Benefits Alert: COVID-19 and Response from National Health Insurance Carriers
March 10, 2020 [From USI National Benefits Experts]
The COVID-19 situation is rapidly changing, and it is likely that the number of cases will grow as testing is becoming more widely available. Several national health insurance carriers have announced their efforts to support members concerned about COVID-19.
Aetna
Aetna is waiving co-pays for all diagnostic testing related to COVID-19 for all Commercial, Medicare and Medicaid lines of business. Aetna is also offering, for the next 90-days, zero co-copay telemedicine for any reason to limit potential exposure in physician offices. This includes all video visits made through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering virtual care.
In addition to the above, Aetna is:
- Sending members diagnosed with COVID-19 care packages from Aetna’s Healing Better program containing over-the counter medications to help relieve symptoms, as well as personal and household cleaning supplies to protect others in the home from potential exposure.
- Utilizing their existing care management programs to proactively contact members most at-risk for COVID-19 to offer them advice on how to protect themselves from the virus and if necessary, where to get tested.
- Extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna Commercial members to limit potential exposure in physician offices while waiting for follow-up care.
CVS Health merged with Aeta in November 2018 and is also providing the following programs to educate members about COVID-19 and address any associated anxiety and stress.
- Crisis Response Lines for all Aetna (Commercial, Medicare, Medicaid) and Caremark members who are experiencing anxiety related to COVID-19.
- Access to the 24x7 Aetna Nurse Medical Line for all Aetna and Caremark members
- Resources for Living toolkits are being sent to all Aetna plan sponsors with materials to alleviate anxiety related to COVID-19.
Anthem
Anthem is covering COVID-19 test with no out-of-pocket costs for members, and no prior authorization will be needed for diagnostic testing related to COVID-19. They are also encouraging members to utilize telehealth when possible and to discuss with their doctor if they should change from a 30-day supply of regular medications to a 90-day supply.
Blue Cross Blue Shield Association
Blue Cross Blue Shield Association announced that its network of 36 independent and locally operated Blue Cross and Blue Shield companies are:
- Waiving prior authorizations and cost-sharing for diagnostic tests and covered services for COVID-19.
- Waiving prescription refill limits on maintenance medications and expanding access to telehealth and nurse/provider hotlines.
This is applicable to members on fully insured, individual, and Medicare Advantages plans, as well as those plans working with state Medicaid and CHIP agencies.
Cigna
Cigna announced they will waive co-pays, deductibles and co-insurance for COVID-19 testing for fully insured and Administrative Services Only (ASO) members, as it will be considered a preventive benefit.
United Healthcare
Like Aetna and Cigna, United Healthcare has also waived all cost-sharing (co-pays, co-insurance, and deductibles) for COVID-19 diagnostic testing for all Commercial, Medicaid and Medicare members. Self-inured plans may also implement similar coverage. Optum’s Emotional-Support Help Line is available to support all United Healthcare members who may be anxious or stressed about COVID-19.
Other carriers are following the example set by the national carriers for covering COVID-19 testing as a preventive benefit. AHIP has a list of health insurance carriers and the assistance they’re offering during the COVID-19 outbreak can be found here.
Self-funded group health plans subject to ERISA are not required to comply with state mandates. Employers with self-funded group health plans should work with their benefits consultants and third-party administrators to determine whether to adopt plan changes to align with the state action. In some situations, the carrier or third-party administrator (TPA) is asking employers with self-funded health plans to “opt-in to” (or to “opt-out of”) the enhanced benefit options.
Many drugs, including brands, generics, and components, are manufactured in Asia but according to the FDA, there is no significant shortage related to COVID-19. The FDA is actively monitoring the pharmaceutical supply chain, but at this time is it expected to continue to meet normal demand.
Employers with any benefit-related questions should reach out to their USI team.
Sources:
https://www.aetna.com/individuals-families/member-rights-resources/need-to-know-coronavirus.html
https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/
https://www.uhc.com/health-and-wellness/health-topics/covid-19/faq
Client Communications, March 9, 2020: MaxorPlus, Coronavirus Disease 2019 – Client Communication. OptumRx, OptumRx monitoring COVID-19 Health Concerns.