Information About COVID-19 Coverage, Cost and Access to Care

Sutter Health Plus covers medically necessary COVID-19 screening and testing (including antibody testing) for our members. We encourage you to contact your primary care physician (PCP) to see if he or she recommends screening or testing for you at this time.

Sutter Health Plus covers medically necessary treatment related to a diagnosis of COVID-19.

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.

Sutter Health Plus understands that your prior authorization may have expired before you were able to use it due to COVID-19. We encourage you to contact your assigned medical group to determine if the original prior authorization will be honored or if you need a new prior authorization. Your assigned medical group is listed on the front of your Sutter Health Plus Member ID Card. You can find their phone number on your Sutter Health Plus Member Portal account, or call Sutter Health Plus Member Services at (855) 315-5800. Member Services is available 8:00 am to 7:00 pm, Monday through Friday.

Sutter Health Plus offers telehealth services. We encourage members to schedule video or telephonic visits to help minimize spread of infection. You can access telehealth services by using:

• Video Visits with licensed providers for treatment and advice. Video Visits are available 8:00 am to 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.

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.

There is no member cost share for medically necessary services related to COVID-19 screening and testing (including antibody testing) beginning February 4, 2020.

There is no member cost share for medically necessary treatment related to a confirmed diagnosis of COVID-19 between February 4, 2020, and September 30, 2020.

Common services related to medically necessary COVID-19 screening, testing and treatment of a COVID-19 diagnosis include, but are not limited to, primary care provider (PCP) office visits, urgent care visits, emergency department visits, inpatient stays, telehealth visits, and lab tests.

Standard member cost shares apply to outpatient prescription drugs prescribed to manage symptoms of COVID-19, such as cough.

There are currently no prescription drugs approved by the Federal Drug Administration (FDA) for the treatment of COVID-19.

No. Sutter Health Plus is waiving the standard member cost shares associated with telehealth for covered services in an effort to minimize spread of infection. This is applicable to telehealth services provided to our members between April 1, 2020 and December 31, 2020.

Yes. Sutter Health Plus notified medical groups of the no member cost share requirement for services related to COVID-19 screening and testing on March 11, 2020. Sutter Health Plus notified medical groups of the no member cost share requirement for telehealth services and COVID-19 treatment on April 23, 2020.

You can call Sutter Health Plus Member Services at (855) 315-5800. Member Services is available 8 a.m. to 7 p.m., Monday through Friday.

You can access telehealth services by using:

• Video visits with licensed providers for treatment and advice. Video visits are available 8:00 am to 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.

You can call USBHPC at (855) 202-0984 or go to their website to find a provider or set up an appointment.

USBHPC offers resources to help manage increased stress and anxiety due to COVID-19 on their website. You can also call USBHPC’s toll-free COVID-19 help line at (866) 342-6892.

Due to the spread of COVID-19, there is an increased need for telehealth services, such as video or telephonic visits. Beginning April 1, 2020, some Sutter Walk-In Care clinics temporarily closed for in-person visits. The temporary closure allows the staff to help with the increase in video visits. Redistributing staff to focus on video visits also helps maintain social distancing.

Please visit our Walk-In Care page for more information on the clinic locations affected by the temporary closure.

Sutter Health Plus members can visit our Walk-In Care page to find more information on the alternate clinic locations.

If you choose to go to an alternate location, we encourage you to call before you go to make sure they are open and can treat your condition.

You can call Sutter Health Plus Member Services at (855) 315-5800. Member Services is available 8 a.m. to 7 p.m., Monday through Friday.

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 a.m. to 8 p.m. every day from a smartphone, tablet or computer.

You can view more information in the Sutter Health FAQs. You can also get additional information on the CDC website.