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Information for HealthChoice members and providers on COVID-19
HealthChoice information on care and coverage for COVID-19
HealthChoice takes member health and well-being very seriously. We are closely monitoring the developing effects of the coronavirus (COVID-19) pandemic and how it relates to you and your health plan benefits. Helping our members and providing support to the medical community is our No. 1 priority.
New updates to coverage expansions
For services from Oct. 1 through Dec. 31, 2020:
Released Oct. 8, 2020
For services from Oct. 1 through Nov. 30, 2020:
Released Sept. 23, 2020
For services from July 1 through Sept. 30, 2020:
Released June 17, 2020
For services March 6 through June 30, 2020:
Released May 12, 2020
Released April 15, 2020
Released April 8, 2020
Released March 30, 2020
Support for our members and the health care community
HealthChoice extended many of its temporary benefits put in place as a response to the pandemic. This information is effective March 6, 2020, through dates of service as indicated below:
- Through Dec. 31, 2020, HealthChoice HDHP members can access telemedicine services through SwiftMD at no cost. HealthChoice members and covered dependents are eligible for free consults with SwiftMD doctors by phone and videoconference. Federal regulations usually require that participants meet their annual deductible before a health plan can waive costs for any medical services other than preventive. However, during the COVID-19 pandemic, there will be no HDHP fee applied for SwiftMD services, regardless of whether or not the visit is related to COVID-19.
- Through Dec. 31, 2020, HealthChoice is expanding its telehealth coverage for both network and non-network providers to include all services that can be effectively performed via telehealth.
- For virtual check-ins, which are short patient-initiated communications with a health care practitioner that do not require audio or video services, HealthChoice is waiving member cost sharing, including copays, deductible and coinsurance, through Dec. 31, 2020. Non-network services are subject to balance billing charges.
- For e-visits, which are online digital evaluation and management services through an online patient portal, HealthChoice is waiving member cost sharing, including copays, deductible and coinsurance, through Dec. 31, 2020. Non-network services are subject to balance billing charges.
- For other covered telehealth services that include real-time interactive audio and/or visual virtual care, HealthChoice will consider these visits to be the same as an in-person visit. Covered services include both urgent and routine medical care, outpatient behavioral care, and physical, occupational and speech therapies (not an all-inclusive list).
- For network services, HealthChoice is waiving member cost sharing, including copays, deductible and coinsurance, through June 30, 2020. Effective July 1, 2020 through Sept. 30, 2020, standard plan provisions including copays, deductible and coinsurance apply unless related to diagnostic testing or treatment of COVID-19. Effective Oct. 1, 2020 through Dec. 31,2020, HealthChoice will again waive member cost sharing for all network telehealth services, including copays, deductible and coinsurance, regardless of whether or not related COVID-19.
- For non-network services, standard plan provisions including deductible and coinsurance apply unless related to diagnostic testing or treatment of COVID-19. Non-network services are subject to balance billing charges.
- For all COVID-19 related services through Dec. 31, 2020, HealthChoice is waiving member cost sharing, including copays, deductible and coinsurance, for covered network and non-network services. This includes diagnostic testing and services as well as treatment for any illness related to COVID-19 that results in the need for standard covered medical treatment. This includes telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home health, emergency department visits and ambulance services. Non-network services are subject to balance billing charges.
- HealthChoice will also cover full member cost sharing for FDA-approved COVID-19 vaccines and medications, along with associated office visits or facility charges, when or if they become available.
- Through Dec. 31, 2020, HealthChoice is removing administrative barriers to facilities by waiving certain certification requirements for admissions related to COVID-19. Providers are responsible for obtaining certification when required. Refer to your HealthChoice health handbook for more information. Admissions to the following levels of care for COVID-19 will not require certification:
- Acute inpatient.
- Long-term acute care (LTAC).
- Acute inpatient rehab.
- Skilled nursing facilities (SNF).
- HealthChoice Dental Plan coverage:
- Through June 30, 2020, virtual dental visits, which include a real-time interactive audio and visual virtual care consultation to triage patients or offer an evaluation to determine if the situation is urgent or emergent, HealthChoice waived member cost sharing, including deductible and coinsurance. Non-network services are subject to balance billing.
Making sure you have access to an adequate supply of your medications is a priority. Check your current medication supply to make sure you have enough on hand. As always, we encourage you to refill your prescription on time.
- As a part of your HealthChoice plan, you are allowed a 90-day prescription supply of your maintenance medications. Ask your physician or pharmacist for information on how to get a 90-day supply.
We understand you may not want or be able to visit a pharmacy to pick up your prescriptions. Home delivery is a good option to ensure you have the medications you need.
- Ask your pharmacy about home delivery options.
- Many retail pharmacies are offering home delivery service. Check with your pharmacy to find out if they offer home delivery and whether there are delivery fees.
- Request your refills be delivered by mail.
- You can have your 90-day supplies of maintenance medications delivered to your home, or any address you choose, once prescribed by your physician.
Additional information and resources:
Emotional support resources – During this stressful time, it may be hard to cope. Mental health is just as important as physical health when it comes to responding to COVID-19. Here are some additional ways to connect to help. Each of these resources is free and available to everyone.
- Emotional support helpline from ODMHSA – The Oklahoma Department of Mental Health & Substance Abuse has a helpline and other mental health resources. Visit coronavirus.health.ok.gov for more information and resources. The helpline is available 24/7 at 877-215-8336 or 2-1-1.
- Emotional support helpline from Optum – This Optum helpline is staffed by professionally trained mental health experts. The helpline is available 24/7 at 866-342-6892.
- On-demand emotional support mobile app – This Sanvello app offers clinically validated techniques, coping tools and peer support. You can download the app from the Apple App store or Google Play store.
SwiftMD telemedicine services – Talk to a board-certified physician 24/7 for a diagnosis or medical advice on minor illnesses or injuries such as allergies, ear infections, pink eye and more. Call SwiftMD at 833-980-1442 or log in at swiftmd.com (use group passcode HCOK20 to get started).
HealthChoice Care Management Program – A team of registered nurses, pharmacists and doctors who understand your plan benefits are available to supplement your doctor’s care and assist you in your health journey. Call a care manager at 888-750-3232 or visit hccarecoordination.com to learn more.
Pharmacy Benefits Manager – for questions regarding your prescription refills or home delivery options call the CVS customer care team at 877-720-9375 or visit the HealthChoice pharmacy benefit page for more information.
Centers for Disease Control and Prevention – The COVID-19 situation continues to evolve quickly. Visit cdc.gov for the latest information from the CDC on COVID-19, including how to protect yourself and what to do if you are sick.
Note: If you believe you might have been exposed to COVID-19 or have symptoms such as fever, cough or difficulty breathing, call your PCP or health care provider right away. Your doctor is in the best position to advise you on needed care.