StayWell Guam Inc.

StayWell continuously monitors the news and updates from Guam & CNMI Public Health, Department of Health, World Health Organization, the Center for Disease Control, and other agencies regarding COVID- 19.

Your coverage will be determined based on the type of services that were performed.

Yes, however, the test must be ordered by a licensed provider. Other guidelines for coverage include:

• Must be approved, cleared, or authorized by the US FDA.
• Must meet testing guidelines of US CDC and performed in coordination with Guam/CNMI Public Health.
• Must be deemed medically appropriate and ordered by an individual's licensed attending physician or authorized health care provider in accordance with accepted standards of current medical practice.
• Must not be payable by Public Health or other health programs.
• Must be billed correctly with supporting documents.
• No Prior Authorization is needed for this testing.

In compliance with the Families First Law, copay/co-insurance/deductible applications will be waived until further notice for COVID-19 testing and the associated visit.

StayWell will cover, without copay/coinsurance/deductible applications, diagnostic tests that are ordered by an individual's licensed attending physician or authorized health care provider and are medically necessary. StayWell generally will not cover a COVID-19 diagnostic test performed at the direction of a member's employer in order to obtain or maintain employment or to perform the member's normal work functions or for return to school or recreational activities, or for travel and quarantine clearance except as required by law.

StayWell will cover, without copay/coinsurance/deductible applications, antibody tests that are ordered by an individual's licensed attending physician or authorized health care provider and are medically necessary. StayWell generally will not cover a COVID-19 antibody (serological) test for the purpose of returning to work or school or for general health surveillance or self-surveillance or self-diagnosis, except as required by law.

No, StayWell will only cover COVID-19 tests that have been ordered by an individual's licensed attending physician or authorized health care provider.

Testing is primarily for those exposed to the virus or showing symptoms. Your health care provider will decide if you need a test based on your exposure risk, symptoms, and guidance from the CDC. The test has to be medically necessary and appropriate and ordered by a licensed attending physician or authorized health care provider for StayWell to cover it.

Coverage for treatment of COVID-19 illness will be subject to standard Plan co-pay/co-insurance/deductible, similar to coverage for treatment of non-COVID-19 illness.

COVID-19 testing is available at the Department of Public Health and Diagnostic Laboratory Services (DLS).

The time it takes to get results varies. It depends on where you get your test done. Some sites can test samples on-site and have results within hours depending on the type of test used. Other sites have to send testing samples to an outside laboratory for analysis. This process may take 2-5 days or more once the laboratory receives the samples.

Telemedicine is not a covered benefit under the health plan. However, during this pandemic, StayWell will cover certain Telehealth services. Telehealth includes an over-the-phone consultation with your doctor. StayWell encourages you to utilize Telehealth services before going to your doctor to ensure you need to be seen during this public health emergency.

StayWell is no longer offering an early refill on medications at this time. StayWell will monitor for the need and adjust accordingly.

For as long as premiums are paid, and you remain eligible for the plan, your benefits and coverage remain the same, with the exception of the temporary benefits. For specific benefits and coverage questions, you may call our office at 671-477-5091.

Testing is only one way to reduce the spread of the COVID-19 virus. You can use other measures (e.g., enhanced personal hygiene, use of facial coverings, and social distancing) to help slow the spread and the need for testing.

COVID-19 testing after completing quarantine generally is not recommended. StayWell will cover the test if deemed medically appropriate and ordered by an individual's licensed attending physician or authorized health care provider in accordance with accepted standards of current medical practice.

In December 2020, the U.S. Food and Drug Administration (FDA) provided the Emergency Use Authorization (EUA) for the national distribution of the COVID-19 vaccine. Vaccines will be released in phases, beginning with priority populations determined by the Centers for Disease Control (CDC) and Guam & CNMI Public Health.

Yes, StayWell will cover, without copay/coinsurance/deductible, approved COVID-19 vaccines at no cost to you. The federal government is currently covering the cost of the vaccine, and StayWell will cover the cost of administering the vaccine when not covered by Guam & CNMI Public Health or any other organization or agency. StayWell will cover the cost of any US FDA COVID-19 approved vaccine and administration when not covered by Guam & CNMI Public Health or any other organization or agency.

No. StayWell members will not have to pay any out-of-pocket costs to receive an approved COVID-19 vaccine. This means you should not receive a bill for the COVID-19 vaccine.

StayWell will follow the guidance provided by the CDC, FDA, and Guam & CNMI Public Health regarding the eligibility to receive the vaccine. Due to the vaccine's current limited supply, the vaccine will be distributed in phases, and the Guam & CNMI Public Health is prioritizing the vulnerable populations to receive it first. Talk with your doctor or pharmacist about when it is the right time for you to get vaccinated. You may also talk with your doctor or pharmacist about the recommended age requirement and dosing schedule for the vaccine being given. As the vaccine supply and distribution increases, more people will be able to get the vaccine.

While you wait for your turn to be vaccinated, and even after you have been vaccinated, StayWell encourages you to keep doing your part to protect yourself and our community. The best way you can do this is to:

• Must be approved, cleared, or authorized by the US FDA.
• Must meet testing guidelines of US CDC and performed in coordination with Guam/CNMI Public Health.
• Must be deemed medically appropriate and ordered by an individual's licensed attending physician or authorized health care provider in accordance with accepted standards of current medical practice.
• Must not be payable by Public Health or other health programs.
• Must be billed correctly with supporting documents.
• No Prior Authorization is needed for this testing.