A state of emergency has been declared related to the outbreak of novel coronavirus (COVID-19). If you are impacted and need assistance in obtaining medical service or prescription drugs, please contact Customer Service at 1-866-597-9560. If you are experiencing a medical emergency, please call 911.

Essence Healthcare is waiving all member related costs associated with the testing and treatment of confirmed or suspected COVID-19 cases from March 6th forward. This includes any applicable co-pays, co-insurance, or deductibles that our members would have normally been responsible for. This waiver will be in effect until May 31,2020, at which time we will reevaluate based on the status and containment of the COVID-19 virus.

Your over-the-counter (OTC) benefit is managed by Convey Health Solutions. Unfortunately, due to the COVID-19 pandemic, Convey is experiencing shortages of certain OTC items. Please visit the Convey website at www.essencehealthcareOTC.com for latest availability. You may also call Convey to place an order and if a specific item is not available, they can help you find an alternative solution. Their number is 1-877-494-2806. Please be assured that Convey is working diligently to refill their inventory. We apologize for any inconvenience this may cause and thank you for your patience.

Here's more information on managing stress during this time.

 

Find a Pharmacy

For your convenience Essence has a large number of pharmacies included in its network. To locate a participating pharmacy near you please click here.

You can search all pharmacies near your location by using Option 1 and selecting "Pharmacy" as the provider type and entering your address. Otherwise you can use Option 2 and type the name of a pharmacy you are looking for.

NOTE: If you do go to an out-of-network pharmacy you may have to pay the full cost when you fill your prescription, rather than paying just the co-payment. You may ask us to reimburse you for our share of the cost by contacting our customer service team and requesting a Part D direct member reimbursement form (DMR). You will need to submit the DMR along with the receipt(s) showing you paid for the Part D medication at an out-of-network pharmacy. Any amount you pay for a covered Part D drug will help you qualify for catastrophic coverage.

Special Note Regarding Using Out of Network Pharmacies

We have network pharmacies outside of the service area where you can get your drugs covered as a member of our Plan. Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available. Below are some circumstances when we would cover prescriptions filled at an out-of-network pharmacy.

  • If you are unable to get a covered drug in a timely manner within our service area, because there are no network pharmacies within a reasonable driving distance that provide 24 hour service.
  • If you are trying to fill a covered prescription drug that is not regularly stocked at an eligible network retail or mail-order pharmacy (these drugs include orphan drugs or other specialty pharmaceuticals).

Before you fill your prescription in these situations, call our Customer Service team to see if there is a network pharmacy in your area where you can fill your prescription.

Y0027_20-322 - Last updated 01/30/2020