TULSA – Blue Cross and Blue Shield of Oklahoma (BCBSOK) announced Thursday it will temporarily waive cost-sharing – in-network co-pays – for “medically necessary medical and behavioral health services” delivered via telemedicine.
The decision applies to more than 850,000 Oklahomans who are insured by BCBSOK and includes telemedicine services retroactive to March 15. The decision was made in response to the COVID-19 pandemic. “First and foremost, we want to make sure our members get the care they need,” said Dr. Joseph Cunningham, plan president for Blue Cross and Blue Shield of Oklahoma. “Waiving in-network co-pays for telemedicine will allow our members to consult a qualified health care provider while avoiding unnecessary visits to clinics, hospitals and emergency rooms.”
Benefits may be different for members covered under certain employer self-funded health plans, depending upon the decisions their employer makes about telemedicine. Between now and April 30, BCBSOK will continue to consider whether to extend the timeframe of this temporary cost-sharing change, said Lauren Cusick, BCBSOK spokesperson.
There are two ways eligible, fully insured members can access these telemedicine benefits without incurring a co-pay, Ms. Cusick said:
• Contact a BCBSOK in-network provider who offers the service through two-way, live interactive telephone and/or digital video consultations; or
• Via the Virtual Visits benefit.
Provided by BCBSOK and powered by MDLIVE, the doctor is in 24/7/365. Members can consult a board-certified doctor licensed in Oklahoma for non-emergency situations by phone, mobile app or online video. Virtual Visits doctors can send e-prescriptions to a local pharmacy. Members can pick an option to activate an MDLIVE account: call MDLIVE at 1-888-976-4081; visit MDLIVE. com/BCBSOK; text BCBSOK to 635-483; or download the MDLIVE app.
Regarding treatment for COVID-19, BCBSOK plans cover medically necessary health benefits, including physician services, hospitalization and emergency services consistent with the terms of member benefits. BCBSOK will not require pre-authorization and will not apply members’ co-pays or deductibles for testing to diagnose COVID-19 when medically necessary and consistent with CDC guidelines.
BCBSOK also continues to work with the Oklahoma Insurance Department to monitor outbreak information, treatment guidance, drug supply and pharmacy availability for our membership, Ms. Cusick said. Members may receive an additional supply of maintenance medication by requesting an early refill from the pharmacy.
BCBSOK pharmacy benefits generally include a 90-day fill benefit at a retail pharmacy or home delivery (by mail). Members can contact a BCBSOK customer service representatives by calling the number on the back of their membership card, or pharmacies can contact Prime Therapeutics (Prime) directly to access these overrides or inquire about the availability of a 90-day benefit.