Page 17 - Work Force September 2022

Important updates for Empire Plan enrollees about COVID-related benefits
On this page are important updates for Empire Plan enrollees about pandemic-related benefits including COVID-19 vaccines, telemedicine, mental health and substance abuse program and COVID-19 testing.
COVID-19 vaccines
COVID-19 vaccines, including newly-approved vaccines that have recently received Emergency Use Authorization, are available at no cost. Please visit vaccines.gov for up-to-date information on COVID vaccine availability, who is eligible for vaccines and boosters and how to find a vaccine location near you.
Empire Plan enrollees receiving a COVID-19 vaccine at a retail pharmacy may be asked for insurance information:
• United Healthcare is the medical provider and Group Number is 030500.
• CVS Caremark is the prescription drug administrator.
• The BIN is: 004336 • The Group: RX6027 • The PCN is ADV
There is no out-of-pocket cost for the vaccine or the single booster dose for enrollees. If you were charged a copayment for your COVID-19 vaccine at a retail pharmacy, contact CVS Caremark to request reimbursement at caremark.com.
Telemedicine visits
Empire Plan enrollees continue to have access to virtual telemedicine
visits for medical and mental health visits 24 hours a day, 365 days a
year through LiveHealth Online (empireblue.com/nys). Telemedicine visits through LiveHealth Online are available with no copayment.
Telehealth
It is important to note that any virtual telehealth visit provided
by an Empire Plan participating provider may be subject to a copayment if the visit is not related to a COVID diagnosis.
Mental Health and Substance Use Program
If Empire Plan enrollees or family members need assistance finding
a mental health or substance use provider, please be reminded that the Empire Plan offers guaranteed access to network level benefits
if you call the Plan administrator, Beacon Health Options clinical referral line for assistance arranging care.
You can reach Beacon Health Options by calling 1-877-769-7447 and press or say 3 to reach the Mental Health and Substance Use Program. You can reach the Clinical Referral Line by selecting option 3 from the MHSU program menu. The Clinical Referral Line is available 24 hours a day, 365 days a year.
COVID-19 testing
In accordance with current regulations, Empire Plan member copayments, coinsurance and deductibles are waived when:
and following U.S. Centers for Disease Control and Prevention (CDC) guidelines (tests specifically for surveillance may be excluded).
• Visits are in conjunction with the above COVID-19 testing to diagnose COVID-19 at the following locations, including telehealth:
• An in-network provider’s office
• An in-network urgent care center
• A hospital emergency department
• Any other in-network outpatient provider setting able to diagnose COVID-19.
COVID-19 at-home testing
Effective Jan. 15, 2022, the federal government directed health insurance providers to cover FDA- authorized at-home COVID-19 diagnostic tests.
• The Empire Plan will cover up to eight FDA-authorized at-home COVID-19 diagnostic tests.
• Over-the-counter diagnostic COVID-19 tests are covered with no out-of-pocket cost
at participating network pharmacies using your Empire Plan ID card.
• If a test is paid for out-of- pocket at a non-participating network pharmacy, Empire Plan members can submit for the maximum reimbursement through United HealthCare
online at www.myuhc.com. • For more information, call
the Empire Plan at 1-877- 769-7447 and select option 1 for the Empire Plan Medical Program, or option 4 for the Empire Plan Prescription Drug Program.
Questions and more resources
• The Empire Plan NurseLine
is available 24 hours a day, seven days a week to answer your health-related questions.
• If you have any questions
or concerns regarding your Empire Plan benefits, call
the Empire Plan toll-free at 1-877-769-7447 and select the option for the appropriate program.
• The New York State Department of Financial Services has developed FAQs about health insurance access during the pandemic. Visit: https://tinyurl.com/DFS-FAQs.
•
COVID-19 testing performed at approved locations
September 2022
The Work Force 17