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COVID-19 Health Benefits

Even during uncertain times, our top priority is the health and safety of our members, employees, communities, and those we work with and serve. With this in mind, please see the plan coverage for COVID-19 testing or treatment in the chart below.

Latest Coverage Information for COVID-19

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If I have questions regarding my health benefits and testing who should I contact?

For questions regarding health benefits and services you should contact our bilingual Member Services Department at 844.471.3244 or email memberservices@superiortpa.com.

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What benefit assistance can Superior offer health plan participants to help with COVID-19?

Effective retroactively to March 1 and through at least September 30, Superior has adopted the following plan benefit changes:

  • COVID-19 testing with a physician or physician's assistant order / prescription will be covered at 100% coverage with no deductible, coinsurance or co-payment.
  • Telehealth services for COVID-19 benefits reimbursed at 100% with no deductible, coinsurance or copayment required.
  • No pre-authorization of COVID-19 testing required but must be physician recommended.
  • One-time early refill for maintenance medications for all plan participants in order to be consistent with the days supply as allowed by their benefit plan (if they have refills remaining on file at a participating retail or mail-order pharmacy).

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What is the cost for a COVID-19 test or antibody test under my health benefit plan?

Your employer-sponsored health plan will waive the costs for COVID-19 testing. There will be no out-of-pocket costs to all eligible plan participants for FDA approved COVID-19 tests*. In addition, there are no out-of-pocket costs for health care provider visits (in and out of network), urgent care visits and emergency room visits that may results in the administration of the test. *Testing must be recommended by a medical professional.

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How do I obtain my COVID-19 test results from a Health & Wellness Center over the weekend?

Our Visalia Wellness Center is available Monday through Saturday from 8 a.m. to 2 p.m. to provide testing results for all regional wellness centers. Call 559.967.0147.

What should I do if I believe I may have come in contact with someone who has tested positive for COVID-19?

If you believe you may have come in contact with someone who has tested positive for COVID-19, contact the Superior Health and Wellness Centers by calling 877.877.7981.

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Is telemedicine an option to seek medical care for COVID-19?

If Teladoc is an offered benefit in your plan, telemedicine is an ideal option for seeking medical care regarding COVID-19. Teladoc, our telemedicine partner, can help answer questions about the disease, evaluate risk and provide support by phone or video. You can schedule an appointment by visiting teladoc.com or call 800.TELADOC.

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What if I need to refill my prescriptions?

OptumRx, our pharmacy benefit manager, is offering a one-time early refill for maintenance medications for all plan participants in order to be consistent with the days supply as allowed by their benefit plan (if they have refills remaining on file at a participating retail or mail-order pharmacy). To locate an in-network pharmacy nearest you visit optumrx.com.

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Can I request my prescriptions be delivered?

Please refer to your plan document to see if home delivery is available to you. If you have questions contact our Member Services team at 844.471.3244 or email memberservices@superiortpa.com.

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What happens if I lose my health benefits because my employer has closed the business and directed employees to “stay at home” to stop the spread of the COVID-19 virus?

Please visit Covered California to learn more about qualifying for special enrollment at healthforcalifornia.com/covered-california/life-events

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If I contract COVID-19 in the workplace and become ill, will my Health Benefits Plan cover my treatment and care?

If you contract COVID-19 in the workplace, between March 19, 2020 and July 5, 2020, there is a rebuttable presumption that you contracted the virus at your workplace. Therefore, you will be covered for your treatment and care by your employer's workers' compensation carrier.

It will be presumed to be work related for the purpose of awarding worker’s compensation benefits as long as the following requirements are met:

  • Employee tested positive within 14 days of having last worked for the employer.

  • The day on which employee worked for the employer was on or after March 19, 2020.

  • The employee’s place of employment was not the employee’s home or place of residence.

  • The diagnosis was made by a licensed and registered physician issued by the California Medical Board and that testing is further confirmed by further testing within 30 days of the date of diagnosis.

If your diagnosis of COVID-19 is determined not be covered by workers' compensation, your Health Benefits Plan will cover your treatment and care.

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If you have any questions regarding your health benefits, please contact our Member Services team at 844.471.3244 or email memberservices@superiortpa.com.