Information about COVID-19 Testing
This section includes information about coverage and non-coverage for Covid-19 testing, when:
You have symptoms and your health care provider decides you need a diagnostic test (covered)
You have a surgery or medical procedure and need a pre-surgical Covid-19 test (covered)
You are tested for non-diagnostic reasons, such as screening required by your employer or by schools. (not covered)
You are tested as part of returning to New York from another state. (not covered)
Please see below for important details.
Coverage for diagnostic testing
Diagnostic tests show whether a person has the Covid-19 virus and the possibility of infecting others.
Independent Health covers COVID-19 testing with no cost-sharing when a healthcare provider decides that testing is medically appropriate for the purpose of diagnosing or treating an individual Independent Health member.
Members of our State products (MediSource, Essential Plan, Child Health Plus) must use participating in-network provider for these services. (These products follow specific coverage guidelines).
Members of our Medicare Advantage plans do not need an order from their health care provider to get a diagnostic test. However, we strongly encourage our members to contact their primary care doctor to help them decide if they need diagnostic test.
Members of our self-funded plans should contact us at (716) 631-2661 or 1-800-257-2753 for specific information about how their plans cover testing. The back of your member ID card indicates “Medical benefits administered by Nova.”
Where to get tested for diagnostic purposes
Contact your primary care provider’s office first.
You may get tested at a New York State or county testing site or urgent care center. Some doctor’s offices, certain pharmacies and all hospitals which participate with Independent Health also offer diagnostic tests.
When Covid-19 Testing is not covered:
Independent Health does not cover testing when it is to screen for:
General workplace health and safety (such as employee return-to-work programs)
Public health surveillance
Attending school (both students and staff), including weekly school screening (as required by the New York Yellow Zone guidelines).
Any other purpose not intended to specifically diagnose or treat an individual.
This policy is consistent with other plans across New York.
New York State travel guidance effective Nov. 4
According to New York State travel guidelines effective Nov. 4, 2020, travelers returning back to New York from other states may get tested for Covid-19 to exit quarantine earlier. Independent Health does not cover this screening test.
Where to get tested for travel and other screening purposes
If you are seeking testing for reasons which are not related to diagnosis and treatment, please discuss your options with the person or organization (e.g. employer, school) asking you to be tested. Government-run sites do not require insurance and may be available to you. However, these sites may prioritize testing resources to those most in need, including but not limited to those with active symptoms, essential workers, or those contact traced and under quarantine.
Coverage for Antibody Testing
Antibody testing with an order or prescription from a primary care provider is covered. (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.)
COVID-19 Vaccine Information
The vaccine is covered with no cost share.
For the most up-to-date information and details on the categories of individuals eligible to get the vaccine and to find out how and where you can get it, visit these websites from New York State:
Or, call the COVID-19 Vaccination Hotline at 1-833-NYS-4VAX (1-833-697-4829), Monday through Sunday from 7 a.m. to 10 p.m.
Public health experts, and federal and state governments recommend everyone to get the vaccine.
The federal Centers for Disease Control and Prevention (CDC) website has information about vaccine safety and what to expect when getting it.
Other important vaccine facts
- COVID-19 vaccination is especially important for people with underlying health problems
like heart disease, lung disease, diabetes, and obesity. People with these conditions are more likely to get very sick from COVID-19. Please consult with your health care provider if you have specific questions about the COVID vaccine and your health.
- Neither of the COVID-19 vaccines that are currently available can cause you to get the disease. For example, the first vaccine approved by the Food and Drug Administration (FDA) uses a small, harmless part of the virus’s genetic material called “mRNA”. This is not the virus. mRNA vaccines teach your body to create virus proteins. Your immune system develops antibodies against these proteins that will help you fight the virus that causes COVID-19 if you are exposed to it. That is called an immune response.
- The Centers for Disease Control and Prevention (CDC) recommends that you get vaccinated
even if you have already had COVID-19 because you can catch it more than once.
- While you may have some short-term antibody protection after recovering from COVID-19, researchers still do not yet know how long immunity after vaccination lasts. That’s why continuing prevention practices like wearing a mask, washing your hands regularly and social distancing will still be important.
Coverage for Treatment and Telehealth
Independent Health covers all services and treatment for our members with no member cost share, including in-person, telehealth, urgent care center, outpatient hospital or emergency room visits when the primary purpose of the visit is COVID-19 testing, diagnosis and treatment.
This coverage applies until further notice to all fully insured commercial plans (including HSA-qualified high deductible health plans), Medicare Advantage, State Products and Individual plan members.
Coverage for self-funded employer plans varies by employer group. 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.”
Care received when ordered by a health care provider as part of a COVID-19 treatment plan.
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.
We encourage members to contact their primary care physician for their medical needs, but we also know this isn’t always possible. When you can’t reach your primary care physician, Teladoc* allows members 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.