PrimeTime Health Plan will follow the Medicare mandate and pay for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, nurse practitioner, pharmacist, or other authorized health care professional. At this time Original Medicare and PrimeTime Health Plan does not reimburse for at-home tests. The U.S. Department of Health and Human Services (HHS) has established a program where individuals covered by Medicare have access to free, at-home tests made available by community health centers and Medicare-certified health clinics.
The federal government has announced Americans will be able to request free rapid COVID-19 tests from the government beginning on Jan. 19. Tests are expected to arrive within 7 to 12 days. Each household will be eligible to receive 4 free tests. Tests continue to be available for free at local community organizations.
To order your free tests from the federal government, visit COVIDtests.gov
Will I have to pay for the Vaccine? No. The federal government purchased the vaccine and insurance companies or Medicare are required to cover the administration costs associated with the vaccine at no cost to the individual. This coverage requirement applies to almost all AultCare plans. If your plan does not cover the cost of the vaccine, there are other resources available to reimburse providers for vaccine administration. You should not be billed for this service.
• The Ohio Department of Health opened a call center to answer questions regarding COVID-19. Licensed nurses and infectious disease specialists are available to answer questions and provide accurate information about COVID-19, the risk to the public, and the state’s response. You can contact the call center at 1-833-427-5634.
• To view all communication by Governor Mike DeWine, click here.
• Click here to review important pharmacy reminders.
PrimeTime Health Plan is committed to providing our members timely resolutions for all questions, complaints, or concerns. If you ever have questions or issues with PrimeTime Health Plan, your benefits, or our providers, please let us know so we can help. Our representatives are available by phone to assist you Monday through Friday, 8:00 am-8:00 pm at 330-363-7407 or toll-free at 1-800-577-5084 (TTY: 711). From October 1st - March 31st, our representatives are available 7 days a week, 8 a.m. to 8 p.m. If you would like to meet with a customer service representative in person, you can visit us during our office hours, Monday through Friday. Our office hours are 8:00 a.m. to 4:30 p.m.
You can also submit a complaint directly to Medicare if you’d like by completing the Medicare Complaint Form. The office of the Medicare Ombudsman (OMO)helps you with complaints, grievance and information requests. Visit their website here.
SPECIAL COMMUNICATION NEEDS
If you or someone you know requires the assistance of a translator, please contact our Service Center at 330-363-7407 or toll-free at 1-800-577-5084 and we will gladly provide one for you. To access our TTY phone line, please dial 711 for the hearing impaired.
PRIMETIME HEALTH PLAN PrimeTime Health Plan is an HMO-POS plan with a Medicare contract. Enrollment in PrimeTime Health Plan depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system.
PrimeTime Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. PrimeTime Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. PrimeTime Health Plan provides free aids and services to people with disabilities to communicate effectively with us, such as Qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). PrimeTime Health Plan provides free language services to people whose primary language is not English, such as Qualified interpreters and information written in other languages. If you need these services, or if you believe that PrimeTime Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can contact or file a grievance with the: PrimeTime Health Plan Civil Rights Coordinator, 2600 6th St. S.W. Canton, OH 44710, 330-363-7456, CivilRightsCoordinator@aultcare.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Civil Rights staff is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html