IRHC COVID-19 coverage information

With the outbreak of COVID-19 (coronavirus), we realize you may have questions regarding your benefits. We are committed to working with providers, hospitals, and clinics across the U.S. who are delivering health care to our members. Per your plan benefits (Article VI Challenger Summary Plan Document), services and treatment you receive from an in-network provider are payable at 100% of the covered amount, excluding copayments. This includes services and treatment related to COVID-19 provided within the U.S.

If you are not able to seek treatment from an in-network provider (physician, hospital, or clinic), exceptions may apply. Please contact Iron Road Healthcare (800-547-0421) and speak with a Care Coordinator to request a waiver of the 60% coinsurance charge for using an out-of-network provider. 

As a benefit to our members, Iron Road Healthcare provides telemedicine services with our partner, Doctor on Demand, for just a $10 copay. To register for Doctor On Demand, visit www.doctorondemand.com. If you have flu-like symptoms, we strongly recommend using Doctor On Demand for an initial screening.  Doctor On Demand has posted information about COVID-19 on our blog, NotchEight (https://notcheightblog.com/).

As a reminder, your benefits from Iron Road Healthcare do not cover you if you’re traveling outside of the U.S. The only service that is covered for members traveling outside the U.S. is a 24-hour stay in the Emergency Department (ED).

For example, if you go to the ED for an Appendicitis, and you are admitted to the hospital for surgery, neither the hospital stay or surgery would be covered. Only treatments you received within the ED in the first 24 hours would be covered. 

This rule also applies if you are traveling outside the U.S. (including cruises outside the country), and contract COVID-19 or have any other medical emergency.

If you have travel plans in the future that will take you outside the U.S., we strongly urge you to consider purchasing travel health insurance to cover you while you are away. Please visit Blue Cross Blue Shield (BCBS) https://www.geobluetravelinsurance.com/ or AIG Travel Guard https://www.travelguard.com/ (AIG) for information and pricing on a travel insurance policy.  Travel Insurance is usually very inexpensive, costing around $50 for a couple of week’s worth of coverage.

The health and welfare of our members is our chief concern, and we are available to answer any questions you may have about your benefits. Please contact Member Services at 800-547-0421 Monday through Friday from 7:30 a.m. to 3:30 p.m., MST. You can also email us at help@ironroadhealthcare.com. If you need assistance after hours, please message us via our Facebook page (facebook.com/ironroadhealthcare). For health care emergencies, call 911.