To comply with the State of Nevada’s emergency regulation related to COVID-19, Hometown Health has added an endorsement to all commercial products which will change the Policy in the following manner:
1. Members will not be required to pay a Deductible, Coinsurance or Copayment for a provider office visit, urgent care center, or emergency room visit when the purpose of the visit is to be tested for COVID-19 in accordance with CDC guidelines. Please notify Hometown Health as soon as possible if you receive services from an out-of-network provider. If a patient has insurance and seeks COVID-19 treatment from an out-of-network provider that has received General or Targeted Distributions from the Provider Relief Fund, the provider has agreed not to seek to collect out-of-pocket payments greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network provider.
2. Members will not be required to pay a Deductible, Coinsurance or Copayment for COVID-19 testing.
3. Members will not be required to pay a Deductible, Coinsurance or Copayment for the COVID-19 immunization (vaccine) when it becomes available.
4. Members may receive non-formulary prescription drugs when a formulary drug is not available to treat the medical condition; this does not apply when a therapeutic alternative is available; non-formulary prescription drugs require prior authorization in order to cover the medication; standard prescription drug cost sharing applies based on plan design.
5. Due to the ongoing COVID-19 emergency, Hometown Health Signature HMO plan members will not be required to get referrals from Primary Care providers to receive specialty care.