WTS Health Covid-19 Testing Policy

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• People who have symptoms of COVID-19
• People who have had close contact (within 6 feet of an infected person for a total of 15 minutes or more) with someone with confirmed COVID-19.
• People who have been asked or referred to get testing by their healthcare provider, local external icon or state health department.
• Not everyone needs to be tested. If you do get tested, you should self-quarantine/isolate at home pending test results and follow the advice of your health care provider or a public health professional.

Reference the CDC at:  https://www.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html

The key to the cost of your Covid-19 testing being covered by your insurance is that it is deemed Medically appropriate by your attending health care provider, in this case GoMed. Medically appropriate is defined as the individual has signs or symptoms of COVID-19 or has had known or suspected recent exposure to SARS-CoV-2. Please keep in mind that this does not include people that just want to be tested, require testing for travel, or require testing required to return to work.

Since the passage of the Families First Coronavirus Response Act (FFCRA) on March 18, most people should not face costs for the COVID-19 test or associated costs. Starting on March 18 and lasting for the duration of the public health emergency, all forms of public and private insurance, including self-funded plans, must now cover FDA-approved COVID-19 tests and costs associated with diagnostic testing with no cost-sharing, as long as the test is deemed medically appropriate by an attending health care provider. This includes high-deductible health plans and grandfathered plans, but does not apply to short-term, limited duration plans. As outlined by CMS in a series of FAQs, there is no limit on the number of COVID-19 tests that an insurer or plan is required to cover for an individual, as long as each test is deemed medically appropriate and the individual has signs or symptoms of COVID-19 or has had known or suspected recent exposure to SARS-CoV-2. Federal guidance does not require coverage of routine tests that employers or other institutions may require for screening purposes as workplaces reopen. 

Reference the CDC at: https://www.cms.gov/files/document/FFCRA-Part-43-FAQs.pdf

Testing could improve traveler safety.

The safest thing to do is to stay home, but if you do decide to travel, testing can help you do so more safely. You and your travel companions (including children) may feel well and not have any symptoms, but you can still spread COVID-19 to others in busy travel environments like in airports, and bus and train stations. You can also spread it to family, friends, and your community after travel. Testing does not eliminate all risk, but it can help make travel safer.

• If you are traveling, consider getting tested with a viral test 1-3 days before your trip. Also consider getting tested with a viral test 3-5 days after your trip and reduce non-essential activities for a full 7 days after travel, even if your test is negative. If you don’t get tested, consider reducing non-essential activities for 10 days after travel.
• Keep a copy of your test results with you during travel; you may be asked for them.
• Do not travel if you test positive; immediately isolate yourself, and follow public health recommendations.
• You may have been exposed to COVID-19 on your travels. You and your travel companions (including children) may pose a risk to your family, friends, and community. Regardless of where you traveled or what you did during your trip, take these actions to protect others from getting COVID-19 for 14 days after travel:
• Stay at least 6 feet/2 meters (about 2 arm lengths) from anyone who did not travel with you, particularly in crowded areas. It’s important to do this everywhere — both indoors and outdoors.
• Wear a mask to keep your nose and mouth covered when you are in shared spaces outside of your home, including when using public transportation.
• If there are people in the household who did not travel with you, wear a mask and ask everyone in the household to wear masks in shared spaces inside your home.
• Wash your hands often or use hand sanitizer with at least 60% alcohol.
• Avoid being around people who are at increased risk for severe illness.
• Watch your health: Look for symptoms of COVID-19, and take your temperature if you feel sick.

Reference the CDC at: https://www.cdc.gov/coronavirus/2019-ncov/travelers/travel-during-covid19.html

At WTS Health our Mobile Urgent Care providers evaluate a patients condition and symptoms as well as other factors in determining an effective treatment plan, all while visiting in your home.

A treatment plan for Covid-19 starts with effective testing. A WTS Health provider may require a test performed by them even if a home test or another clinic test has been performed and delivered a positive result.

Once a positive case of Covid has been identified and confirmed, the WTS Health provider will determine the best course of action for treatment of the symptoms as well as the Covid-19 virus itself.

These treatments may include a variety of options to treat the symptoms as well as to treat Covid-19 directly with antiviral options like Pfizer’s PAXLOVID and others. You and the provider will discuss and decide what treatment is best for you based on the FDA recommendations and medical history.   

Once a course of action has been developed, your provider will write the appropriate prescriptions and deliver them electronically to the pharmacy of your choice or when appropriate, will offer to dispense medications as available for a small additional cost.

From the U.S. Food and Drug Administration:

The U.S. Food and Drug Administration issued an emergency use authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use) for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kilograms or about 88 pounds) with positive results of direct SARS-CoV-2 testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. Paxlovid is available by prescription only and should be initiated as soon as possible after diagnosis of COVID-19 and within five days of symptom onset.

Paxlovid is not authorized for the pre-exposure or post-exposure prevention of COVID-19 or for initiation of treatment in those requiring hospitalization due to  severe or critical COVID-19. Paxlovid is not a substitute for vaccination in individuals for whom COVID-19 vaccination and a booster dose are recommended. The FDA has approved one vaccine and authorized others to prevent COVID-19 and serious clinical outcomes associated with a COVID-19 infection, including hospitalization and death. The FDA urges the public to get vaccinated and receive a booster if eligible. Learn more about FDA-approved or -authorized COVID-19 vaccines.

Paxlovid consists of nirmatrelvir, which inhibits a SARS-CoV-2 protein to stop the virus from replicating, and ritonavir, which slows down nirmatrelvir’s breakdown to help it remain in the body for a longer period at higher concentrations. Paxlovid is administered as three tablets (two tablets of nirmatrelvir and one tablet of ritonavir) taken together orally twice daily for five days, for a total of 30 tablets. Paxlovid is not authorized for use for longer than five consecutive days.

The issuance of an EUA is different than an FDA approval. In determining whether to issue an EUA, the FDA evaluates the totality of scientific evidence available and carefully balances any known or potential risks with any known or potential benefits of the product. Based on the FDA’s review of the totality of the scientific evidence available, the agency has determined that it is reasonable to believe that Paxlovid may be effective for the treatment of mild-to-moderate COVID-19 in authorized patients. The agency has also determined that the known and potential benefits of Paxlovid, when used consistent with the terms and conditions of the authorization, outweigh the known and potential risks of the product. There are no adequate, approved and available alternatives to Paxlovid for the treatment of COVID-19.

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-covid-19