Coverage for COVID-19
Coverage for COVID-19
CDPHP continues to waive cost-share* (copays, coinsurance, and deductibles) for coronavirus (COVID-19) related testing and vaccine administration.
CDPHP will pay for COVID-19 testing (including rapid testing)* that has been determined to be medically appropriate by an attending provider or pharmacist, and when testing is approved by the FDA or issued an Emergency Use Authorization (EUA).
Testing ordered or requested by someone other than an attending provider or pharmacist, or performed without an order, including testing on asymptomatic individuals as required by employers, schools, camps, sports, and epidemiological research, or for the purpose of travelling to and from New York state, is not covered.
For more information on coverage of at-home COVID-19 test kits, please visit our FAQ page.
Coverage/ Billing/ Financial Hardship
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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.
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If a subsidized individual is new to these products, they will still receive a premium invoice, but will not be terminated for non-payment.
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Medicaid, Child Health Plus, and Essential Plan cases with a coverage end date through December 31, 2022, will be extended for an additional 12 month period.
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This extension also applies to Medicaid enrollees whose coverage originated through a local Department of Social Services (LDSS).
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In addition, Medicaid enrollees with coverage terminations on or after March 18, 2020 will be reinstated.
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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.
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The new notice will inform the consumer of the new deadline to renew their coverage.
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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 subsidies or financial help. We are here to help you update your information and you can reach us at 1-844-237-4773.
COVID-19 Vaccines, Tests, and Treatments for NYS Medicaid Members
*Some employers who self-fund do not have this benefit. If you are unsure if your plan includes this benefit, please contact CDPHP member services.