Coronavirus (COVID-19) Frequently Asked Questions

If you have symptoms of coronavirus (COVID-19), call your doctor. Based on the details of your symptoms and any recent travel, your doctor will follow guidance from the state department of health to determine whether it’s recommended that you get tested.

No. The Food and Drug Administration (FDA) has not authorized any test that is available to purchase for testing yourself at home for COVID-19. Please be aware that there are unauthorized fraudulent COVID-19 tests for sale.

Call your doctor. Your primary care doctor will follow guidance from the state department of health to determine what the best next steps are for you. Unless it’s an emergency, stay home. Do not go to public places and avoid public transportation. As always, if you are experiencing severe symptoms, call 911 or go to your local emergency department. Severe symptoms include high or very low body temperature, shortness of breath, confusion, or feeling like you may pass out. If you decide to go to the emergency department, call ahead and let them know you are coming, if you are able. This will allow them to safely prepare for your arrival.

The following information applies for all our plans.

If you go to an in-network doctor to get tested for the coronavirus (COVID-19):

  • Your test and visit to diagnose COVID-19 (whether in-person or a virtual telehealth visit) will be covered by your plan. There will be no cost-sharing, including copays, coinsurance, or deductibles. Virtual visits include video and/or phone visits.

If you go to an out-of-network doctor to get tested for the coronavirus (COVID-19):

  • Your test and visit to diagnose COVID-19 (whether in-person or virtual telehealth visit) may NOT be covered by your plan. All normal coverage restrictions and cost-sharing charges will apply for care or treatment, including inpatient hospital admissions. Some plans do not cover out-of-network services, so this could include the total cost for services.

If you go to the emergency room to be tested for COVID-19:

  • Your test and visit to diagnose COVID-19 will be covered by your plan. There will be no cost-sharing, including copays, coinsurance, or deductibles. Service you get for an emergency room visit will always be covered, if you are admitted to the hospital.

We have safe and convenient options for members:

·       All EmblemHealth members have access to our 24-hour Nurse Hotline (877-444-7988)

·       AdvantageCare Physicians (ACPNY) is now offering virtual visits for all patients. ACPNY patients should call 646-680-4227 to use this service.

·       For EmblemHealth members with telemedicine as part of their benefit plan, we partner with Teladoc for virtual doctor visits. Visit Teladoc® online or by calling 800-835-2362 to talk with a doctor 24 hours a day, seven days a week.

If you are seeing the doctor for flu-like symptoms and your doctor recommends that you get tested for the coronavirus, your doctor’s visit is covered by your plan at no cost to you.

The following information applies for all our plans.

If you use in-network telehealth services, including a phone call or virtual visit with your in-network doctor for something not related to coronavirus (COVID-19):

  • Your virtual telehealth visit will be covered by your plan. There will be no cost-sharing, including copays, coinsurance, or deductibles. Virtual visits include video and/or phone visits.

If you use on out-of-network telehealth service or have a virtual visit with an out-of-network doctor for something not related to coronavirus (COVID-19):

  • This may NOT be covered by your plan. All normal coverage restrictions and cost-sharing charges will apply for care or treatment, including inpatient hospital admissions. Some plans do not cover out-of-network services, so this could include the total cost for services.

The annual flu vaccine does not protect against the coronavirus. We do encourage members to always get their annual flu vaccine because it is the single best thing you can do to protect yourself and your family from various strains of the flu.  

Currently, testing is only being done on patients whose doctor (following guidance from the Centers for Disease Control and Prevention (CDC) and state departments of health) recommends them to be tested. If you are concerned about upcoming travel or anything else associated with the coronavirus, it’s important to remember the steps you can take to stay safe. For tips to protect you and your family, visit our dedicated EmblemHealth coronavirus webpage, which is continuously updated.

Call your doctor or surgeon to see if it is still scheduled. Some hospitals and facilities are holding off on performing elective surgeries, so it is best for you to check directly with the doctor who is going to perform your surgery.

If you already paid your copay at your first preoperative (pre-op) appointment for a physical or bloodwork but were unable to have your surgery due to coronavirus (COVID-19), and that copay was not refunded, you will not have to pay another copay at the pre-op appointment before your rescheduled surgery.

Yes. To reduce face-to-face contact during the coronavirus (COVID-19) outbreak, Express Scripts has partnered with CVS and Walgreens to provide free home delivery of prescriptions covered by EmblemHealth. Delivery is 1-2 days. Same-day delivery is not available.

 

This agreement started March 16 for CVS, and March 23 for Walgreens. All CVS and Walgreens retail locations have been notified. The agreement will be in place for 30 days for each location. At the end of 30 days, Express Scripts will decide if it is still necessary.

 

To request delivery of your prescription(s):

CVS: You can request delivery in the following ways:

·      Mobile web: This is accessible through the Order Ready Text message when a prescription is ready for pickup. Simply click the link and request delivery (you are required to enroll in text messages from CVS).

·      CVS Mobile App: Like mobile web, but no text messaging is required.

·      Call your local pharmacy: With this option, you may experience longer-than-average wait times; please be patient.

 

Walgreens: You must be enrolled in Walgreens Express™ delivery program and should opt in to receive text messages. When the prescription is ready for pickup, you will receive a text, which will offer you the delivery option. Learn more.

 

In addition, our partner, Medly Pharmacy, offers in-home delivery, in some cases on the same day, in New York City, Long Island, and New Jersey. They offer service in a half-dozen languages, including Spanish, Cantonese, Mandarin, and Russian. To connect with a Medly Pharmacy agent, call or text Medly at 800-595-0643 or visit their website.

 

For information on long-term medicines (maintenance drugs), see our next FAQ on getting a larger supply of prescriptions during the outbreak.

For members who are under quarantine or concerned about visiting pharmacies during the outbreak:

 

EmblemHealth covers 90-day supplies of long-term medications (or maintenance drugs) through Express Scripts mail order so members can get their medications delivered right to their home. Express Scripts also gives members access to pharmacists 24 hours a day, seven days a week, in case they have questions about their medications.

 

Sign up online -- If you already have a myEmblemHealth account, sign in to access your pharmacy benefits. Under “pharmacy,” click on “continue to Express Scripts.” Click “Home” in the Express Scripts window and you will see a list of available prescription refills. Select the items you want to order and follow the instructions to complete your request.

 

By phone -- To start using Express Scripts by phone, have your prescription number ready and call:

Medicare – 877-866-5828

Medicaid – 877-866-4165

All other plans – 877-866-5798

 

Mobile app – Download the app on your mobile device from the App Store, Google Play or Amazon apps.

 

By Fax --You can also ask your doctor to fax your new prescription with a fax cover sheet directly to Express Scripts at 800-837-0959 or use ePrescribe.

 

In addition, our partner, Medly Pharmacy, offers in-home delivery, in some cases on the same day, in New York City, Long Island, and New Jersey. They offer service in a half-dozen languages, including Spanish, Cantonese, Mandarin, and Russian. To connect with a Medly Pharmacy agent, call or text Medly at 800-595-0643 or visit their website.

If you want an early refill for your prescription due to the COVID-19 outbreak, it will help to tell your pharmacist to enter the Submission Clarification Code (SCC) 13. By entering SCC 13, the pharmacist is overriding your standard prescription fill in their system. It will make the process go smoother. Some pharmacies are not as familiar with this new code; that’s why we are telling you about it. If your early refill is rejected even after entering this code, please ask your pharmacist to contact the Express Scripts Pharmacy Help Desk at 800-922-1557.

We are monitoring the situation and will be updating our dedicated EmblemHealth coronavirus webpage with the latest information you need to know. You can also find information from the Centers for Disease Control and Prevention (CDC) on their website.

EmblemHealth wants every New Yorker to have the security of health insurance to ensure they can get the care they need, especially in these uncertain times.

 

New York State has opened a special enrollment period through April 15, 2020 to help uninsured New Yorkers get coverage as the coronavirus spreads. If you  need coverage, visit the NY State of Health, the Official Health Plan Marketplace, at nystateofhealth.ny.gov or call 855-355-5777 to complete an application and enroll in coverage.  If you have coverage available through your employer and have not taken advantage of it, check with your employer about special enrollment options.
 

Centers for Medicare & Medicaid Services has opened a special enrollment period through May 31, 2020 for people eligible for Medicare plans.

 

EmblemHealth can help you apply for health insurance—including Medicare, Medicaid, Child Health Plus, Essential Plan and Qualified Health plans. Shop plans or all us at 800-447-9169 (TTY: 711) For assistance in Mandarin or Cantonese call 866-650-2668.  For assistance in Spanish call 833-336-2536.

Your safety and health are our top priority. Stay up to date on coronavirus (COVID-19) here.