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Coronavirus (COVID-19) Frequently Asked Questions
General FAQs
If you have symptoms of coronavirus (COVID-19), call your doctor. Based on the details of your symptoms, your doctor will let you know whether it’s recommended that you get tested. If you are fully vaccinated, check the most up-to-date CDC guidance for information on testing. Talk to your doctor if you’re not sure. You can find more information about testing here.
You can find up-to-date information on vaccines, your coverage and benefits, and more on our vaccine webpage. For information on how to get vaccinated, visit your city or state’s COVID-19 vaccine sites: New York City, New York State, New Jersey, Connecticut, Pennsylvania.
You can find trusted information on vaccine safety, doses, and more on the CDC’s webpage.
The best ways to help keep you and your family safe from COVID-19 are to:
- Get vaccinated
- Wash your hands often and disinfect frequently touched surfaces.
- Wear a mask over your nose and mouth when around others. Remember to check your state’s guidance on wearing masks in public spaces. The CDC now recommends that fully vaccinated people wear a mask in certain situations.
- Avoid crowds and stay at least 6 feet away from people outside of your household.
- Monitor your health for any COVID-19 symptoms.
- Stay home if you are sick.
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.
Benefits
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.
- See the question above for more details on using telehealth services.
- During the COVID-19 State of Emergency, Medicare Advantage members do not need a referral from their primary care doctor to visit a specialist.
- You can find more information about testing here.
Taking care of your mental health is an important part of living a healthy life. Visit our mental health page for resources, information on how to access your benefits, and tips on to support friends and family.
Remember: If your stress feels overwhelming or unmanageable, get help now. Call 888-447-2526 (Montefiore members 800-401-4822) for confidential, 24/7 support.
Pharmacy
For members who are under quarantine or want to avoid 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.
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.
Coverage
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.
Open Enrollment for Individual and Family Plans is now available through December 31, 2021. Explore our affordable plans and enroll soon to make sure you have the coverage you need for 2021. 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.
If you have a Medicare Special Election Period you can join a Medicare plan.
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.
If you’ve recently had a change in income or lost your job, we can help you see if you qualify for a new health insurance program that may be a better fit for you. You may be eligible for other lower-cost or even free health insurance that keeps you covered. You can visit emblemhealth.com or call 888-432-8026 for a new health insurance program. You can also go directly to the NY State of Health Marketplace, visit nystateofhealth.ny.gov, or call Marketplace Customer Service at 855-355-5777 to update your application.
If you can’t afford your current premium, you may be eligible to switch to lower-cost or even free health insurance. We can help! Visit emblemhealth.com or call us at 888-432-8026.
During the COVID-19 national emergency, EmblemHealth is extending the time within which our members must pay their premium (the amount you pay for your health insurance each month). The special COVID-19 grace period varies by health insurance programs, so be sure to speak with our Customer Service representatives to understand how this applies to your coverage.
If you do not pay your past-due premium within the extended grace period, and your health insurance is terminated, you will be responsible for paying any claims for health care services you received after your coverage ended.
These payments should not be added as income for any NY State of Health consumer.
COVID-19 Treatment
Yes, members can receive treatment for COVID-19 with therapies approved or authorized by the FDA using their pharmacy benefits. Your regular cost-share may apply. This may include deductibles, coinsurance, or copays. Medicaid members have no cost-sharing for these treatments.
Your plan covers antivirals and monoclonal antibodies that are approved or authorized by the FDA. Treatments may help your body fight the COVID-19 virus. It’s important to tell your healthcare provider as soon as you test positive because some of these medicines work best when taken early. Your provider can provide a prescription if you need one of these treatments.
Your healthcare provider can provide a prescription if you need one of these treatments. You can bring your prescription to one of the pharmacies in our network. Test-to-Treat sites throughout the country can also provide tests and treatment in the same visit.
Additional Resources - American Rescue Plan
Yes. New York has announced uninsured individuals can purchase a health plan at lower costs at any time through the end of 2021. Call us at 888-432-8026 or contact the NY State of Health at nystateofhealth.ny.gov, by phone at 855-355-5777, or connect with a free enrollment assistor starting April 1 to learn about affordable health insurance options where you live.
Yes. We are currently working with the state to make sure this works seamlessly for you.
