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Coronavirus Information | Ambetter from PA Health & Wellness
Coronavirus Resource Center
Testing, Screening and Other Benefits
COVID-19 Home Testing Kits
HHS Secretary Alex Azar renewed the COVID-19 Public Health Emergency (PHE). This extends flexibilities and funding tied to the PHE to continue until October 13, 2022.
With this renewal, the various testing, screening, billing, and telehealth coverages that were implemented in response to the COVID-19 PHE in 2020 will be extended to our members. This extension will go through October 13, 2022 until the PHE is either terminated or extended again. This extension does not affect coverages that had already been made effective through December 31, 2020.
Do you have any questions about this extension or the covered benefits impacted by it? Please contact Member Services.
Yes, when medically necessary diagnostic testing is ordered and/or referred by a licensed health care provider, your Ambetter plan will cover the cost of COVID-19 tests and the associated physician’s visit. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services.
Yes, when medically necessary antibody testing is ordered and/or referred by a licensed health care provider, your Ambetter plan will cover the cost of COVID-19 antibody tests. Your plan’s copayment, coinsurance and/or deductible cost-sharing requirements will be waived on COVID-19 antibody tests.
Yes, your plan utilizes Teladoc to provide telehealth services. All telehealth consults are now screened for COVID-19 symptoms and risk factors. Teladoc providers will evaluate your symptoms and contact history to assess your COVID-19 risk, and then help guide you through the next steps for care and testing, if needed. We are also encouraging members use telehealth visits for non-urgent health issues. If you haven’t used Teladoc before, you can visit their website or download the mobile App to get started. You can download the Teladoc app on the App Store or Google Play.
In addition to Teladoc, you may also be able to set up a telehealth consultation directly with your primary care provider. You can reach out to your primary care provider or their office to see what kind of virtual care options are available to you. We are temporarily waiving prior authorization for in-network telehealth services.
Yes. Save Money and Get Your Prescriptions Delivered to Your Door!
CVS Mail Order
As an Ambetter member, you can maximize your pharmacy benefits by filling your prescriptions with CVS Caremark Mail Service Pharmacy, the only in-network mail order pharmacy. Eligible members pay only 2.5x* their regular copay for a three-month fill. Delivery is free and can be to your home, workplace, or any address you choose.
Two easy ways to get started:
1. Call your doctor and ask them to send a new 90-day prescription to CVS Caremark Mail Service Pharmacy.
2. Or, request a new 90-day prescription at Caremark.com.
*2.5x copay is only applicable for three-month mail order fills from CVS Mail Order. All other three-month mail order fills will be subject to the standard 3x copay.
No. The COVID-19 vaccines will be covered at no cost to you. However, you may experience a cost share for associated care in an office setting. You do not need to obtain a prior authorization for your vaccines.
Please call the administering facility/provider you received your first dose from to ask about your vaccine information and verify your second appointment/location.
The provider should have scheduled a second appointment with you at the same facility when you received the first dose. However, you can receive your second dose from another provider/facility, and you should present your COVID-19 Vaccination Record Card.
Contact your Primary Care Physician or local In-Network Pharmacy to confirm your eligibility and to schedule an appointment for your booster. You should present your COVID-19 Vaccination Record Card.
Yes. Please contact Member Services. You may be able to receive transportation by contacting United Way-211 to access local community resources for transportation, which may include the Lyft Vaccine Alliance Program.
You may receive free masks (N95 respirators) at a participating location near you by visiting the Center for Disease Control and Prevention’s Find Free Masks site or calling 1-800-232-0233 (TTY 1-888-720-7489).
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