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 1st, 2020 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 December 31, 2020.

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.


Services that Do Not Require a Referral

The following are examples of services that do not require a referral from your PCP.

  • Routine women’s health care, including breast exams, mammograms, Pap tests, and pelvic exams (must see in-network specialist).
  • Routine dental services (must see in-network dentist).
  • Routine vision exams (must see in-network provider).
  • Flu shots, hepatitis B, and pneumonia vaccinations.
  • Transportation to or from a plan-approved location provided by an Essence transportation provider (for plans where this benefit is available).
  • Visits to a participating SilverSneakers® fitness center.
  • Emergency services, whether you get these services from in-network providers or out-of-network providers.
  • Urgently needed care that you get from out-of-network providers when you are temporarily outside the Plan’s service area. Also, urgently needed care that you get from out-of-network providers when you are in the service area but, because of unusual or extraordinary circumstances, the in-network providers are temporarily unavailable or inaccessible. The emergency room co pay applies to urgently needed care visits outside of the U.S.
  • Dialysis (kidney) services that you can get when you are temporarily outside the Plan’s service area. If possible, please let us know before you leave the service area where you are going to be so we can help arrange for you to have maintenance dialysis while outside the service area.
  • Behavioral health visits from a network provider.

*List is not all inclusive and is subject to change and is only applicable if your plan requires a referral.

Y0027_20-322 - Last updated 01/30/2020