The WTC Health Program has announced, with reference to the COVID-19 outbreak, the following:
If the WTCHP feels a patient has “certain certified WTC-related conditions that may put them at higher risk of illness from COVID-19”, they will cover COVID-19 testing.
- There are no processing delays for WTC Health Program enrollments, certifications, or claims at this time.
- Members should keep upcoming monitoring and treatment appointments, unless otherwise advised by your clinic. Clinics are continuing to provide care through telehealth services (phone or video) when possible. Contact your clinic for more details.
- Members should continue following CDC’s guidelines for COVID-19 prevention.
The WTCHP will cover treatment for COVID-19 when “certain criteria are met,” including that the member was eligible for COVID-19 testing, the treatment is authorized by the Program, and the treatment is not experimental.
Many WTCHP patients are “at high risk due to certified WTC-related conditions”.
The WTCHP states all its policies are aligned with CDC testing guidance.
If you have any questions about COVID-19 testing, you should contact your WTCHP clinic so they can approve you.
For more information, see the WTCHP COVID-19 website: https://www.cdc.gov/wtc/covid19.html
COVID-19 Testing and Treatment
We cover limited COVID-19 testing for members with certain certified WTC-related conditions that may put them at higher risk of illness from COVID-19. Treatment for COVID-19 is covered when certain criteria are met, including that the member was eligible for COVID-19 testing, the treatment is authorized by the Program, and the treatment is not experimental.
We are able to provide COVID-19 testing and care to members who are at high risk due to certified WTC-related conditions while ensuring that the Program adheres to its WTC-related care mission, Program requirements, and the James Zadroga 9/11 Health and Compensation Act. All COVID-19 testing and treatment available through the WTC Health Program will align with CDC testing guidance.
Your Clinical Centers of Excellence or the Nationwide Provider Network can inform you about whether the Program will cover the cost of COVID-19 diagnostic testing. Coverage of COVID-19 treatment cost requires approval by the Program Administrator, on a case-by-case basis.