COVID Frequently Asked Questions

You shouldn’t just show up at a hospital or clinic and ask to be tested. Testing is authorized based on the clinical judgment of a provider, exposure, travel history and symptoms. Guidance on when TRICARE covers testing is at: https://tricare.mil/HealthWellness/HealthyLiving/Coronavirus/Coronavirus-Testing. You can contact your local or state health department for assistance.

Note:

Asymptomatic active duty service members (ADSMs)

• If you’re non-active duty who have no symptoms or weren’t recently exposed, TRICARE may not cover your test. Testing is based on medical necessity and appropriateness. You may talk to your provider or visit your local or state health department’s website for COVID-19 testing information.
  • Active duty member (Tier 1-4). If you are an active duty member, you may get a COVID-19 test.
  • If you have symptoms, you may be be tested within your unit, at a military hospital or clinic, or by a civilian provider as long as your provider determines the test is medically necessary. When seeking care:
    • A TRICARE-authorized provider has to order the test. (You don’t need a referral unless it’s required by state or local authorities.)
    • A TRICARE-authorized facility/lab has to run the test.
• Tests have to be FDA Emergency Use Authorization (EUA) tests or FDA-approved Nucleic Acid Amplification (NAA) tests, which includes the Reverse Transcription Polymerase Chain Reaction (RT-PCR).
• The FDA COVID-18 EAU list is at https://www.fda.gov/medical-devices/conronavirus-disease-2019-covid1019-emergency-use-authorizations-medical-devices/vitro-diagnostices-eau. 
• If you are symptom free and are required to be tested, but can’t get the test at a military hospital/clinic or are in a remote location, TRICARE will pay for testing under the Supplemental Health Care Program (SHCP) COVID-19 blanket waiver if you meet the criteria. The SHCP waiver supports testing for mission readiness and deployability per DoD guidance. The same criteria noted in the sub-bullets above still apply.
• If you and your eligible family members are required and approved to travel overseas, you may get a COVID-19 test to enter another country. You have to pay for the tests out of pocket and file a claim for reimbursement under your travel orders.

Your health care provider decides if you need for a test based on your exposure risk, symptoms, and guidance from the CDC. Currently, the CDC does not recommend testing every single person who wants to be tested. The Department of Defense follows these guidelines. There is a screening process in place. 

A local military hospital or clinic, as long as it can run tests for COVID-19. You have to have symptoms of the virus and have a doctor’s order for testing. If it can’t, the hospital/clinic will send your sample to an outside laboratory for testing. A military or TRICARE-authorized provider has to order or do the test.

Stay informed at www.tricare.mil/coronavirus.

Update: New Department of Defense (DoD) Force Health Protection Guidance Supplements for military hospitals and clinics on COVID-19 testing.  See Supplements 10 and 11 at https://www.defense.gov/Explore/Spotlight/Cononavirus. 

Per the guidance, military hospitals and clinics may test you if you are a:

• Service member. (This includes Reserve members and National Guard members in a title 10 or title 32 duty status on orders for greater than 30 days). 
• DoD civilian employee who isn’t a DoD health care beneficiary. Your supervisor must determine you are urgently required to be in your DoD workplace.
• Family member who is a DoD/TRICARE eligible beneficiary.

DoD contracted employees. They should follow the processes for getting medical as in their contract. As needed, the government may modify existing contracts to set up processes to provide access to testing.

Testing for national employees outside the United States. DoD offices should refer to country-specific labor agreements or contracts. They should consult with legal counsel for guidance and any limits on testing.

Individual MTFs will make the decision regarding the operation of drive-through testing centers based on the HPCON status of the facility and local conditions.

Visit the CDC website for test information.

Considerations for who should be tested:

• 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, or local or state health department.

Not everyone needs to be tested. If you do get tested, you should self-quarantine/isolate at home while waiting for test results. Follow the advice of your health care provider or a public health professional.

If you have symptoms of COVID-19

• If your symptoms are mild:
  • Your healthcare provider (physician, nurse practitioner, pharmacist, etc.) may advise a SARS-CoV-2 test.
  • If you test positive for SARS-CoV-2 infection or are not tested, you should self-isolate for at least 10 days after symptom your symptoms start. You should be fever free for at least 24 hours without the use of fever-reducing medications, and your other symptoms improve.
  • If you live with a person at increased risk of severe illness (for example an elderly relative or other individuals with underlying conditions), take special precautions in the home to protect that individual according to CDC guidelines.
• If your symptoms get worse while you are isolating, or become moderate/severe, (e.g., shortness of breath or severe fatigue), contact your healthcare provider immediately or seek emergency care.
• If you test positive, you don’t need to repeat a test for at least 3 months.
• You don’t need a follow-up negative test to return to work or school, as long as
  • You didn’t require hospitalization, AND
  • It has been at least at least 10 days after symptom your symptoms start. You should be fever free for at least 24 hours without the use of fever-reducing medications, and your other symptoms improve.

If you were in close contact, such as within 6 feet of a person with documented SARS-CoV-2 infection for at least 15 minutes and don’t have symptoms.

• You need a test. Contact your healthcare provider or public health official. Testing is recommended for all close contacts of persons with SARS-CoV-2 infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important to quickly identify and test contacts of individuals with SARS-CoV-2 infection. While waiting for your test results, you should self-quarantine/isolate at home. Stay away from household members to the greatest extent possible and use a separate bedroom and bathroom, if available.
  • A single negative test doesn’t mean you will remain negative at any time point after that test.
  • Even if you have a negative test, you should still self-isolate for 14 days.
• If you can’t self-isolate, or you are a critical infrastructure worker that must work, wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.
• If you live with a person at increased risk of severe illness (for example an elderly person or other individuals with underlying medical conditions), take special precautions in the home to protect that individual according to CDC guidelines.
• Healthcare providers in close contact of a person with documented SARS-CoV-2 infection while using recommended personal protective equipment, don’t need to be tested

If you don’t have COVID-19 symptoms and haven’t been in close contact with someone known to have SARS-CoV-2 infection (meaning being within 6 feet of an infected person for at least 15 minutes).

• You don’t need a test unless your healthcare provider or a public health official recommends it.
• If you are tested, you should self-quarantine at home until you know your test results. Follow your healthcare provider’s advice based on your test results.
• A negative test doesn’t mean you will remain negative at any time after that test.

If you are in a high SARS-CoV-2 transmission zone and attended a public or private gathering of more than 10 people (without universal mask wearing and/or physical distancing).

• Your healthcare provider or public health official may advise a SARS-CoV-2 test.
• If you are tested, you should self-isolate at home until you know your test results. Follow your health care provider’s advice based on the test results.
• A negative test doesn’t mean you will remain negative at any time after that test.
• Even if you have a negative test, you should wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.
• Take special precautions in the home to protect any person(s) with increased risk of severe illness according to CDC guidelines.

There is additional guidance on this web site for social gatherings (more than 10 people) or if you live or work in a nursing home or long-term care facility. 

Per DoD Supplemental Guidance (Supplement 10), uniformed service hospitals and clinics may offer COVID-19 testing. Whether you should be tested is based on your provider’s clinical judgment and your symptoms and history. If the military hospital or clinic can’t run the test, it sends your sample to an outside laboratory for testing. You may get a test if ordered by a TRICARE-authorized provider and run by a TRICARE-authorized lag. Talk to your provider about their testing process. You may contact local and state health departments for information on testing locations they approve and cover.

You should first call your health care provider before using a home test.

• TRICARE will cover an at-home COVID-19 test if it is an U.S. Food and Drug Administration-approved test ordered by an authorized TRICARE provider and run by a TRICARE-authorized lab/facility.
• Individual MTFs will determine if they have capacity to process at-home tests. Contact your MTF for more information.

Note: You shouldn't be ordering or purchasing a test until you have a doctor's order. You may have to pay out of-pocket for the test and submit a copy of the doctor's order with your claims for TRICARE reimbursement consideration.

The viral test for COVID-19 is a simple nasal swab.

Copays will be waived retroactively to March 18 for approved COVID diagnostic testing and office visits related to the testing. If you paid any copays for testing related to COVID-19 and the resulting office visits with a network or non-network provider, you may file a claim for reimbursement.

The time it takes to get results varies. It depends on where you get your test done. Some site can test samples on site. Results may be available within minutes. 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.

The screening process begins when you contact your provider or the MHS Nurse Advice Line to discuss your symptoms and it will begin with a series of questions.

The nurse or staff member decides whether your symptoms may be due to COVID-19 or another illness requiring treatment. You might get advice on self-care since symptoms often can be treated at home.

The nurse/staff member may arrange a telephone visit between you and a health care provider or tell you to call your provider directly. The provider can talk with you about possible exposure, your symptoms, and discusses treatment. The provider may give you self-care advice to use at home. Or, he or she may tell you to go to your primary care clinic or emergency to be tested.

It’s important to call first so we can protect you, other patients, and medical staff from unnecessary exposure to COVID-19.

• The COVID-19 test is free. The COVID-19 Test should only be done when your provider thinks your symptoms show likely infection.
• Effective March 18, under the Families First Coronavirus Response Act, TRICARE is also waiving copays for doctor-ordered COVID 19 testing office visits.
• The law doesn't waive copayments and cost-shares for the treatment due to infection. Copays and cost shares remain the same for TRICARE program and plans.
• Under TRICARE you have fairly low out-of-pocket costs, a catastrophic cap and protection against balance billing.
• Active duty service members and ADFMs under Prime do not have cost-shares and so are not impacted by this law.
• Due to the claims billing process and modifications, TRICARE can't immediately waive all copayments and cost-shares. Beneficiaries may have to pay up front and file a claims for reimbursement until the contractors can modify their systems.
• If you receive a prescription for medication, your copay still applies. By law, TRICARE can't waive pharmacy copays. Consider filling your medication through home delivery or at a retail pharmacy depending on your MTFs operating status.

If you’re located overseas: Beneficiaries overseas with a cost-shareA percentage of the total cost of a covered health care service that you pay. (retirees and their family members, active duty family members (ADFMs) under TRICARE Select, and TRICARE For Life) may be eligible for cost share waivers. This is only if the COVID-19 test with the visit meets the requirements of the law. It has to be FDA approved, cleared, or authorized. Some tests used and TRICARE-covered overseas may not meet this statutory requirement. This includes the World Health Organization test, which is not currently FDA authorized.

There is CDC-published criteria to guide healthcare providers. They are encouraged to use their own medical judgment for testing purposes. Providers usually base testing on your exposure and symptoms. Also, you may have another illness or infections that may be making you sick, like the flu or a nasal infection.  Providers may choose to rule out these other cases before testing for the coronavirus.

The DoD follows CDC guidelines.  Currently, CDC does not recommended testing every single person who wants to be tested.  There is a limited supply of COVID-19 tests due to the needs for tests and the production of testing supplies. Testing can provide a way to reduce the risk for certain people, but it is not the only way. Combined with other risk mitigation and public health measures, such as enhanced personal hygiene, use of facial coverings, social distancing, etc., we can slow community transmission.

Providers can find the CDC’s testing priorities at https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html.

Testing is a primarily for those exposed to the virus or showing symptoms. The test has to be medically necessary and appropriate and ordered by a provider in a military hospital or clinic, or a TRICARE-authorized provider. Testing is a way to reduce of getting the virus for certain people, but it is not the only way. You can use other measures (e.g. enhanced personal hygiene, use of facial coverings, social distancing, etc.) to help slow the spread and the need for testing.

For information on TRICARE’s coverage of COVD19 testing, visit https://tricare.mil/HealthWellness/HealthyLiving/Coronavirus/Coronavirus-Testing.

If you’re enrolled in TRICARE Prime Remote or are a TRICARE Select beneficiary, it’s up to your civilian provider to assess your status and determine if you need testing. They may want to first test you for other infections, flu, bacteria, and then will follow-up with the COVID-19 test if he or she feels it’s necessary. The COVID-19 Test is only being done when a provider thinks your symptoms show likely infection. The testing is free.

• Effective March 18, under the Families First Coronavirus Response Act, TRICARE is also waiving copays for doctor-ordered COVID 19 testing office visits.
  • The law doesn't waive copayments and cost-shares for the treatment due to infection. Copays and cost shares remain the same for TRICARE program and plans.
  • Under TRICARE you have fairly low out-of-pocket costs, a catastrophic cap and protection against balance billing
• Active duty service members and ADFMs under Prime do not have cost-shares and so are not impacted by this law.
• Due to the claims billing process and modifications, TRICARE can't immediately waive all copayments and cost-shares. Beneficiaries may have to pay up front and file a claims for reimbursement until the contractors can modify their systems.
• If you receive a prescription for medication, your copay still applies. By law, TRICARE can't waive pharmacy copays. Consider filling your medication through home delivery or at a retail pharmacy depending on your MTFs operating status.

If you’re located overseas: 

The TRICARE Overseas Program contractor follows the established guidelines and standards of care for COVID-19 testing for the country, host nation, and/or regional health authority (e.g., World Health Organization), where you're treated. This is due to the lack of FDA-regulated tests outside the U.S.

TRICARE will waive copayments and cost-shares for tests the TRICARE Overseas Program contractor approves under DHA guidelines and standards.

The hospital department that provides emergency services to patients who need immediate medical attention.

They are likely available in most ERs. They may be set aside for who were exposed to or in contact with someone exposed to the virus AND showing symptoms. Tests are not likely to be offered for screening purposes for all others.

Not at this time. TRICARE covers COVID-19 testing when:

• a TRICARE-authorized provider, based on sound clinical judgment, determines it’s medically necessary and appropriate, and
• the beneficiary, your child, has COVID-19 symptoms. (Exception: testing for active duty service members).

Testing locations (sites/labs) have to be TRICARE-authorized for TRICARE to pay on the claim.

CDC guidance:

• CDC does not currently recommend universal symptom screenings (screening all students grades K-12) be conducted by schools.
• Parents or caregivers should be strongly encouraged to monitor their children for signs of infectious illness every day.
• Students who are sick should not attend school in-person.

Per DoD, if your child has no symptoms or no recent exposure to COVID-19, you should visit your local or state health department’s website for COVID-19 testing information.

Getting a COVID-19 test is not guaranteed by the local or state health departments.  Many civilian clinics and hospitals are following CDC guidance and are not testing asymptomatic individuals.

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/symptom-screening.html.

Background:

On March 24, 2020, the Assistant Secretary of Defense for Health Affairs released a policy.  It directed postponement of all elective surgeries and procedures. The reasons for the policy change:

• Conserve personal protective equipment,
• Apply critical resources (people and equipment) to meet COVID-19 care requirements, and
• Protect patients and staff from COVID-19.  

There were two exceptions to the policy. You could have surgery or a procedure if:

(1)    It impacted your ability as an active duty service member to deploy, or your medical readiness status

(2)    Delaying it increased the risk to your health to an unacceptable level.  Your provider makes this determination.  

Update –  19 May, 2020:

The Assistant Secretary of Defense for Health Affairs released a new policy.  It lines up with the Department of Defense health protection condition (HPCON) framework. 

The guidance for military hospitals and clinics is:

• At HPCON C: May be able to resume outpatient elective surgeries/procedures
• At HPCON B: May be able to resume inpatient elective surgeries/procedures

Military clinic or hospital Directors and Commanders base their decisions to offer services on:

• The installation’s HPCON levels
• Health care capacity at the hospital or clinic, and in the TRICARE network
• Staffing
• If Personal Protective Equipment is available

The two exceptions to policy still apply.  You can have an elective surgery/procedure if (1) it affects your readiness or deployment status as an active duty member, or (2) there is an unacceptable risk to your health without it. 

The Department still encourages you to use virtual care (audio-video, phone) when you can. 

Work with your military medical hospital or clinic, or your dental treatment facility.  Staff should be able to talk to you about the status of your surgery or procedure.  They can guide you on what need to do to reschedule it.

It does if you usually use military hospitals or clinics or military dental clinics. This includes:  

• Active Duty Service Members
• TRICARE Prime-enrollees
• Reserve and National Guard service members
• Other eligible beneficiaries, on a space available basis. 

You have to show as eligible in the Defense Enrollment Eligibility Reporting System(DEERS) A database of information on uniformed services members (sponsors), U.S.-sponsored foreign military, DoD and uniformed services civilians, other personnel as directed by the DoD, and their family members. You need to register in DEERS to get TRICARE. (DEERS).   

The regional contractors are extending the end dates for certain referrals and authorizations. This change applies to those with end dates of 1 March through 30 June 2020. The extension doesn’t apply to all services. Contractors informed network providers about the change. They listed those services that aren't included in the extension.

To check your referral or authorization:

• Check the stateside contractors' secure system or call them.
• Contact the overseas contractor.

If you have questions, talk to your provider or contact your regional contractor.  

Elective surgeries and procedures are those that are not urgent and can be rescheduled for a later date. Examples include, but are not limited to:

• Laser surgery
• Hernia repair
• Non-emergent back surgery
• Colonoscopies
• Joint replacements

MTFs and DTFs will continue to conduct surgeries and procedures to save lives and avoid further harm from underlying conditions or diseases, or where the risk of delaying the procedure outweighs all other considerations.

We encourage those who are impacted by this policy to talk to their local MTF or DTF.

This policy applies to all eligible beneficiaries who use our military medical treatment facilities or dental treatment facilities, including:

• Active duty service members
• Active duty family members
• Retirees
• Retiree family members
• Reserve Component and National Guard service members on active duty or issued a delayed-effective date active duty orders
• Other eligible beneficiaries

Work through your military medical treatment facility or dental treatment facility; each facility can address your concerns, and can provide guidance on rescheduling and how to proceed.

In the executive order, the President stated: “To ensure that our healthcare system is able to surge capacity and capability to respond to the spread of COVID-19, it is critical that all health and medical resources needed to respond to the spread of COVID-19 are properly distributed to the Nation’s healthcare system and others that need them most at this time."

No. Military clinics and hospitals will remain open. This is only for elective surgeries and procedures. For those who have may have COVID-19 symptoms, we encourage you to call your local treatment facility’s COVID hotline and follow the instructions on how to seek care.

Non-elective procedures, particularly acute and urgent care, will continue, as well as procedures that will keep a Service member medically ready and deployable.

MTFs and DTFs will continue to provide routine appointments and exams, such as check-ups, specialty consultations, and prenatal visits at this point in time. However, individual MTFs and DTFs may further limit availability based on response demands.

For information on expired ID cards and DEERS enrollment, visit https://www.cac.mil/Coronavirus/. Topics covered include:

• Frequently Asked Questions - DoD Response to COVID-19/DoD ID Cards & Benefits
• DEERS Enrollment and ID Card Issuance During COVID-19
• DEERS Enrollment/ID Card Issuance Guide During COVID-19 DoD Civilian Employee CAC Retention
• DoD Memorandum, “Common Access Card Retention for Department of Defense Civilian Personnel Transferring Between Department of Defense Components,” dated December 20, 2016
• RAPIDS Site Locator (RSL)
• https://www.dmdc.osd.mil/rsl/
• RAPIDS Appointment Scheduler (RAS)
• https://rapids-appointments.dmdc.osd.mil/
  

To ensure DoD ID card offices are postured to maintain continuity of operations, and to minimize the number of non-essential required visits at DoD ID card offices, the following guidance is in effect:

Uniformed Services ID Cards (USID)

• If a cardholder's affiliation is unchanged, USID cards which expired on or after January 1, 2020, are authorized for continued benefit use through June 30, 2021.
• Termination of cardholder affiliation with the DoD or termination of benefit eligibility shall be verified electronically prior to confiscating an expired USID card with an expiration date on or after January 1, 2020.
• Remote USID card renewals and reissuance shall be expanded.
• Remote family member enrollment/eligibility updates are authorized.
• Remote USID card initial issuance for first-time issuance or replacement of lost/stolen ID card is authorized.
• All remotely-issued USID cards shall be issued with an expiration date not to exceed one year from the date of issuance.
• The minimum age for initial USID card issuance is increased from 10 to 14 years.
• Continued use of the Reserve USID card to obtain active duty benefits is authorized for mobilized Reservists and their eligible dependents.

The following guidance is is for Common Access Cards (CAC) and Volunteer Logical Access Credentials (VoLAC)

• CAC and VoLAC will expire on September 30, 2020 due to the high rate of CAC reissuance and low rate of certificate extensions.
• CACs and VoLACs which expire on or after April 16, 2020, and are within 30 days of expiration, may have the certificates updated using ID Card Office
• Online to allow for continued use for logical access through September 30, 2020. The User Guide below provides details on who is eligible, and whom to contact for questions or problems.
• CACs shall not be reissued due to printed information changes (e.g., promotions, name changes).
• CACs that expire on or after April 16, 2020, are authorized for continued use to facilitate access to benefits through September 30, 2020, if the cardholder’s eligibility for benefits is unchanged.
• Existing and new Trusted Associate Sponsorship System (TASS) applications will be valid for 180 days, permitting TASS-sponsored cardholders to take advantage of the remote options to update their certificates.

You can find and related information at https://www.cac.mil/Coronavirus/.

• The COVID-19 test is only being done when a provider thinks your symptoms show likely infection. The testing is free.
• The COVID-19 test is free. The COVID-19 test should only be done when your provider thinks your symptoms show likely infection.
• Effective March 18, under the Families First Coronavirus Response Act, TRICARE is also waiving copays for doctor-ordered COVID 19 testing office visits.
• The law doesn't waive copayments and cost-shares for the treatment due to infection. Copays and cost shares remain the same for TRICARE program and plans.
• Under TRICARE you have fairly low out-of-pocket costs, a catastrophic cap and protection against balance billing.
• Note: You may pay out of pocket if you receive a test from a location that’s not a TRICARE-authorized provider.
• Active duty service members and ADFMs under Prime do not have cost-shares and so are not impacted by this law.
• Due to the claims billing process and modifications, TRICARE can't immediately waive all copayments and cost-shares. Beneficiaries may have to pay up front and file a claims for reimbursement until the contractors can modify their systems.
• If you receive a prescription for medication, your copay still applies. By law, TRICARE can't waive pharmacy copays. Consider filling your medication through home delivery or at a retail pharmacy depending on your MTFs operating status.

If you’re located overseas: Beneficiaries overseas with a cost-share (retirees and their family members, active duty family members (ADFMs) under TRICARE Select, and TRICARE For Life) may be eligible for cost share waivers. This is only if the COVID-19 test with the visit meets the requirements of the law. It has to be FDA approved, cleared, or authorized. Some tests used and TRICARE-covered overseas may not meet this statutory requirement. This includes the World Health Organization test, which is not currently FDA authorized.

• Medicare covers the lab tests for COVID-19. You pay no out-of-pocket 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 you need to stay in the hospital under quarantine.
• If you have a Medicare Advantage Plan, you have access to these same benefits. Medicare allows these plans to waive cost-sharing for COVID-19 lab tests. Check with your plan about your coverage and costs.
• Scammers may use the coronavirus national emergency to take advantage of people while they’re distracted. As always, guard your Medicare card like a credit card, check Medicare claims summary forms for errors, and if someone calls asking for your Medicare Number, hang up! Check for guidance at Medicare.gov.
• TRICARE acts as second payer for Medicare and TRICARE covered services, to include coronavirus testing, treatment, and hospitalization.

DHA will not be hosting an ACD specific Town Hall.

TRICARE is allowing a temporary exception to the use of telehealth capabilities for ABA services, but it is limited. Telehealth, by videoconferencing, is being allowed for an unlimited use of CPT 97156 with GT modifier. This code a temporary, timed, 15-minute session for use by the authorized ABA supervisor (or as delegated to an assistant behavior analyst) for guiding the parents/caregivers (with or without the beneficiary present) to utilize the ABA TP protocols to reinforce adaptive behaviors.

This starts March 31, 2020 and runs through May 31, 2020. Should the period of emergency extend past May 31, 2020, the Defense Health Agency will provide additional guidance on a possible extension of this exception to policy.

To view additional FAQs and a full article go to: https://www.health.mil/Military-Health-Topics/Conditions-and-Treatments/Autism-Care-Demonstration.

You can also get information at: https://tricare.mil/autism and https://tricare.mil/CoveredServices/IsItCovered/TelementalHealth.

TRICARE covers many telehealth/telemedicine services when:

• Medically or psychologically necessary,
• Appropriate,
• With a military or TRICARE-authorized provider.

Services may include:

• Primary, routine, and specialty care,
• Behavioral health care like psychotherapy, Family guidance/training from a board certified behavior analyst under the Autism Care Demonstration, or
• Physical therapy or occupational therapy.

Update:

The Department published an interim final rule on May 12, 2020. It makes three temporary changes to TRICARE regulation. The goal is to ensure you have access to care during the national health emergency due to the pandemic.

With the rule change:

1. TRICARE will temporarily pay for certain phone (audio-only) telehealth services. The visit must be medically or psychologically necessary. It must be appropriate.

• For example, you may have a phone visit with your provider to evaluate and manage your care, or you may have a psychotherapy visit.
• TRICARE won’t pay for all phone visits. Some aren’t appropriate by phone, e.g. intensive outpatient programs. In these cases, your visit must be face-to-face or through audio-video channels.
• If your care normally requires a physical exam, an audio-only visit isn’t appropriate. (This includes a remote physical exam using a “telepresenter”- which may be a nurse with digital tools and resources.)
• Your provider can’t bill separately for administrative services. For example, he or she can’t bill for setting up the appointment or verifying your prescriptions. These costs are part of the audio-only visit itself.
• TRICARE billing and payment rules still apply.
• TRICARE program and plan rules still apply. For example, if you are TRICARE Prime, you still need to get a PCM referral for specialty care.

2. TRICARE is temporarily paying providers who practice across state or country lines. This only applies when federal, state, or host nation laws allow the out-of-state or international practice. It helps in areas where there is a high-need for health care services.

• It applies to both in-person and telemedicine services.
• Federal, state, or host-nation licensing requirements apply.
• Stateside: The license has to permit practice out-of-state.
• Overseas: The provider’s host-nation has to permit inter-country practice. The provider has to be licensed in both countries.
• Your provider can’t barred or restricted from practice in any state. He or she can’t be on the Department of Health and Human Services sanction list.

3. TRICARE is temporarily waiving copays or cost-shares for telehealth services. This includes your deductible (if applicable).

• This is for TRICARE-covered services from in-network providers. It’s not just for your COVID-19 care.
• It’s for both Prime and Select enrollees.

These temporary changes are in effect:

• Starting May 12, 2020, for the United States. They will be in place until the end of the President’s declared national emergency
• Starting March 10, 2020, overseas. They may be in place beyond the U.S. national emergency end date, based on local conditions.

You may not see these changes right away as the contractors have to make system changes.

If you have a question about a telehealth claim, reach out to your regional contractor. 

• TRICARE may cover telemedicine services overseas. Services must be medically or psychologically necessary and appropriate.
• Civilian TRICARE Overseas Program (TOP) network or participating providers have to:
• Follow host nation country privacy laws 
• Meet telemedicine credentialing requirements
• Follow TRICARE policy requirements
• You still have to get required referrals, pre-approvals, or authorizations for services. If you have:
• TRICARE Overseas Program (TOP) Prime: Your primary care manager (PCM) has to submit a “Defer to Network Request (DTNR)” to the overseas contractor. The DTNR has to note the need for telemedicine services.
• TOP Prime Remote: You must call your TOP Regional Call Center for all of your telemedicine services. This includes your first visit and follow-up visits that you may need.
• If you self-refer for services, you must see a telemedicine credentialed provider. This would apply if you choose to self-refer for some outpatient mental health services.
• Active duty service members must get pre-authorization for all types of mental health care that they seek. This will come from your PCM at your military hospital or clinic or from the overseas contractor.
• Telemedicine must have both live video and audio for TRICARE to cover it. TRICARE doesn’t cover telemedicine services through:
• Audio-only conferencing
• Phone calls
• Texts
• Services that TRICARE doesn’t now cover under the TOP are not covered through telemedicine.

To learn more, contact your TOP Regional Call Center.

The Defense Health Agency issued guidance on the telemental health services, to include IOPs.

• Providers may use interactive telecommunications systems for TRICARE-covered diagnostic and treatment services.  Services have to be medically or psychologically necessary, and appropriate.
• Definitions:
• Medically or psychologically necessary. The frequency, extent, and types of medical services or supplies represent appropriate medical care and are generally accepted by qualified professionals to be reasonable and adequate for the diagnosis and treatment of illness, injury, pregnancy, and mental disorders or that are reasonable and adequate for well-baby care.
• Appropriate medical care.
• (i)   Services performed in connection with the diagnosis or treatment of disease or injury, pregnancy, mental disorder, or well-baby care which are in keeping with the generally accepted norms for medical practice in the United States;
• (ii)   The authorized individual professional provider rendering the medical care is qualified to perform such medical services by reason of his or her training and education and is licensed or certified by the state where the service is rendered or appropriate national organization or otherwise meets CHAMPUS standards; and
• (iii)   The services are furnished economically. For purposes of this part, “economically” means that the services are furnished in the least expensive level of care or medical environment adequate to provide the required medical care regardless of whether or not that level of care is covered by CHAMPUS.
• Partial Hospitalization Program (PHP). PHP is normally 6 hours of more per day of behavioral health services. PHP via telehealth is not a covered benefit.  The DHA is going to make a decision on possible coverage in the future. 
• Intensive outpatient services:  TRICARE may cover these services by telehealth during the COVID-19 crisis only.  TRICARE already covers outpatient psychotherapy, crisis therapy, family therapy, and group therapy via telehealth.  It will do so after the crisis is over.
• Intensive Outpatient Program (IOP)
• This is normally a 2 to <6 hour outpatient program. It takes place in an organized setting, day or evening
• Providers may carry out some IOP services via telehealth (for example, individual psychoeducation, case management, recreational therapy, etc.). Telehealth won’t cover: drug screening, group psychotherapy, and some other services. 
• TRICARE policy requires a referral OR prior-authorization for IOP care.
• The IOP, or PHP providing IOP services, by telehealth must be at the same intensity and level of services required by those programs per policy.  The provider has to show its offering all components of the IOP via telehealth (e.g., at least 2 hours of services). IOPs have to document all services via telehealth in the medical records and on the claim.
• Medication Assisted Treatment (MAT) and Opioid Treatment Programs (OTP)
• TRICARE may cover MAT and OPT services by telehealth when appropriate.  The MAT and OPT must meet SAMHSA regulations and guidance.  See https://www.samhsa.gov/sites/default/files/otp-guidance-20200316.pdf and https://www.samsha.gov/sites/default/files/faqs-for-oud-prescribing-and-dispensing.pdf.
• Methadone care shall also follow SAMHSA requirements.
• Other outpatient behavioral health telehealth services. 
• Providers may offer TRICARE-covered services via telehealth. This may include evaluation and management, psychotherapy, medication management, and more.  A TRICARE-authorized provider may bill for professional services via telehealth if it can’t offer IOP services aren’t at the same intensity or frequency as required for those programs. Providers have to follow existing policies.

If you have questions, contact your regional contractor.

Many providers offer COVID-19 antibody tests. There’s no solid proof that all tests are accurate or useful. Antibody tests do have the ability to test your blood for the presence of antibodies, and a possible past infection with the coronavirus.    

TRICARE may cover an FDA-approved test if: 

• It’s ordered by a TRICARE-authorized provider, and
• It’s medically necessary, appropriate, and safe.

TRICARE won’t cover antibody blood tests:

• To see if someone is safe to return to work,
• As part of public health outreach, or
• For research purposes.

As always, contact your medical provider before you get a test done. 

Only through a congressional law may TRICARE waive premium payments. There currently is no such law. The Defense Health Agency (DHA) is studying COVID-19’s effects on beneficiaries who pay enrollment fees or premiums for their TRICARE health plan during the national health emergency due to the pandemic.

For TRICARE Reserve Select (TRS), DHA is reviewing TRS premium payments for those in units which suspended paid drills. It hopes to have a decision soon.  Until there’s a decision, if you miss a payment or don’t pay on time, they contractor will disenroll you from TRS. Call your contractor for reconsideration if this happens. If you can’t keep up your TRS payments, you may also find health coverage through the Health Insurance Marketplace: https://www.healthcare.gov/.

Military pharmacies may change a number of services to keep you safe during this COVID-19 period.  Leadership evaluates the pharmacy’s status on an ongoing basis. They look at the installation, pharmacy services, and other local conditions.

Changes in operations to military pharmacies may include:

• Decreasing the number of people in the waiting area
• Setting up different times for you to drop off prescriptions and pick them up
• Setting up other places for you to pick up your drugs
• Changing the hours and days they are open
• Limiting who they serve (e.g. Active Duty only). This is on a temporary basis.
• Closing the pharmacy.  This is on a temporary basis.

Social distancing and safety protocols may also vary by location.  This may include: 

• Limiting the number of people in the pharmacy waiting area
• Using signs, e.g. setting up a six foot distance between people
• Setting up physical barriers, e.g. Plexiglas in pharmacy windows
• Using touchless ID card scanning
• Set up prescription pick-up services where people don’t make direct contact with each other.

Some military pharmacies offered drive through or curbside services by borrowing staff from other specialtiesA branch of medicine or surgery that a doctor specializes in., such as dentistry. We’ll likely won’t be able to continue to offer these options for several reasons.  For example: support staff have to return to their normal duties; prescription volume will increase as routine visits and elective procedures restart.

Call your military pharmacy refill call-in line for MTF pharmacy information.  You can search for the pharmacy phone number at tricare.mil/mtf.

You may want to consider what options may be best for you. 

First, make sure there are still refills on your prescription. The prescription label shows how many refills you still have.  We encourage you to get your refills at the appropriate time. Standard refill policies allow you to refill or renew a prescription drug when 25% (military pharmacy) or 33% (Home Delivery) of your current prescription remains. This should help you stay on track with your drugs during this time.

Military pharmacies offer a 90-day supply of most medications.

• Check on the status of your military pharmacy before you need your prescription. Call the pharmacy refill line. Check back regularly for updates. Look for your pharmacy's phone number at tricare.mil/mtf.
• You can get up to a 90-day supply of drugs with $0 copaymentA fixed dollar amount you may pay for a covered health care service or drug..
• Ask your civilian provider to e-prescribe new prescriptions to the military pharmacy.

Home delivery is the next most affordable option after military pharmacies.

• You can switch to Home Delivery to get up to a 90-day supply of most drugs with one copayment.
• Copayments apply for anyone not on active duty.
• You can make the switch by phone, online, or via the Express Scripts app. Visit tricare.mil/pharmacy for more information.

At a retail network pharmacy, you can get up to three, 30-day supplies

• Copayments apply for each 30-day supply for anyone not on active duty.
• If you currently fill 30-day supplies at a local pharmacy, you can ask your doctor to write a new prescription for a 90-day supply (if allowed by law).  Three copays apply.
• You can transfer your prescriptions to a retail network pharmacy.  Ask the pharmacy o call your military pharmacy, or call your provider for a new prescription for the retail pharmacy. Visit tricare.mil/pharmacy for more information.

You can: 

• Get up to a 90-day supply at a military pharmacy at no cost.
• Get up to three, 30-day supplies at a time at retail (three copays apply at that time)
• Get up to a 90-day supply through TRICARE Home Delivery (one copay applies).

For example, the copayment for a 90-day supply of generic medication is $10 with home delivery.  It’s $39 for three 30-day supplies from a retail pharmacy.

Active Duty Service Members (ADSMs) can fill prescriptions at any military or retail network pharmacy, or through the TRICARE Home Delivery Pharmacy Program. They have a $0 copayment.

There are many ways to switch a prescription to home delivery to include phone, online, and via the Express Scripts mobile app. While our goal is to limit disruptions to service, and the nature of the virus and local outbreaks is unpredictable.  Pharmacy statuses may change quickly. 

Should you have any questions or concerns about your individual situation, pharmacists are available 24/7 within military pharmacies or with the pharmacy contractor, Express Scripts, Inc., to answer questions, offer counseling and support, and assist with prescription orders.

You can call your MTF pharmacy refill line to check for changes to pharmacy services, closures, and resuming services. You can look up your pharmacy’s number via http://www.tricare.mil/mtf.

There are several actions you can take:

• Call your MTF pharmacy refill line to check for changes to service offerings, closures, and resumption of services: You can look up your pharmacy’s number via http://www.tricare.mil/mtf.
• Switch your prescription to TRICARE Pharmacy Home Delivery by calling Express Scripts at 877-363-1303 or visiting http://www.militaryrx.express-scripts.com/home-delivery.
• Call your retail network pharmacy and ask them to call your military pharmacy to transfer your medication or call your provider for a new prescription for fill at a retail pharmacy
• Find a retail network pharmacy via https://militaryrx.express-scripts.com/find-pharmacy.
• Call Express Scripts at 877-363-1303 to speak with a pharmacist 24/7.
• If you don't have any refills, call your provider to send a new prescription to either the Express Scripts TRICARE Pharmacy Home Delivery or your network retail pharmacy.
• MTF pharmacies have staff available to assist

Yes. Copayments are directed by law and the Department of Defense can’t waive them.

Visit https://tricare.mil/Costs for an overview of pharmacy copayments. You can search your specific drug(s) can determine your medication coverage and copayments at http://www.express-scripts.com/tform.

We encourage you to refill your drugs at the appropriate time. Standard refill policies, which allow you to refill or renew a prescription drug when 25% of your current prescription remains. This process should help you stay on track with your drug supply during this time.

We understand the desire to be prepared. Present conditions don’t call for early refills through Home Delivery or at retail. We are monitoring the situation closely and are updating our information and policies as the situation requires.

Should you have any questions or concerns about your individual situation, Express Scripts pharmacists are available 24/7 to answer questions, offer counseling and support, and assist with prescription orders. Call Express Scripts at 877-363-1303.

The home delivery network is fully operational and able to absorb a potential increase in the Department of Defense workload. In addition to home delivery, the retail network is currently not experiencing any lack of services. Many retail network pharmacies offer home delivery as well

Based on Health Protection Condition (HPCON) levels and spread of COVID-19 at the particular location, Military Medical Treatment Facility (MTF) Directors are authorized to limit pharmacy services with a step-wise approach that prioritizes the readiness posture of the United States Military. The following limitations MAY be implemented:

• First, beneficiaries who aren’t enrolled to an MTF may be temporarily required to switch to home delivery or a retail network pharmacy due to local COVID-19 impact.
• If a further reduction in services is required, MTF-enrolled Retirees and Family members may be temporarily required to switch to home delivery or a retail network pharmacy.
• Finally, the temporary closure of a local military pharmacy may require all local beneficiaries to switch to home delivery or a retail network pharmacy on a temporary basis.

Will this impact me?

The best way to find out if a change in pharmacy services impacts you is to call your local military pharmacy and/or the prescription refill number to find out about the pharmacy’s operating status. The MTF will routinely update the prescription refill line with the latest information on its pharmacy’s status.

While we expect limited impact at most military pharmacies, all eligible beneficiaries may be impacted due to the spread of COVID-19.

How will you transfer my prescription if the military pharmacy is closed?

The Defense Health Agency issued guidance to military pharmacies to ensure that work-around solutions, to include remote capabilities in case of full closure. Staff will be available to assist in transferring your prescription to either mail order or a network retail pharmacy of your choice.

What if I can’t reach my military pharmacy?

Express Scripts is the DOD’s pharmacy benefit contractor and supports the DOD in delivering the pharmacy benefit to its 9.5 million beneficiaries. Express Scripts pharmacists are available 24/7 to help answer questions about your prescriptions, to include supporting prescription transfers. You can call Express Scripts anytime at 877-363-1303.

If you are unable to find a solution with your prescription after speaking with Express Scripts, you may want to call your provider directly and ask them to e-prescribe a new prescription to Express Scripts or to a network retail pharmacy of your choice.

At this time, there is no plan to waive refill restrictions to get prescriptions refilled early.

TRICARE offers beneficiaries the option to get a 90-day supply of their drugs at military pharmacies, via TRICARE Pharmacy Home Delivery, or at retail network pharmacies.

To maintain patient and personnel safety during the COVID-19 national health emergency due to the pandemic, DHA is taking actions and making changes to military pharmacy operations. Several military pharmacies are practicing social distancing with drive-through or curbside pharmacy services. Call your local military pharmacy (the refill line) to check for changes and limitations to service. Visit www.tricare.mil/mtf to look up the phone number of your military pharmacy.

Retail network pharmacies are also taking measures for safe prescription pick up. They are practicing social distancing, adjusting hours, and/or many offer delivery options or curbside pickup. You can find more information about retail pharmacy operations during COVID-19 at: https://militaryrx.express-scripts.com/notices/other/get-your-medications-while-maintaining-distance-others.

TRICARE Pharmacy Home Delivery is an affordable option that limits your exposure compared to in-person pick up. To learn more about switching to home delivery, go to https://www.tricare.mil/CoveredServices/Pharmacy.

apply to each prescription for non-active duty service members. Depending on the type of albuterol or levalbuterol inhaler, you may pay:

• $10 (home delivery) or $13 (retail network pharmacy) for one fill of a generic inhaler
• $29 (home delivery) or $33 (retail network pharmacy) for one fill of a name-brand inhaler, or
• $60 for one fill of a non-formulary inhaler.

Visit the TRICARE Formulary Search Tool at www.express-scripts.com/tform for more on the category and cost of your medication.

To get your refills, visit www.militaryrx.express-scripts.com to use the Express Scripts mobile app.  You may also call Express Scripts at 1-877-363-1303.

These inhalers have always had quantity limits.  The Defense Health Agency tracks and analyzes drug ordering, use, and supply data. Based on the data, it sets drug quantity limits. DHA works with manufacturers and wholesalers to decide current and future limits on an as needed basis.

As of 10 July, there is no longer a limit on these drugs. You can get prescriptions filled at the pre-COVID-19 amounts:

• Up to a 90-day supply per prescription at a military pharmacy
• Up to a 30-day supply per prescription at a retail network pharmacy
• Up to 90-day supply per prescription through TRICARE Pharmacy Home Delivery

TRICARE pharmacy copays still apply (for other than active duty service members).

• If your see a provide in an office or clinic:
• Your prescription has to be FDA-approved for your medical condition (e.g. lupus, arthritis, or malaria); not for COVID-19.
• Your provider has to request prior authorization if your prescription starts on or after 15 March 2020.Have your doctor search for your drug at www.express-scripts.com/tformo for prior authorization information.

DHA is constantly monitoring drug supply and availability. It may consider placing temporary quantity limits on other drug as needed to make sure all beneficiaries who need them can get them.

Update:

https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#coviddrugs

Hydroxychloroquine sulfate (HCQ) and chloroquine phosphate (CQ) to treat COVID-19. 

On June 15, 2020, based on continued review of scientific evidence the FDA determined that the statutory criteria for emergency use authorization (EUA) of these meds for COVID-19 are no longer being met.  FDA determined that CQ and HCQ are not likely to be effective in treating COVID-19 for the authorized uses in the EUA. Also, based on ongoing serious cardiac adverse events and other serious side effects, the known and potential benefits of CQ and HCQ no longer outweigh the known and potential risks for the authorized use. This calls for withdrawal of the EUA for HCQ and CQ for the treatment of COVID-19.

Section 564(c)(2) of the Food, Drug, and Cosmetic Act

Quarantine, in general, means the separation of a person or group of people reasonably believed to have been exposed to a communicable disease but not yet symptomatic, from others who have not been so exposed, to prevent the possible spread of the communicable disease. It is recommended by the CDC to quarantine for 14 days because symptoms usually emerge 2-14 days after exposure.

No. You need to stay at home and not go anywhere.

Yes. All family members should quarantine if one family member is quarantined. Please contact your health care provider if you have questions.

Isolation is used to separate people who have already been infected with a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example, hospitals use isolation for patients with infectious tuberculosis.

Quarantine is used to separate and restrict the movement of people who aren’t sick who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease.

Contact your local military clinic or hospital, your local health department, or the MHS Nurse Advice Line at 1-800-874-2273, Option 1 or online: https://mhsnurseadviceline.com.

We are instituting risk assessments and if necessary, medical evaluations, for all personnel prior to departure on any military aircraft. Additionally, we are putting preventive monitoring measures in place for those who have recently traveled. Specifically, for those who recently traveled to, though, or from a CDC Travel Health Advisory Level 2 or Level 3 country, we are directing that they stay at home at 14 days, practice social distancing, and self-monitor for potential symptoms of COVID-19 including taking their temperature twice a day. For all other returning travelers, including those traveling within the United States, we are telling them to practice social distancing and be mindful in their daily self-observation for any signs or symptoms of COVID-19. For all, we are telling them that if they feel sick, they should immediately self-isolate, notify their leadership, and call the appropriate medical authorities for assistance.

No, this policy applies to all personnel who travel or have recently traveled. However, the actions we expect our leaders and people to take are dependent upon their travel routes and locations. At this time, all countries other than the United States are either Level 2 or Level 3, which requires screening whether it was for travel to, from, or through.

All medical facilities have infectious disease protocols in place, not just for COVID-19 but for any infectious disease. Patients who test positive are isolated from the general population in designated isolation rooms.

Military hospitals and clinics are now offering virtual telehealth visits, through audio-video conferencing or by phone.  They are doing this to limit exposure for you, other patients and the medical staff. 

If you get have a telehealth appointment, make sure you answer any of the telephone numbers the military clinic or hospital has on file for you.  Or answer your phone at the designated time of your appointment, even if it shows as a blocked or restricted number.  If you have questions or problems, please contact the clinic or send your team a secure message. 

At this time it’s too soon to know as we are still learning about the virus.

If you have a true medical emergency, call 911. If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

If you have asthma, or other underlying conditions, the COVID-19 can cause inflammation. If you feel you’re experiencing symptoms, contact your provider to be evaluated.

An allergy is a reaction by your immune system to something that doesn’t bother most other people (e.g. pollen, dust, mites, etc.). Allergies symptoms can include a runny nose, sneezing, itching, rashes, swelling, or asthma. COVID -19 is the disease caused by the corona virus. Symptoms include fever, coughing or sneezing, or difficulty breathing. As you can see, there are similar symptoms. If you don’t have a fever, it’s likely you may be suffering from allergies.

Per the U.S. Food and Drug Administration (https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19). 

At this time, FDA is not aware of scientific evidence connecting the use of NSAIDs, like ibuprofen, with worsening COVID-19 symptoms. The agency is investigating this issue further and will communicate publicly when more information is available. However, all prescription NSAID labels warn that “the pharmacological activity of NSAIDs in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections.”

For those who wish to use treatment options other than NSAIDs, there are multiple over-the-counter and prescription medications approved for pain relief and fever reduction. FDA suggests speaking to your health care professional if you are concerned about taking NSAIDs and rely on these medications to treat chronic diseases.

Here is guidance from the Defense Health Agency:   

• Immunization of uniformed service members is of the highest priority.  The goal is to achieve and maintain readiness.
• Military clinics:
• Provider exams may not be necessary (e.g., well-baby check).  This is a military hospital or clinic decision.
• Pediatric clinics:  The priority is for newborns, infants, young children, and those prone to infection (e.g., immune problems).  They are likely to get shots before older children with routine needs.
• Adult Clinics:  The priority is for those prone to infection.  They are likely to get shots before those needing routine shots.
• To limit COVID-19, you may experience:
• Verbal screening for possible infection,
• Separate appointments for immunization versus sick-patient visits, and/or
• Separate immunization locations.
• Immunization clinics are to inform to parents and patients.  They should tell you about how to catch up on routine immunizations after COVID-19.
• Civilian providers and clinics may have similar guidance and processes.   Contact you provider for more specific information.

Note:  Rabies post-exposure treatment is the only immunization considered “urgent”. These shots have the highest priority for care.You may want to contact your daughter’s school.  Some school are allowing for delays in immunization dates.

The CDC has a wealth of information available and up-to-date on COVID-19. Visit: https://www.cdc.gov/coronavirus/2019-nCoV/index.html

The FAQ portion of the CDC COVID response can be found at: https://www.cdc.gov/coronavirus/2019-ncov/faq.html.

COVID-19 is a viral respiratory illness that can spread from person-to-person. It’s a novel coronavirus that was first identified during an investigation into an outbreak in China.

The virus spreads through close contact between people and by droplets from coughs or sneezes.  Some people without symptoms may be able to spread the virus. In general, the more closely a person interacts with others and the longer that interaction, the higher the risk of COVID-19 spread.

It also spreads when a person touches a surface with the virus on it, and then touches his or her nose, mouth, or eyes.

The risk of COVID-19 spreading from animals to people is considered to be low. It looks like COVID-19 can spread from people to animals in some situations.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html.

• People with COVID-19 have a wide range of symptoms – ranging from mild symptoms to severe illness.Symptoms may appear 2-14 days after exposure to the virus. 
• People with these symptoms or combinations of symptoms may have COVID-19:
• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea
• Seek emergency medical attention if you show these signs or symptoms:
• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face

This list is not all possible symptoms. Please consult your medical provider for any other symptoms that are severe or concerning to you. Call 911 or call ahead to your local emergency facility: Notify the operator that you are seeking care for someone who has or may have COVID-19.

View the CDC website at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.  

Check out the “Self Checker” on that same site.   

Reported illnesses range from very mild (with no reported symptoms) to severe, including some deaths. COVID-19 is a new disease. Based on what we know at this time, people with the following conditions might be at an increased risk for severe illness from COVID-19:

• Older adults, especially those with underlying medical conditions.
• Asthma (moderate-to-severe)
• Cerebrovascular disease (affects blood vessels and blood supply to the brain)
• Cystic fibrosis
• Hypertension or high blood pressure
• Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Pregnancy
• Pulmonary fibrosis (having damaged or scarred lung tissues)
• Smoking
• Thalassemia (a type of blood disorder)
• Type 1 diabetes mellitus

There are other people who may need to take extra precautions. 

• Racial & Ethnic Minority Groups
• People Experiencing Homelessness
• Pregnancy and Breastfeeding
• People with Disabilities
• People with Developmental and Behavioral Disorders

Click on the links for more information these conditions. For information on what steps to take to stay healthy, visit https://www.cdc.gov/coronavirus/2019-ncov/community/retirement/checklist.html.

According to the Centers for Disease Control (CDC), patients may experience symptoms of COVID-19 within two to 14 days after exposure.  See the CDC website at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-increased-risk.html.

You may have COVID-19 if you:

• Came in contact with someone diagnosed with COVID-19, or 
• You or someone you came in contact with traveled to an area where the infection is sustained or widespread.  (See the CDC country list at https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html)

AND

• You now have a fever, cough, difficulty breathing or other symptoms of COVID-19. See https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  

Here are 2 handy starting places for help on what to do:

1. The CDC Self-Checker. This tool is for those 13 years and older, and parents and caregivers of children ages 2 to 12. It helps a person decide when to seek testing or medical care. The tool asks a series of questions. Based on the responses, provides recommended actions and resources.
2. The MySymptoms checker from the Department of Defense serves a similar purpose. It offers feedback and direction specifically for DoD military and civilian personnel.

If you have symptoms, were exposed to someone with COVID-19, or traveled to areas where infection is widespread, please don’t make an appointment or walk into your local military or civilian hospital or clinic. Instead, speak to a Registered Nurse or office staff member in advance. That person will assess your symptoms and advise you on what to do.  You may:

• Call the Military Health System Nurse Advice Line (MHS NAL) at 1-800-874-2273, Option 1 or online at https://mhsnurseadviceline.com/
• Call your military or civilian primary care clinic directly
• Send your primary care physician a secure online message, if you can do so.
• If you’re enrolled to a military hospital or clinic, you may also:
• Call the appointment line; the appointment line staff can submit a telephone consult to your primary care clinic nurse if you ask for one

Send your primary care team a secure message in the TRICARE Online or MHS GENESIS Patient Portal.

The nurse or staff member decides whether your symptoms may be due to COVID-19 or another illness requiring treatment.  You might get advice on self-care since symptoms often can be treated at home.

The nurse/staff member may arrange a telephone visit between you and a healthcare provider or tell you to call your provider directly.  The provider can talk with you about possible exposure, your symptoms, and discusses treatment.  The provider may give you self-care advice to use at home.  He or she may tell you to go to your primary care clinic or emergency room/urgent care. 

This is so we can protect you, other patients, and medical staff from unnecessary exposure to COVID-19. 

You should only go to a clinic or hospital if you are advised to, or are having difficulty breathing or have flu-like symptoms that aren’t getting better with time.  First, call for advice.  The nurse or office staff will assess your symptoms.  They may have you speak to a healthcare provider or tell you to come directly to the office/clinic or hospital. You should:

• Call the Military Health System Nurse Advice Line (MHS NAL) at 1-800-874-2273, Option 1 or online at https://mhsnurseadviceline.com/
• Call your military or civilian  primary care clinic directly
• Send your primary care physician a secure online message, if you can do so.

If you’re enrolled to a military hospital or clinic, you may:

• Call your military clinic/hospital appointment line; the appointment line staff can submit a telephone consult to your primary care clinic nurse if you ask
• Send your MTF primary care team a secure message in the TRICARE OnLine or MHS GENESIS Patient Portal
  

There are a number of things you can do (https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html?), including:

• Practice good personal hygiene.  This includes:
• Washing your hands (at least 20 seconds with soap and water) or use a hand sanitizer that is at least 60% alcohol
• Clean and disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, keyboards, toilets, faucets, and surfaces. Clean first, the disinfect.
• Using tissues when you cough or sneeze, throwing the tissues away, and washing your hands
• Coughing or sneezing into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
• Avoiding touching your eyes, nose, and mouth
• Avoiding being close to others who are ill or showing symptoms.  Greet people verbally instead of shaking hands or hugging.
• Limiting touching frequently touched services in public, e.g. opening doors, pressing elevator buttons, using hand rails, handling menus

• Get a flu shot if you didn’t get one earlier.  The flu vaccine won’t protect you from COVID-19, but the flu currently poses a greater threat to the public than COVID-19.
• Avoid public activities or areas visited by a large number of people.
• Avoid close contact with people who are sick.
• Greet people verbally instead of shaking hands or hugging.
• Stay at least 6-feet (about 2 arms' length) from other people.
• Cover your nose and mouth with a cloth face cover when around other others.
• Monitor your health. Watch for symptoms, in yourself and others.
• Get the pneumonia vaccine if you’re eligible. It’s recommended for adults 65 and older, all children younger than 2 years, persons 2 through 64with certain health conditions, and adults 19-64 who smoke cigarettes (https://www.cdc.gov/vaccines/vpd/pneumo/index.html)  

It doesn’t protect you from COVID-19, but lowers your risk of bacterial infection.

Note:  Face masks

• CDC recommends that you wear masks in public settings around people who don’t live in your household and when you can’t stay 6 feet away from others. Masks help stop the spread of COVID-19 to others.

Overview

• Wear masks with two or more layers to stop the spread of COVID-19
• Wear the mask over your nose and mouth and secure it under your chin
• Masks should be worn by people two years and older
• Masks should NOT be worn by children younger than two, people who have trouble breathing, or people who cannot remove the mask without assistance
• Do NOT wear masks intended for healthcare workers, for example, N95 respirators
• CDC does not recommend the use of gaiters or face shields. Evaluation of these face covers is on-going but effectiveness is unknown at this time.
• If you want to wear a gaiter, it should have 2 layers (either part of the gaiter or if the gaiter can be folded over).
• Wash you mask regularly. Always remove your mask correctly (by the ties; not the part over the mouth and nose). Wash your hands after handling or touching a used mask.

For information on masks, and how to select wear, and clean your mask, visit: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

 

CDC knows that wearing face masks coverings may not be possible in every situation or for some people. In some situations, wearing a face mask may worsen a physical or mental health condition, lead to a medical emergency, or introduce significant safety concerns. For example,

• If you are deaf or hard of hearing—or if you care for or interact with a person who is hearing impaired—you have problems if you rely on lipreading to communicate. In this case, consider asking others to use a clear face covering. If that’s not possible, ask them to consider using written communication, closed captioning, or decreasing background noise while wearing a cloth face covering that blocks your lips.
• Some people with developmental disabilities, sensory integration concerns or tactile sensitivities, certain mental health conditions, or limited cognitive ability may have a negative reaction to wearing a face mask. They should consult with their healthcare provider as part of the decision to wear a face mask.
• Younger children (e.g., preschool or early elementary aged) may be unable to wear a face mask properly, especially for a long period. Have your children wear face masks when it’s hard to maintain a distance of 6 feet from others (e.g., during carpool drop off or pick up, or when standing in line at school). Ensure your child’s face mask is the right size and fit. Teach and remind your children about how important it is to wear face masks. Make sure they wear the covering correctly.
• Don’t wear face masks while in activities that may cause the face mask to become wet, like when swimming at the beach or pool. A wet face mask may make it difficult to breathe. For these activities like swimming, it is important to maintain physical distance from others when in the water.
• If you do high intensity activities, like running, wearing a face mask may make it difficult to breathe. If you need to you should consider doing the activity where there is greater air circulation and air exchange (for instance, outdoors versus indoors). You need to maintain a safe physical distance from others.
• If you work in a place where face masks may increase your risk of heat-related illness or cause safety concerns (e.g., straps getting caught in machinery), check with an occupational safety and health professional to find out what is the best face covering for your work. Outdoor workers may use face masks when in close contact with other people, like during group travel or shift meetings. They may remove the mask when social distancing is possible.

Speak to a Registered Nurse, office staff member, public health office first.  Someone should be able to assess your symptoms and advise you on what to do.  You may:

• Call the Military Health System Nurse Advice Line (MHS NAL) at 1-800-874-2273, Option 1 or online at https://mhsnurseadviceline.com/
• Call your military or civilian primary care clinic directly
• Send your primary care physician a secure online message, if you can do so.
• If you’re enrolled to a military hospital or clinic, you may also:
• Call the appointment line; the appointment line staff can submit a telephone consult to your primary care clinic nurse if you ask for one
• Send your primary care team a secure message in the TRICARE OnLine or MHS GENESISMHS GENESIS is currently available at Fairchild Air Force Base, Madigan Army Medical Center, Naval Hospital Bremerton, Naval Health Clinic Oak Harbor, Travis Air Force Base, Naval Air Station Lemoore, the Presidio of Monterey, and the Mountain Home Air Force Base. Patient Portal

If your military or TRICARE-authorized civilian provider has the ability to provide telehealth/telemedicine services (securely and in accordance with their license), certain services are covered.  You may have copays or cost shares. Telehealth must be HIPPA-compliant and protect your privacy. See the article at https://tricare.mil/CoveredServices/BenefitUpdates/Archives/03_24_2020_TRICARE_covers_certain_telemedicine_services.

TRICARE covers most medical care, psychotherapy, physical therapy and occupational therapy, and Applied Behavioral Analysis (ABA) services by telehealth when medically necessary.

Yes. Military hospitals and clinics have the capability to test for COVID-19 for people for whom testing will change treatment decisions or change exposure risks to others (i.e., healthcare workers).  If it lacks the ability to test in-house, it will send the sample to an outside laboratory.

No, clinics and hospitals follow federal or state guidelines for keeping sick patients away from others.  They also follow strict guidelines on infection control and cleaning public areas and treatment rooms.  You should feel safe to get treatment, elective procedures, or even deliver your baby.

If you were exposed, you should contact your local military clinic or hospital, the Military Health System Nurse Advice Line at 1-800-874-2273, Option 1 or online at https://mhsnurseadviceline.com/, or your local health department. They can arrange for information to be gathered by the public health team.

First, Service members must check with their Service and local installation for guidance on travel outside of the local community. You must be aware of the risks associated with travel outside your local community.  The CDC publishes guidelines on how to avoid risk and prevent infections. 

• Anyone planning international travel should visit www.travel.state.gov to get the latest information on travel restrictions.

Note: The Department of Defense has information on travel restrictions and PCS moves. Visit: https://www.defense.gov/Explore/Spotlight/Coronavirus/Latest-DOD-Guidance/

Develop a household plan based on daily needs and routine. Check your food and supplies; make care arrangements for children, elders and pets; and make sure you have enough critical prescription drugs. 

Public health officials may recommend actions if there is a local community outbreak.  They will likely take actions that limit exposure, such as cancelling large gatherings. Check out the CDC website on how to prevent illness and protect yourself:  https://www.cdc.gov/coronavirus/2019-ncov/protect/index.html

Most people can recover from COVID-19 at home. Treatment is similar for that of the flu - rest and fluids. There are currently no antiviral drugs recommended or licensed by the U.S. Food and Drug Administration for COVID-19 for adults or children.  Families should try to prevent the spread of respiratory infections, by covering coughs and sneezes, cleaning hands often with soap and water or 60% alcohol-based hand sanitizer, and staying up to date on vaccinations, including the flu vaccine.  Follow the Center for Disease Control (CDC) instructions on how to take care of yourself at home (https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html).

Doctors treat severe cases in the hospital - with intravenous fluids and breathing machines if necessary. 

Children should clean their hands often using soap and water or 60% alcohol-based hand sanitizer.  They should use tissues if they cough or sneeze, throw the tissues away, and then wash their hands.  Children should stay away from people who are sick.  They should stay up to date on vaccinations, including the flu shot. 

They aren’t that different.  Children have the same cold-like symptoms, such as fever, runny nose, and cough. One child had vomiting and diarrhea.  Severe symptoms are uncommon. For more information, go to FAQS for Children. (https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/children-faq.html )

Children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease are a higher right for severe illness from COVID-19 than other children.

Treatment is similar for that of the flu - rest and fluids.  There are currently no antiviral drugs recommended or licensed by the U.S. Food and Drug Administration for COVID-19 for children or adults.  Children and their family members should try to prevent the spread of infection by covering coughs, cleaning hands often with soap and water or 60% alcohol-based hand sanitizer, and staying up to date on vaccinations, including influenza.  

Pregnant women might be at an increased risk for severe illness from COVID-19 compared to non-pregnant women. Pregnant women with COVID-19 are more likely to be hospitalized and are at increased risk for intensive care unit (ICU) admission and receipt of mechanical ventilation than nonpregnant women.

There may also be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick.

If you are pregnant:

• Do not skip your prenatal care appointments or postpartum appointments. If you are concerned about attending your appointment due to COVID-19, talk to your healthcare provider. 
• If you have questions about the best place to deliver your baby, discuss them with your healthcare provider.
• Call your healthcare provider if you have an urgent medical question. 
• In case of emergency, call 911 or go to your local emergency department. If you are not driving, call the emergency department on the way to explain that you are pregnant and have an emergency.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

We still don’t know about the risks of COVID-19 to newborns.

• Newborns can be infected with the virus that causes COVID-19 after being in close contact with an infected person.
• Some babies have tested positive for the virus shortly after birth. It is unknown if these babies got the virus before, during, or after birth.
• Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are a few reports of newborns with severe illness.
• A small number of other problems, such as preterm (early) birth and other problems with pregnancy and birth, have been reported in babies born to mothers who tested positive for COVID-19. We do not know if these problems were related to the virus.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

If you choose to breastfeed:

• Breast milk provides protection against many illnesses and is the best source of nutrition for most infants.
• You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding.
• We do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.

If you have COVID-19 and choose to breastfeed:

• Wear a cloth face covering while breastfeeding.  Wash your hands with soap and water for at least 20 seconds before each feeding.

If you have COVID-19 and choose to express breast milk:

• Use a dedicated breast pump (not shared).
• Wear a cloth face covering during expression and wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts and before expressing breast milk.
• Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
• If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

People of any age with the following conditions are at increased risk of severe illness from COVID-19:

• Chronic kidney disease
• COPD (chronic obstructive pulmonary disease)
• Immunocompromised state (weakened immune system) from solid organ transplant
• Obesity (body mass index [BMI] of 30 or higher)
• Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Sickle cell disease
• Type 2 diabetes mellitus

For more information, if you have a specific condition, visit https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.

If you are at higher risk for serious illness from COVID-19 because of your age or because you have a serious long-term health problem, it is extra important for you to take actions to reduce your risk of getting sick with the disease. Limit your interaction with other people as much as possible. Take precautions to prevent getting COVID-19 when you do interact with others. Visit https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html.

You should:

• Have drugs and supplies on hand
• Call your military or civilian health care team to ask if you need extra prescription drugs in case there is a COVID-19 outbreak in your area and you need to stay home for longer than your prescriptions will last.
•  for more information.) You may be able to have an authorized person pick up your drugs from the military or retail pharmacy or get them delivered to your home – call your pharmacy for information. If you are sick and should stay home, think about using the TRICARE mail-order pharmacy program. (Certain rules may apply that you’ll need to follow.  See tricare.mil/pharmacy
• Be sure you have over-the-counter medicines and supplies (tissues, fever-reducing drugs, etc.) on hand to treat fever and other symptoms.
• Have enough household items and groceries on hand so that you can stay at home for a long period of time – as determined your care provider and local guidance
• Take everyday safety measures:
• Avoid contact with people who are sick.  Stay home as much as possible
• Wash your hands often - with soap and warm water for at least 20 seconds.  Wash your hands after blowing your nose, coughing, or sneezing, or being in a public place.
• If soap and water aren’t available, use a hand sanitizer that is at least 60% alcohol.
• Avoid crowds, especially in poorly ventilated spaces.  Don’t shake hands or hug others.   Your risk of exposure to respiratory viruses like COVID-19 is higher in crowded, closed-in settings with little air flow if there are people in the crowd who are sick.  Use extra caution if you have to go out in public. 
• Limit your touching of frequently touched surfaces: elevator buttons, door handles, hand rails.
• Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Wash or sanitize your hands after touching often-touched public surfaces
• Avoid touching your face, nose, and eyes, much as possible.
• Clean and disinfect your home to remove germs: clean and disinfect frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones).
• If COVID-19 is spreading in your community, take extra steps to distance yourself from other people.  Think about ways of getting food to your home, for example, have family, or social and commercial services drop them off.

• Pay attention for COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call the MHS Nurse Advice Line or your primary care provider for advice.
• If you start having emergency warning signs for COVID-19 get medical care quickly. In adults, emergency warning signs may be:
• Difficulty breathing or shortness of breath
• Constant pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

• If you start having emergency warning signs for COVID-19 get medical care quickly. In adults, emergency warning signs may be:
• Difficulty breathing or shortness of breath
• Constant pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face
• Stay home and call your provider or local military or civilian clinic or hospital.  Let them know about your symptoms.
• If your breathing or chest pains are severe, call 911.  Tell them you may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.
• If you are not sick enough to be hospitalized, you can recover at home. Follow the Center for Disease Control (CDC) instructions on how to take care of yourself at home. (https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html)

If you have symptoms of COVID-19:

• If your symptoms are mild:
• Your healthcare provider (physician, nurse practitioner, pharmacist, etc.) may advise a SARS-CoV-2 test.
• If you test positive for SARS-CoV-2 infection or are not tested, you should self-isolate for at least 10 days after symptom your symptoms start. You should be fever free for at least 24 hours without the use of fever-reducing medications, and your other symptoms improve.
• If you live with a person at increased risk of severe illness (for example an elderly relative or other individuals with underlying conditions), take special precautions in the home to protect that individual according to CDC guidelines.
• If your symptoms get worse while you are isolating, or become moderate/severe, (e.g., shortness of breath or severe fatigue), contact your healthcare provider immediately or seek emergency care.
• If you test positive, you don’t need to repeat a test for at least 3 months.
• You don’t need a follow-up negative test to return to work or school, as long as
• You didn’t require hospitalization, AND
• It has been at least at least 10 days after symptom your symptoms start. You should be fever free for at least 24 hours without the use of fever-reducing medications, and your other symptoms improve.

If you were in close contact, such as within 6 feet of a person with documented SARS-CoV-2 infection for at least 15 minutes and don’t have symptoms.

• You need a test. Contact your healthcare provider or public health official. Testing is recommended for all close contacts of persons with SARS-CoV-2 infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important to quickly identify and test contacts of individuals with SARS-CoV-2 infection. While waiting for your test results, you should self-quarantine/isolate at home. Stay away from household members to the greatest extent possible and use a separate bedroom and bathroom, if available.
• A single negative test doesn’t mean you will remain negative at any time point after that test.
• Even if you have a negative test, you should still self-isolate for 14 days.
• If you can’t self-isolate, or you are a critical infrastructure worker that must work, wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.
• If you live with a person at increased risk of severe illness (for example an elderly person or other individuals with underlying medical conditions), take special precautions in the home to protect that individual according to CDC guidelines.
• Healthcare providers in close contact of a person with documented SARS-CoV-2 infection while using recommended personal protective equipment, don’t need to be tested.
  
  

If you don’t have COVID-19 symptoms and haven’t been in close contact with someone known to have SARS-CoV-2 infection (meaning being within 6 feet of an infected person for at least 15 minutes).

• You don’t need a test unless your healthcare provider or a public health official recommends it.
• If you are tested, you should self-quarantine at home until you know your test results. Follow your healthcare provider’s advice based on your test results.
• A negative test doesn’t mean you will remain negative at any time after that test.

If you are in a high SARS-CoV-2 transmission zone and attended a public or private gathering of more than 10 people (without universal mask wearing and/or physical distancing).

• Your healthcare provider or public health official may advise a SARS-CoV-2 test.
• If you are tested, you should self-isolate at home until you know your test results. Follow your health care provider’s advice based on the test results.
• A negative test doesn’t mean you will remain negative at any time after that test.
• Even if you have a negative test, you should wear a mask, physically distance, avoid crowds and indoor crowded places, wash your hands frequently, and monitor yourself for symptoms.
• Take special precautions in the home to protect any person(s) with increased risk of severe illness according to CDC guidelines.

There is additional guidance on this web site for social gatherings (more than 10 people) or if you live or work in a nursing home or long-term care facility. https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-overview.html.
 

• Teledentistry is the use of telehealth systems in dentistry.  It isn’t the same as face-to-face exams or treatment.  It:
• Limits exposure to COVID-19 through social distancing
• Delivers virtual health and education. 
• Lets dentists and dental specialists advise patients.  They can consult with other dental providers. They can assess and direct a patient to the right source of care (if needed). 
• Serves patients with certain dental conditions and concerns.
• Can decrease the number of patients seeking dental care at emergency departments (ED).
• Providers offer advice and education through: 
• Live video interaction
• Store-and-forward.  This is when a patient, provider, or location sends records or data to a different dental provider or specialist.  This happens using secure system.  
• There may not be a way to conduct a teledentistry appointment.  The patient may not have internet access. The patient’s locate is too remote – there’s not enough bandwidth.  A provider may call to provide advice, consultation, and/or triage.

Does the Military Health System (MHS) offer teledentistry?

• The Military Health System (MHS) offers teledentistry.  Providers may use it, for example, when: 
• A patient quarantined at home needs a virtual appointment
• A dentist has to assess a Service member’s dental risk before deployment
• A dental providers need to consult with other dental or medical providers
• Providers base its use on good clinical judgment. 
• Service Members and the Corporate Dental System (CDS).  CDS will let service members know if they can get teledentistry appointments at local dental treatment facilities.
• A diagnosis may not be possible in a teledentistry appointment.  It may require a physical exam and new x-days.  But, impressions may be helpful to advice, educate, or triage the patient.
• Dental providers must follow HIPAA rules. Providers should:
• Only use DoD or DHA-approved means to conduct the visit (This only applies to military providers.)
• Confirm the patient’s identity.
• Avoid others being in the room during the visit to protect the patient’s privacy.
• Send documents and images through secure means.  For example, use encrypted email, a secure system.

TRICARE doesn’t usually cover teledentistry. The Defense Health Agency is granting a temporary waiver due to COVID-19.  Dental providers may now offer limited exams or consults through teledentistry.  Check with your dentist to see if he or she offers this service.  

United Concordia Companies Inc. (UCCI), is the contractor for TDP and ADDP.  UCCI recognizes teledentistry codes.  Visit TDP and ADDP for more information.