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Coverage for COVID-19

CDPHP Waiving Cost-Share for Behavioral Health Care Services for Essential Employees

The COVID-19 crisis has had an immeasurable impact on all New Yorkers, particularly those on the front lines, such as health care workers, first responders, and all employees deemed essential. As such, Governor Andrew M. Cuomo has issued an emergency regulation removing all cost-share for essential employees seeking outpatient behavioral health care services with an in-network provider. Effective May 2, 2020, this regulation has recently been extended through Friday, November 27, 2020.

If you are an essential worker, you will pay no out-of-pocket costs when receiving mental health care services. For a list of employees considered essential, visit the NYS DFS website.

The change affects all CDPHP commercial, Medicaid (although there is no cost-share for Medicaid), Child Health Plus, and Essential Plan members, as well as all self-funded ASO groups that have elected to waive cost-shares for essential employees. The change does not apply to CDPHP Medicare Advantage members or members of self-funded groups that did not choose to follow the mandate.

Please note, the regulation does not apply to members enrolled in federally qualified health savings accounts (HSAs). For federally qualified plans that do not have an HSA, you must meet the deductible before CDPHP will waive any applicable co-insurance or copays.

Podcast: Meeting Your Needs During the COVID-19 Pandemic

To learn more about what CDPHP has done and is doing to meet the needs of its providers, members, and employees during the COVID-19 pandemic, we invite you to listen to this podcast by Dr. John Bennett, CDPHP president and CEO.

The emotional and psychological well-being of essential workers is critically important in the continuing fight against COVID-19. We thank you for your support.

Coverage for COVID-19 Testing/Treatment

The health and safety of our members and the community is a top priority at CDPHP. With this in mind, CDPHP is waiving cost-share* (copays, coinsurance, and deductibles) for all coronavirus (COVID-19) related testing and treatment. This change is retroactive for all COVID-19 treatment, including hospitalizations, office visits, and testing.

For more information about testing in your community, contact your county health department.

CDPHP will begin covering rapid COVID-19 testing when administered in a physician office, effective August 17, 2020 and for the duration of the public health emergency. This will apply to tests that carry the Food & Drug Administration (FDA) Emergency Use Authorization (EUA) approval.

Coverage/ Billing/ Financial Hardship

  • CDPHP wants to work with you to ensure you maintain coverage.

  • CDPHP is providing a deferral of April and May’s premium payments until June. This applies to all individual members who are experiencing financial hardship due to COVID-19. 

  • A special enrollment period has been created for uninsured New York residents who are seeking health insurance coverage.

  • As part of this period, eligible individuals who enroll in coverage with CDPHP or through the New York State of Health Marketplace between March 16, 2020 and April 15, 2020 will have coverage effective either April 1 or May 1, 2020.

  • Additionally, CDPHP will not terminate any subsidized member currently enrolled in the Essential Plan or Child Health Plus for non-payment throughout the duration of the crisis. Full-pay Child Health Plus members will be required to pay premium per state guidance. If you are having any difficulty in paying you premium, our enrollers would be happy to assist you in reviewing your application to see if additional subsidies are available. Please call 1-844-237-4773. 

  • If a subsidized individual is new to these products, they will still receive a premium invoice, but will not be terminated for non-payment.

  • Coverage for Medicaid, Essential Plan, and Child Health Plus enrollees enrolled through NY State of Health who are scheduled to renew their coverage during the COVID-19 emergency will be automatically extended for four (4) months. 

  • This extension also applies to Medicaid enrollees whose coverage originated through a local Department of Social Services (LDSS). 

  • In addition, Medicaid enrollees with coverage terminations on or after March 18, 2020 will be reinstated. 

  • Enrollees who have already received a renewal notice do not need to act. Consumers will receive a new renewal notice from NY State of Health when the emergency has ended.

  • The new notice will inform the consumer of the new deadline to renew their coverage.

  • If you have had a change in income due to the pandemic and are currently a NY State of Health member, you may be eligible for additional subsides or financial help. We are here to help you update your information and you can reach us at 1-844-237-4773.   

*Some employers who self-insure do not have this benefit. If you are unsure if your plan includes this benefit, please contact CDPHP member services.

During a Crisis, Knowing Your Health Benefits is More Important than Ever

Register for a CDPHP online member account to be prepared in case you need care, and to stay up-to-date on claims. Quickly and easily check coverage for health care services, access resources, track your out-of-pocket spending, and much more.