COVID-19 Frequently Asked Questions

Premium Payments for Life and other AMA-Sponsored Insurance Plans

‎Q. I am experiencing financial hardship due to the pandemic. What should I do?

A. The underwriters of the AMA-sponsored insurance plans have extended renewal premium payment periods to July 1, 2020, to ensure that impacted insureds continue to remain insured. If you have experienced a financial hardship as a result of COVID-19 or the Stay At Home orders and are having difficulty making premium payments, please contact us to discuss alternative payment options at 800-458-5736, Monday through Friday, 8:00 a.m. to 5:00 p.m., Central Time.

Pending Applications for Insurance Underwritten by New York Life Insurance Company

Q: I recently applied for insurance coverage, but I think I need to have labs done with a paramed.  How will that be done?   

A: The underwriting team at New York Life is working with their partners to ensure business continuity and safety during this time.

ExamOne, a Quest Diagnostics Company, provides Telephone Interview and Paramedical services for our applicants during the underwriting process. They are currently following the Centers for Disease Control and Prevention (CDC) guidelines for COVID-19. 

Their team has implemented a work from home policy and their call center remains at full capacity to complete interviews. Their collection network will proceed with examinations, using the same protocol as they do today which is handling every specimen with standard biohazard safety precautions as well as additional precautions. 

When a representative from Exam One contacts you to conduct a brief tele-interview, and schedule an appointment, they will ask you the following questions:

  • In the last 14 days have you exhibited signs of fever or respiratory distress, or had close contact with someone who has? 
  • In the last 14 days have you traveled to any Restricted Travel Area or taken a cruise, or had close contact with an individual who has? 
  • You can find a list of restricted travel locations here: https://wwwnc.cdc.gov/travel/notices 

If you answer yes to either question, you may be directed to delay scheduling the appointment for 14 days from diagnosis, contact or date of travel, and advised to contact the insurance company. 

Disability and Office Overhead Expense Coverage 

Q: I have been exposed to the virus and have chosen to self-isolate. Will my disability benefit pay me?

A: Insureds with Short Term Disability, Long Term Disability or Office Overhead Expense coverage may be eligible for benefits if you are not able to work due to or having been exposed to COVID-19.  These policies pay benefits to insureds who, as a result of a sickness or injury, are unable to perform their occupation.  In order to be eligible for benefits, insureds must submit medical documentation by a medical professional that their sickness (COVID-19 exposure) meets the policy’s definition of disability and prevents you from performing your occupation.

A quarantine situation must also be supported with medical documentation.  Recommendations from government officials or CDC guidelines, office closure or absence from work due to childcare issues do not qualify.

Many factors will determine if a claim will be covered, including the type of loss, the type of coverage and the terms and conditions of the certificate and policy.  New York Life will evaluate whether a benefit is payable in accordance with the applicable waiting period and any other limitations, as they would for any other sickness or injury. 

Q: I am self-isolating because I am experiencing flu like symptoms but have not been diagnosed with COVID-19. Will my disability benefits pay me?

A: Insureds with Short Term Disability, Long Term Disability or Office Overhead Expense coverage may be eligible for benefits if you are not able to work due to or having been exposed to COVID-19.  These policies pay benefits to insureds who, as a result of a sickness or injury, are unable to perform their occupation.  In order to be eligible for benefits, insureds must submit medical documentation by a medical professional that their sickness (COVID-19 exposure) meets the policy’s definition of disability and prevents you from performing your occupation.

A quarantine situation must also be supported with medical documentation.  Recommendations from government officials or CDC guidelines, office closure or absence from work due to childcare issues do not qualify.

Many factors will determine if a claim will be covered, including the type of loss, the type of coverage and the terms and conditions of the certificate and policy.  New York Life will evaluate whether a benefit is payable in accordance with the applicable waiting period and any other limitations, as they would for any other sickness or injury. 

Q: I am under quarantine because I have been diagnosed with COVID-19. Will my disability benefits pay me?

A: Insureds with Short Term Disability, Long Term Disability or Office Overhead Expense coverage may be eligible for benefits if you are not able to work due to or having been exposed to COVID-19.  These policies pay benefits to insureds who, as a result of a sickness or injury, are unable to perform their occupation.  In order to be eligible for benefits, insureds must submit medical documentation by a medical professional that their sickness (COVID-19 exposure) meets the policy’s definition of disability and prevents you from performing your occupation.

A quarantine situation must also be supported with medical documentation.  Recommendations from government officials or CDC guidelines, office closure or absence from work due to childcare issues do not qualify.

Many factors will determine if a claim will be covered, including the type of loss, the type of coverage and the terms and conditions of the certificate and policy.  New York Life will evaluate whether a benefit is payable in accordance with the applicable waiting period and any other limitations, as they would for any other sickness or injury. 

Q: I am unable to work because I have to stay home and take care of a sick family member. Is this covered under by disability coverage? 

A:  The Disability Pro plans include a Family Care benefit that will pay up to one basic Monthly Benefit to care for, supervise or coordinate services for a Close Family Member with a Serious Health Condition. The health condition must be certified by the Close Family Member's Attending Physician. To qualify, you must be working at least 20% fewer hours and have a loss of 20% or more of your Average Monthly Income, due to the time off. The Monthly Benefit is the amount payable in proportion to the loss of monthly income up to a maximum of one basic Monthly Benefit. A Close Family Member is: (1) your spouse or domestic partner; (2) a child, including a step-child, adopted child  or (3) the your parents. A Serious Health Condition is a condition that causes the Close Family Member: (1) to be unable to complete, without substantial supervision, two of six Activities of Daily Living; (2) to require substantial supervision due to severe Cognitive Impairment; (3) to be hospitalized; or (4) to become terminally ill with a condition that is reasonably expected to result in death within 12 months. 

Q: Due to COVID-19, I’m no longer working full time - I was temporarily laid off or my hours have been reduced. Am I still covered?

A: New York Life is providing an administrative exception for disability insureds whose insurance coverage would end under the terms of your contract if you are no longer working full time.  This administrative exception will allow you to maintain your coverage through June 30, 2020, even though you are not working full time, as long as premium payments are made. *

*No policy will be lapsed due to non-payment until at least 7/1/20.  AMA Insurance and New York Life are following state and federal guidelines and this date may be extended.  If it does, insureds will be notified of the extensions. 

Certain policies (such as Disability Pro G-30639-0) contain a Layoff or Leave of Absence Benefit that continues your insurance beyond the date the insurance would otherwise end if the insured is no longer at Actively Engaged Full-Time Work due to lay-off, leave of absence, or a leave of absence required by state law or by the Family and Medical Leave Act of 1993 (FMLA). Coverage will continue for up to 90 days during a temporary layoff or a leave of absence. 

Q:Who do I contact if I need to submit a claim?

A: To file a claim, call us at 800-458-5736, provide the date disability began and request a claim form be sent to you, or go to wecare@amainsure.com and provide the same information and a claim form will be emailed or mailed to you. 

Medicare Supplement Coverage 

Remember, services that are covered by Medicare are covered by your Medicare Supplement plan.

Q: What COVID 19 services does Medicare cover?

A:

  • Medicare covers the lab tests for COVID-19 at 100%.  You pay no out of pockets costs. 
  • Medicare covers all medically necessary hospitalizations. This includes if you’re diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay but instead need to stay in the hospital under quarantine.
  • At this time, there’s no vaccine for COVID-19. However, it will be covered if one becomes available. 

*PLEASE NOTE – scammers may use the coronavirus national emergency to take advantage of people while they’re distracted,  As always, guard your Medicare card and Medicare identification number like you would a credit card, check Medicare claims summary forms for potential errors or unexplained visits, and if someone calls asking for your Medicare Number, hang up!

Q: My doctor has cancelled my next appointment and offered to call me instead. Does Medicare cover telehealth visits?

A: Medicare has temporarily expanded the coverage of telehealth services to respond to the current Public Health Emergency.  These services provide you with more access – from your home, on your cell phone, and allow you to interact with a wider range of providers (doctors, nurses, nurse practitioners, clinical psychologists, and licensed social workers). During this time, you will be covered for a specific set of services including evaluation and management visits (common office visits), mental health counseling and preventive health screening without a copayment. This will help to ensure you are able to visit your doctor from your home, without having to go to a doctor’s office or hospital to minimize your exposure to COVID-19. 

Medicare also pays for “virtual" check ins and online patient portals. Go to Medicare.gov to learn more about these service that require that you pay your usual Medicare coinsurance and deductible for these services.

Q: Can I get extra medication since I can’t leave my house?

A:

  • Yes, contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case you need to stay home for a prolonged period. 
  • Consider using mail order for your routine medications. 

Q: What if I can’t pay my premium on time?

A:   Transamerica and AMA Insurance are committed to supporting you during this challenging time, including keeping this valuable coverage. In order to allow for additional time for the payment of premium, you are allowed a grace period of 90 days from the due date for insureds in all states. Transamerica and AMA Insurance will follow all state and federal directives prohibiting cancellation for non-payment during the COVID-19 crisis. 

Transamerica is extending the grace period, not waiving premium that falls due during this period.  Insureds will be responsible for payment of any unpaid premium, when the grace period extension ends.

Q: How can I protect myself against Medicare fraud?  

A:

  •  The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about fraud schemes related to the novel coronavirus (COVID-19).
  • Scammers are offering COVID-19 tests to Medicare beneficiaries in exchange for personal details, including Medicare information. However, the services are unapproved and illegitimate. 
  • Fraudsters are targeting beneficiaries in a number of ways, including telemarketing calls, social media platforms, and door-to-door visits.
  • These scammers use the coronavirus pandemic to benefit themselves, and beneficiaries face potential harms. The personal information collected can be used to fraudulently bill Federal health care programs and commit medical identity theft. If Medicare or Medicaid denies the claim for an unapproved test, the beneficiary could be responsible for the cost.
  • Be suspicious of any unexpected calls or visitors offering COVID-19 tests or supplies. If your personal information is compromised, it may be used in other fraud schemes.
  • Ignore offers or advertisements for COVID-19 testing or treatments on social media sites.
  • A physician or other trusted healthcare provider should assess your condition and approve any requests for COVID-19 testing.
  • If you suspect COVID-19 fraud, contact National Center for Disaster Fraud Hotline (866) 720-5721.

Catastrophic Major Medical Coverage

Q:  I have a $20,000 - $1,000,000 deductible that hasn’t been met. Will charges related to COVID-19 be covered under my plan?

A: United States Life Insurance Company in the City of New York will waive cost sharing (deductible and coinsurance) on services to diagnose or rule out COVID-19 including diagnostic testing, office visits, telemedicine, urgent care visits, and emergency room visits.

Accidental Death and Dismemberment (AD&D) Coverage

Q: Is a death due to COVID-19 covered under my AD&D plan?

A: COVID-19 is a disease and is not a covered condition within Accidental Death and Dismemberment insurance (AD&D). 

General Information Applicable to All Insureds*

Q: How do I focus on what I can control? 

A: Anxiety, particularly about uncertainty, is a normal part of life. But sometimes our anxious minds may cause us to feel alarmed or panicked and we then may feel more endangered than we actually are and underestimate our ability to manage the thing we are worried about. 

Remind yourself: There are a number of things you can do to reduce the spread of COVID-19 and to protect yourself, your loved ones and your community. These community and self-care measures include staying home if you are sick, frequently washing your hands for at least 20 seconds, getting enough sleep, and managing stress. If you are at higher-risk of serious illness, you should take special precautions. 

Q: How do I avoid unreliable information? 

A: Sometimes when we are nervous or uncertain, we may find ourselves repeatedly checking the news, going into a “Google spiral,” or getting information from questionable sources. While we may be tempted to do this, it often fuels panicky feelings and doesn’t help us to feel better. Try to set a self-care limit for yourself of only checking the news once or twice a day and only going to reliable information sources such as ama-assn.org or cdc.gov/coronavirus (CDC).

Q: What can I do while trying to comply with stay at home orders in our communities?

A:

  • Go for a walk or run but maintain physical distance from others while doing so
  • Walk your dog but don’t congregate in dog parks or at other public places
  • Shop at grocery stores that remain open, as long as you’re not sick, and practice social distancing.  Wear a mask and gloves if it makes you feel more comfortable as a protection for yourself and others.  Many grocery stores have designated hours for older customers and other stores are reducing the number of customers that can be at the store at one time.  Check the store’s website for special hours and tips on the best time to visit.   

*https://www.ama-assn.org/delivering-care/public-health/covid-19-frequently-asked-questions

 

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