COVID-19 100% Coverage Ending June 30

Thank you for choosing Optima Health. As you know, in an effort to support our clients and members, Optima Health began providing 100% coverage for many services related to the COVID-19 pandemic. We previously announced that we would extend coverage through May 31, 2021 for select services and have decided to extend coverage through June 30, 2021.

However, now that infection rates have decreased, after June 30 the following benefits will be covered according to each group’s benefits:

  • all telehealth visits, including telephone only, with any in-network care provider, other than those associated with COVID-19 diagnostic testing as described below*
  • any necessary in-network or emergent out-of-network treatment of COVID-19*
  • relaxed workforce changes for laid off employees
  • off-anniversary plan changes for Small, Mid-Market, and Large Group clients
  • coverage for temporarily laid-off employees
  • premium changes due to enrollment

The following will still remain covered in full through the duration of the public health emergency:

    • cost shares for all covered out-of-pocket member costs associated with COVID-19 diagnostic testing, rendered in person or via telehealth technology, as deemed appropriate by the ordering provider
    • cost shares for vaccine dose(s)

For more information on these changes, visit optimahealth.com/covid-19/brokers to view our updated Frequently Asked Questions. If you have additional questions, please contact your Optima Health representative.

* Select self-funded employers may have opted to extend this coverage past June 30, 2021.