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EmblemHealth Cohort 1: COVID-19 MEMBER COST SHARING NOTIFICATION

NOTICE | MARCH 31, 2020

Dear Provider,

HealthCarePartners (HCP), like you, is taking all measures to ensure that all 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.

No Cost Sharing

We are writing to tell you that as an HCP provider for EmblemHealth members, there is no cost-sharing (including copayments, coinsurance or deductibles) for members for the diagnostic visit and related lab test for Coronavirus (COVID-19) when using in-network providers. 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 (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.
  • We encourage you to visit HealthCarePartnersNY.com to view updates about COVID-19.

Contact your Provider Representative if you have questions.

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

Sincerely,

Robert LoNigro, MD, MS
President, HealthCare Partners, MSO
EVP, HealthCare Partners, IPA