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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 March 6 through June 30, 2020:

  • HealthChoice is now waiving member cost sharing for FDA-authorized antibody testing while the Emergency Use Authorizations are in effect.

Released May 15, 2020 

  • HealthChoice is now waiving member cost-sharing for all covered network telehealth services. Members can now access $0 virtual care even when not related to COVID-19 through:
    • SwiftMD telemedicine services for minor illnesses or injuries.
    • Network providers who deliver virtual care, such as virtual check-ins, e-visits and other covered services that can be performed effectively using telecommunication technology.

Released April 15, 2020

  • HealthChoice is now covering problem-focused virtual dental visits under the HealthChoice Dental Plan, if offered by your dentist. This includes 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. For virtual dental visits, HealthChoice will waive member cost sharing, including deductible and coinsurance. Non-network services are subject to balance billing.
  • HealthChoice has updated coverage for testing administered by clinical diagnostic laboratories. 

Released April 8, 2020

  • For all COVID-19-related services, HealthChoice will waive 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 has expanded telehealth coverage for both network and non-network providers to include all services that can be effectively performed via telehealth. Telehealth services that include real-time interactive audio and visual virtual care are now covered 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. Standard plan provisions, including copays, deductible and coinsurance, apply unless related to diagnostic testing or treatment of COVID-19.
  • HealthChoice is removing administrative barriers to facilities by waiving certain certification requirements for admissions related to COVID-19.

Released March 30, 2020

Support for our members and the health care community

To ensure all HealthChoice members have access to prevention, testing and treatment needed to handle the nation’s current situation, effective for services March 6 through June 30, 2020:

  • HealthChoice members can access telemedicine services through SwiftMD at no cost to the member. All fees are waived for any covered HealthChoice member, regardless if the visit is related to COVID-19 or not.
  • 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 will waive member cost sharing, including copays, deductible and coinsurance. 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 will waive member cost sharing, including copays, deductible and coinsurance. Non-network services are subject to balance billing charges.
    • For other covered services that include real-time interactive audio and visual virtual care, HealthChoice will consider these telehealth 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. For network services, HealthChoice will waive member cost-sharing, including copays, deductible and coinsurance. 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, 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.
  • 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:
    • For 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 will waive member cost sharing, including deductible and coinsurance. Non-network services are subject to balance billing. 

Prescription Refills

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:

Members

Frequently asked questions on COVID-19

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.

Providers

HealthChoice temporary expansion of benefits – Coverage and reimbursement details.

HealthChoice Online Certification Portal – Certification criteria and electronic submission forms.

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