Information About Your COVID-19 Coverage and Cost Share
COVID-19 Coverage and Cost
Sutter Health Plus covers medically necessary COVID-19 screening and testing at zero cost to members. We consider services medically necessary if you experience symptoms and meet Centers for Disease Control and Prevention (CDC) criteria for screening or testing. We also defer to the clinical judgement of the treating provider to determine medical necessity. We encourage members to schedule video or telephonic visits to help minimize spread of infection and ease pressure on provider offices, urgent care centers and emergency rooms.
Frequently Asked Questions
OpenWill Sutter Health Plus cover my COVID-19 screening and testing?
Yes. Sutter Health Plus covers medically necessary COVID-19 screening and testing for our members.
- Sutter Health Plus affiliated providers are able to conduct screening for COVID-19.
- Sutter Health Plus affiliated labs are able to collect specimens for testing and send out for processing, if necessary.
OpenWhat will my cost sharing be for COVID-19 screening and testing?
There is zero member cost share for medically necessary services related to COVID-19 screening and testing.
OpenWhat type of services will have zero member cost share?
Common services related to medically necessary COVID-19 screening and testing include, but are not limited to, primary care provider (PCP) office visits, urgent care visits, emergency department visits, telehealth visits, and lab tests.
OpenWill Sutter Health Plus inform providers about the zero cost share requirement?
Yes. Sutter Health Plus notified our medical groups of this information on March 11, 2020.
OpenWhat should I do if a provider charges me cost sharing at the time of service or I later get a bill for services related to COVID-19 screening or testing?
You can call Sutter Health Plus Member Services at (855) 315-5800. Member Services is available 8:00 am – 7:00 pm, Monday through Friday.
OpenWhat will my cost sharing be for COVID-19 related treatment?
Standard member cost shares apply to COVID-19 related treatment.
OpenWill Sutter Health Plus cover services related to COVID-19 if I get them while I am outside of the service area?
Yes. Sutter Health Plus covers out-of-area urgent and emergent services for our members. Services related to COVID-19 are considered urgent at this time.
OpenWhat if I cannot get a prescription drug due to a shortage caused by the COVID-19 outbreak?
You can call Sutter Health Plus Member Services at (855) 315-5800. Member Services is available 8:00 am – 7:00 pm, Monday through Friday.
OpenWhat if I have a clinical concern about COVID-19 or if I experience related symptoms?
You should call your PCP or the Sutter Health Plus 24-Hour Nurse Advice Line for help with clinical questions. You can call Sutter Health Plus 24-Hour Nurse Advice Line at (855) 836-3500.
You also have access to video visits with licensed providers for treatment and advice. Video visits can help minimize the spread of infection and ease pressure on provider offices, emergency rooms, and urgent care centers. Video visits are available 8:00 am – 8:00 pm every day from a smartphone, tablet or computer.
OpenDoes Sutter Health Plus offer telehealth services?
Yes. Sutter Health Plus offers you access to telehealth services. We encourage members to schedule video or telephonic visits to help minimize spread of infection and ease pressure on provider offices, urgent care centers and emergency rooms. You can access telehealth services by using:
- Video visits with licensed providers for treatment and advice. Video visits are available 8:00 am – 8:00 pm every day from a smartphone, tablet or computer.
- The Sutter Health Plus 24-Hour Nurse Advice line at (855) 836-3500.
You can also contact your PCP directly to discuss symptoms and additional telehealth options that might be available through their medical group.
OpenDoes Sutter Health Plus offer telehealth for behavioral health services?
Yes. U.S. Behavioral Health Plan of California (USBHPC), our partner for the treatment of mental health, behavioral health and substance use disorders, also offers telehealth services. You can call USBHPC at (855) 202-0984 or go to their website to find a provider or set up an appointment.
OpenWhere can Sutter Health Plus members find information about COVID-19?
You can view more information in the Sutter Health FAQs. You can also get additional information on the CDC website.