COVID-19 Member Cost-Sharing Notification

Dear Provider,

EmblemHealth, like you, is taking all measures to ensure that all our members have access to the services they need during the coronavirus (COVID-19) outbreak. We value your partnership in caring for our members every day. During this public health crisis, it is critical to ensure that together we support patients’ health and well-being and remove any barriers to care.

 

This is why we are writing to tell you that all EmblemHealth plan members who use an in-network provider for the diagnostic visit and related lab test for COVID-19 will have no cost-sharing (including copayments, coinsurance, or deductibles) for those services. This applies to all care settings, including any in-network facility where COVID-19 diagnosis and testing are being delivered. It also includes in- and out-of-network emergency rooms.

 

Telehealth services (via phone/virtual check-in/virtual visit via Skype, FaceTime, or other video exchange)

 

EmblemHealth members across all our product lines will have no cost-sharing (including copayments, coinsurance, or deductibles) for in-network telehealth visits. These visits have no cost-sharing whether or not that visit includes testing for COVID-19. Members with a benefit plan that includes the Teladoc program will also have no cost-sharing for Teladoc visits. The telehealth cost-sharing waiver may not apply to ASO plans.

 

Please do not collect cost-sharing payments from any EmblemHealth member for the services described in this letter until further notice.

 

These temporary cost-sharing waivers do not apply to out-of-network providers. All normal coverage restrictions and cost-sharing charges will apply for care and treatment, including non-emergency inpatient hospital admissions.

 

Important notes

  • Please follow the Centers for Disease Control and Prevention (CDC) guidelines for coding (a link to the CDC coronavirus website can be found on our dedicated provider COVID-19 website page at emblemhealth.com/providers).
  • We have posted this notice to our website, and we encourage you to visit emblemhealth.com to view our member and provider information about COVID-19. We will continue to monitor the outbreak and update these pages as we receive information from state and federal authorities.
  • We know that you or your staff may have questions about this. Contact Provider Services at 866-447-9717, or you may also call your Relationship Manager directly. We will help you get the answers you need.

 

Thank you for being an EmblemHealth provider partner. We want to keep you informed and deliver updates to you as quickly as possible. You can help by signing in to the provider portal at emblemhealth.com/providers and making sure we have your current email address. If the email there is incorrect, please use the “Change Email” link on that page to correct it.

 

We appreciate your commitment in continuing to provide care for our members.

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