State Health Benefit Plan COVID19 Testing/Treatment – No Cost to Members

All New Jersey State Health Benefit plans including all PPOs (CWA Unity, NJ Direct, NJ Direct 10 & 15, etc.), HMO, Tiered network and high deductible plans will cover all testing and treatment for COVID19 without member payment of copays, deductible or any other out of pocket costs.

No Limits on Early Refill of Maintenance Drugs

OptumRx will drop all prohibition against the “early” refill of maintenance drugs for all SHBP prescription plans.  Controlled substances such as opioids will continue to have prohibitions against early refills.

Telemedicine and Telehealth Offered with No Member Copay for In-network Providers

State Health Benefits Plan has announced all in-network, and out-of-network providers may provide telemedicine (audio/visual through Skype, Google, etc.) and Telehealth (audio only)remote office visits during the COVID19 emergency and receive payment for an office visit.   Members who have Telemedicine/Telehealth visits during the COVID19 crisis with an in-network provider will not have a copay or any other cost.   Members who receive Telemedicine/Telehealth from an out-of-network provider will continue to pay a copay and deductible amounts.
Telemedicine/Telehealth behavioral health visits are included.

Governor Murphy Orders Free COVID19 Testing for Uninsured

Most part-time, intermittent, and seasonal employees are ineligible for coverage through State Health Benefits, and many may be completely uninsured.  To ensure that uninsured individuals have access to testing for COVID-19, the Murphy Administration requires hospitals and Federally Qualified Health Centers (FQHCs) to waive patient fees for testing and related diagnostic services for those who lack health insurance.