are aligned with the most up-to-date guidelines from MassHealth. For more information on MassHealth, you can visit Mass.gov.

AllWays Health Partners commercial members have access to On Demand telemedicine services for virtual urgent care. If you are an AllWays Health Partners member, you can log in to the member portal for instructions to get started.

In addition, we are offering free telemedicine resources to our provider partners to protect providers and patients from exposure while allowing for the continuation of care. Please contact your provider to learn more about the telemedicine options that they have available.

For My Care Family members, telemedicine services are covered when medically necessary and clinically appropriate and to access out-of-network providers for the initial COVID-19 test or treatment when no in-network providers are available, in accordance with MassHealth guidance.

The Massachusetts Health Connector offers coverage resources and support to uninsured residents. Learn more at MAhealthconnector.org.

Please note that individuals are encouraged to update their income information through the Health Connector website to see if they’re eligible for MassHealth benefits or additional support.

Mental health is a key part of our overall well-being—and AllWays Health Partners here to help. Visit our mental health resources page to find useful resources to help you get the support you need.

For more information

Visit our COVID-19 Resource Center to find resources for employers and our provider FAQ.

Where can I get updates on COVID-19?

The best source for credible news on COVID-19 is the CDC. You can check their website to find the latest updates and recommendations, including resources like:

The Massachusetts Department of Public Health is also a helpful resource for more of the latest updates.

 

Contact us

Our Customer Service team is here to answer any of your questions Monday through Friday, 8:00 AM to 6:00 PM and Thursdays 8:00 AM to 8:00 PM.

Call866-414-5533
Emailcustomerservice@allwayshealth.org 
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Get in touch with a Care Manager
Our Care Managers can help you navigate major life changes. If you are interested in learning more about how they can help, visit our care management page.