AmeriHealth New Jersey expands telemedicine coverage
Changes encourage social distancing and increase access to care during COVID-19 outbreak
Cranbury, NJ, April 3, 2020 — AmeriHealth New Jersey announced today it is expanding coverage of telemedicine services. The change is one of many efforts to encourage social distancing and increase access to care. The expansion remains in effect for the duration of New Jersey’s public health emergency.
The expanded telemedicine coverage for fully insured plans includes:
- Providing coverage for any service which may be appropriately delivered via video or telephone through telemedicine (including but not limited to primary care, specialty, ancillary services, behavioral health).
- Waiving cost-sharing on any telemedicine services, including non-COVID-19 related services.
- Waiving prior authorizations on any telemedicine services while the COVID-19 emergency order is in place. Providers must notify AmeriHealth New Jersey that the member is receiving services.
The new expansion of telemedicine complies with recently enacted New Jersey legislation.
For self-funded health plans, coverage of telemedicine services is provided for COVID-19 services related to testing without member cost-sharing consistent with the federal Families First law.
Members should ask their primary care doctor or specialist to see if they can conduct a visit by phone or video chat. Members can also access MDLive through our member website at amerihealthnj.com.
AmeriHealth New Jersey is also:
- Waiving cost-sharing for COVID-19 inpatient treatment.
- Temporarily suspending prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through April 30.
- Temporarily suspending prior authorization requirements for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required.
- Covering and reimbursing member cost-sharing (such as copays, deductibles, and coinsurance) for the COVID-19 test and the administration of the test when performed at a physician’s office, urgent care center, or an emergency room.
- Covering medically necessary health care costs to treat infectious diseases, including COVID-19, based on the terms of the member’s insurance plan.
- Lifting prescription refill restrictions, such as the “refill too soon” limit, for all commercial and individual members with AmeriHealth New Jersey pharmacy benefits. AmeriHealth New Jersey has also been encouraging members to use their 90-day mail order benefit.
AmeriHealth New Jersey’s top priority during the COVID-19 situation is to ensure members have access to the care, education and support they need. Besides updating coverage policies, AmeriHealth New Jersey has assisted members through Registered Nurse Health Coach outreach, digital resources, and more.
For more information about COVID-19 and AmeriHealth New Jersey’s response, please visit amerihealthnj.com/covid-19.
About AmeriHealth New Jersey
For more than 25 years AmeriHealth New Jersey* has been dedicated to enhancing the health and well-being of the people and communities we serve. Our members are at the center of everything we do. Since the onset of the Affordable Care Act, we have been committed to offering health plans on the Individual Marketplace, which has expanded access to coverage for New Jersey residents. We are exclusively focused on New Jersey with plans designed to meet the unique needs of individuals, small- and mid-sized businesses, municipalities and boards of education across the state. We also provide administrative services to self-funded groups. Named one of the Best Places to Work for the past nine years, AmeriHealth New Jersey is located in Cranbury, NJ. For more information, visit amerihealthnj.com.
*AmeriHealth Insurance Company of New Jersey | AmeriHealth HMO, Inc.
Manager, Public Relations
AmeriHealth New Jersey