Frequently Asked Questions
At this time, StayWell is continuing to monitor how the treatment program will be administered and how members will be affected, and will provide necessary updates on coverage.
On December 22, US FDA authorized Pfizer's antiviral pill, Paxlovid, to treat COVID-19 under EUA. Paxlovid is the first antiviral COVID-19 pill authorized in the US for people who test positive for SARS-CoV-2 to take at home before their condition requires hospitalization. High-risk individuals (those at least 60 years old or have a serious underlying condition) who are at least 12 years old and weigh at least 88 pounds are eligible for this treatment with a prescription. Paxlovid combines a new antiviral drug (nirmatrelvir) with a previously approved medication (ritonavir); these drugs are co-packaged for oral administration twice-a-day for five days. Although the Biden Administration secured 10 million treatment courses of Paxlovid, only 65,000 treatment courses are available immediately. By the end of January, the supply is estimated to expand to 250,000 treatment courses. On December 23, the US FDA issued an EUA for a second oral antiviral pill, Merck's molnupiravir, for those whom alternative COVID-19 treatment options authorized by the US FDA are not accessible or clinically appropriate. To be eligible for this prescription, adults at least 18 years old must have a positive direct SARS-CoV-2 viral test result and be considered high risk for progression to severe COVID-19, including hospitalization or death.
Merck has an agreement with the Federal government to supply 3.1 million courses of molnupiravir to the EUA. As with Paxlovid, supplies for molnupiravir are also anticipated to be limited initially. Like COVID-19 vaccines, the Federal government procured these oral antiviral drugs to be available to applicable patient populations free of charge during the COVID-19 Public Health Emergency at certain pharmacies. However, this does not include payment of a dispensing fee to pharmacies.
For more information, please visit:
Commissioner, O. of the. (2021, December 22). Coronavirus (COVID-19) Update: FDA Authorizes First Oral Antiviral for Treatment of COVID-19. FDA. Reference link: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-covid-19.
Commissioner, O. of the. (2021b, December 23). Coronavirus (COVID-19) Update: FDA Authorizes Additional Oral Antiviral for Treatment of COVID-19 in Certain Adults. FDA. Reference link: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-treatment-covid-19-certain.
Division, N. (2021, June 9). Biden Administration announces U.S. government procurement of Merck’s investigational antiviral medicine for COVID-19 treatment. HHS.gov. Reference link: https://www.hhs.gov/about/news/2021/06/09/biden-administration-announces-us-government-procurement-mercks-investigational-antiviral-medicine-covid-19-treatment.html.
Division, N. (2021b, November 18). Biden Administration Secures 10 Million Courses of Pfizer’s COVID-19 Oral Antiviral Medicine as Additional Tool to Reduce Hospitalizations and Save Lives. HHS.gov. Reference link: https://www.hhs.gov/about/news/2021/11/18/biden-administration-secures-10-million-courses-pfizers-covid-19-oral-antiviral-medicine-as-additional-tool-reduce-hospitalizations-save-lives.html.
StayWell encourages you to keep doing your part to protect yourself and our community. The best way you can do this is to:
- Wear a face mask
- Continue social distancing
- Wash your hands frequently
- Get vaccinated
Yes, StayWell has extended the enhanced benefit o¬ffering under the StayWell Temporary Telehealth Program (STEP) until the Public Health Emergency Declaration due to COVID-19 has been resolved or new regulations have been set out by the Federal Government. This program allows you to continue your healthcare without the need for face-to-face provider-patient consultation as deemed appropriate by your provider. During the emergency period, StayWell may waive or modify certain telehealth policy exclusions and requirements by providing coverage for telephone evaluation involving audio-video interaction between the qualified clinician provider and StayWell member.
Qualified Clinicians are StayWell-credentialed physicians, nurse practitioners, physician assistants and mental health providers in Guam and CNMI.