Independent Health will cover the following services with no member cost share for our commercial group and individual plans (including HSA-qualified high deductible health plans), Medicare Advantage and State programs until further notice:

• Care received when ordered by a health care provider as part of a COVID-19 treatment plan.
• In-network telehealth/telemedicine services, whether or not COVID-19 related. Please note, Medicare Advantage Members will continue to be responsible for the cost share associated with ancillary services (e.g. dietitians).
• Laboratory testing and services, including in-person and telehealth visits, urgent care center, outpatient hospital or emergency room when the primary purpose of the visit is COVID-19 testing and diagnosis.
• Antibody testing with an order or prescription from a primary care provider. (While CMS regulations do not require a provider’s order for Medicare Advantage members, we encourage providers to discuss the benefit of the test with those members.)

*Members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on telehealth benefits and the cost. The back of your member ID card indicates “Medical benefits administered by Nova.”

Independent Health is waiving the member cost share (copayments, deductibles and coinsurance) on certain services:

Telehealth and Telemedicine: To encourage social distancing and help reduce the risk of spreading this virus, Independent Health will cover any in-network telehealth/telemedicine services, whether or not COVID-19 related. There will be $0 copay or cost-sharing* for members for these services.

*Medicare Members are responsible for the cost share associated with ancillary services (e.g. dietitians). Members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on telehealth benefits and the cost.

Teladoc®: Although we encourage our members to contact their primary care physician for their medical needs, we realize this isn’t always possible. So, when you can’t reach your primary care physician, Independent Health’s telemedicine benefit is provided through Teladoc* allows you to talk with a doctor anytime, anywhere by phone, mobile app or online 24 hours a day, 7 days a week.

We will waive the cost share for Teladoc services during the COVID-19 outbreak for our members’ ease and convenience. Learn more about Teladoc including how to get started.

*Teladoc is not available to MediSource, MediSource Connect, Essential Plan and Child Health Plus members. Additionally, members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on Teladoc benefits and the cost.

Note to Medicare Advantage Members: Due to the emergency declaration, Medicare Advantage members may obtain care from out-of-network providers at the in-network cost sharing. For more information, see the page called “Getting care during a disaster.”

No. You will not have to pay for COVID-19 testing ordered by a health care professional, including at a doctor’s office, urgent care center or emergency room. All laboratory testing and diagnostic services that occur for testing and diagnosis of COVID-19 will have no member cost share* for all plans, including HSA-qualified high deductible health plans (HDHPs).

*Members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on telehealth benefits and the cost.

No, you will not have to pay for any care you receive when ordered by your doctor as part of your COVID-19 treatment plan. You will be fully covered for the treatment and services you receive for COVID-19. Independent Health will continue to waive the cost share for these services until further notice.

If you seek treatment for a health issue, illness or injury that is unrelated to COVID-19, you will be responsible for paying the standard copays or coinsurance per your current benefits.

Due to the emergency declaration, Medicare Advantage members may obtain care from out-of-network providers at the in-network cost sharing. For more information, see the page called “Getting care during a disaster.”

Antibody tests look for past infection with the coronavirus that causes Covid-19. After someone has been infected with the coronavirus, their body usually produces antibodies in response to the infection. Antibodies are proteins that help fight off infections.

Depending on when someone was infected and the timing of the antibody test, the test may not find antibodies in someone’s blood with a current COVID-19 infection, because it can take one to three weeks for antibodies to appear after symptoms occur. This means a person infected with COVID-19 may not yet have developed antibodies, leading to a negative test result.

At this time, antibody testing is covered with no cost-share if the test is determined to be medically appropriate and ordered by your healthcare provider.

If you are Medicare Advantage member, you do not need an order from your provider but we encourage to speak with your provider about the benefits of testing

If you are a member of State Program or Product (MediSource, Child Health Plus, or Essential Plan: If you are enrolled in a State Program with Independent Health, we strongly encourage you to work with your primary care provider or other healthcare providers who participate with Independent Health to help decide and arrange COVID-19 virus or antibody testing. If it is not an emergency, you have to get your services from in-network providers. Working with in-network providers will help ensure you are not billed in error by providers that do not participate with Independent Health.

If you are a member of a self-funded group: Members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information about this coverage. The back of your member ID card indicates “Medical benefits administered by Nova.”

The CDC has advised that antibody tests should not be used to diagnose an active COVID-19 infection. An antibody test may not indicate current infection, because it typically takes one to three weeks to make antibodies after symptoms occur.

The CDC has also advised that we do not know yet if having antibodies to the virus can protect someone from getting infected with the virus again, or how long that protection might last. For these reasons, it is important that you discuss with your primary care provider the value of antibody testing. If your primary care provider orders antibody testing for you, you should be sure to follow up with your provider to discuss your test results and what they may mean.

The lab that conducts the test is required to tell you:

• If the test has not been reviewed by the Food and Drug Administration.
• False negative results can occur. You could have infection not detected by the test.
• False positive results can occur. Positive results may be due to past or present infection with non-COVID-19 coronavirus strains such as the common “cold.”
• Results from antibody testing should not be used as the sole basis to diagnose or exclude COVID-19 infection, or to inform infection status.

There are several county and State testing locations in Western New York, so check with your health care provider, as well as your county’s Health Department website for testing locations.

Testing for the COVID-19 virus or the antibody required by an employer is the employer’s responsibility. Therefore, if COVID-19 virus or antibody testing is required for going or returning to work, please check with your employer for further information and guidance. Independent Health does not cover testing that is a requirement for going or returning to work.

Yes, to confirm the test is medically appropriate, you need an order from your doctor before you get tested in order for the test to be covered with no cost share. Your primary care provider will determine if you need a test based on medical criteria. and will ensure that the costs of the testing are covered. Certain testing sites may not require a prescription but may also ask for payment in advance and reimbursement for covered services will have to be submitted and processed by Independent Health. To reduce out-of-pocket cost, you may go to one of the county or State testing sites.

If you are a Medicare Advantage member, you do not need a doctor’s order, but we encourage you to speak with your health care provider about the benefits of testing.

You must check with your health care provider to determine if the test is medically appropriate.

Many physician practices have been working to set up telehealth capabilities so they can treat their patients through remote technologies in lieu of a patient visit. The availability of telehealth services varies by physician practice. These services can include consultation by phone, email, online portal or video.

At this time, we have removed the member cost share* for any in-network telehealth services, even if it’s not COVID-19 related. We have expanded this coverage to encourage social distancing and help reduce the risk of spreading this virus. You should check with your doctor’s office to see if it provides telehealth services. Each practice may have their own way of scheduling and conducting these types of services.

If your doctor does not offer telehealth services or you are having difficulty reaching your doctor due to increased call volume, you may be able to use our telemedicine benefit through Teladoc*, which allows you to talk with a doctor anytime, anywhere by phone, mobile app or online 24 hours a day, 7 days a week. We have waived the member cost share for Teladoc services during the COVID-19 outbreak for your ease and convenience. For more information, click here.

In addition, we offer a 24-Hour Medical Help Line, which allows our members to speak with an experienced registered nurse to get answers to questions. The nurses can help members learn more about the treatment and procedure options available for different health problems and diseases. The phone number for the 24-Hour Medical Help Line can be found on the back of your Independent Health member ID card.

*Teladoc is not available to MediSource, MediSource Connect, Essential Plan and Child Health Plus members. Additionally, members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on benefits and the cost.

Now, more than ever, it is very important to have a primary care physician. A primary care physician (PCP) can properly coordinate your care and serve as the central source for information and guidance on all matters of your health and well-being – even if you’re healthy.

Not sure how to choose the right PCP for you? We can help. Contact Member Services by phone or e-mail.

In the meantime, you may be able to use our telemedicine benefit through Teladoc*, which allows you to talk with a doctor anytime, anywhere by phone, mobile app or online 24 hours a day, 7 days a week. For more information, click here.

In addition, we offer a 24-Hour Medical Help Line, which allows our members to speak with an experienced registered nurse to get answers to questions. The nurses can help members learn more about the treatment and procedure options available for different health problems and diseases. The phone number for the 24-Hour Medical Help Line 1-800-501-3439.

If you are thinking of going straight to a facility or hospital for care, we encourage you to call ahead and discuss your concerns with their staff first.

*Teladoc is not available to MediSource, MediSource Connect, Essential Plan and Child Health Plus members. Additionally, members who are Self-Funded through your employer should contact us at (716) 631-2661 or 1-800-257-2753 for more information on benefits and the cost.