All PlansCoverageHigh impact
March 2020 In The Know
EmblemHealth·NY·Provider News
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Summary
EmblemHealth waives all cost-sharing (copayments, coinsurance, deductibles) for COVID-19 diagnostic visits, lab tests, and telehealth visits when using in-network providers. Preauthorization is not required for COVID-19 testing, and providers must not collect any payments from EmblemHealth members for these specific services.
Action Required
Immediately: Billing team must stop collecting copayments, coinsurance, and deductibles from all EmblemHealth members for COVID-19 diagnostic visits, lab tests, and telehealth visits with in-network providers. Update billing system to waive cost-sharing for these services. Do not submit preauthorization requests for COVID-19 testing. Follow CDC guidelines for COVID-19 screening and coding. Normal cost-sharing applies for follow-up care and treatment including hospital admissions.