How 3 Major Payers Extended Temporary COVID-19 Benefits into 2021

Aetna

Aetna will waive cost-sharing for inpatient coronavirus treatment for commercial and Medicare Advantage members through January 31, 2021.

The payer will be waiving costs to members for in-network, outpatient telemental and telebehavioral health visits for commercial plan members through January 31, 2021.

Aetna will also waive cost-sharing for Aetna Student Health plan members for in-network telemedicine and telebehavioral health visits and for Medicare Advantage members for specialist visits through the last day of January 2021.

The company has also taken steps to encourage members to return to their providers for primary care services.

CMS discouraged providers from allowing elective and non-urgent care visits during the first wave of the pandemic.

Since then, patients have been hesitant to expose themselves to COVID-19 by returning to the doctor’s office. Hospital and outpatient visits dropped 60 percent during the first months of the crisis.

Avoiding primary care and preventive care can cause and amplify negative downstream health effects. Thus, in order to re-engage members in their primary care, some payers are offering to cover all primary care costs for certain patient populations.

For instance, Aetna is waiving Medicare Advantage members’ primary care costs for in-network visits. Regardless of whether the visit is in-person or through telehealth, the reason for the visit, or the services provided, members will receive full coverage for these visits through January 31, 2021.

Blue Cross Blue Shield companies

The Blue Cross Blue Shield companies’ regulations are not entirely uniform, but many are extending their coronavirus benefits into 2021.

Arkansas Blue Cross and Blue Shield and Health Advantage fully insured health plans and individual policies are extending their coronavirus coverage to align with the January 21, 2021 federal mandate.

This includes waiving coronavirus diagnostic tests that are ordered by healthcare providers. Additionally, the payer is waiving cost-sharing for fully insured members who have been diagnosed with COVID-19 as their primary diagnosis, whether the member receives care in an in-network medical clinic, urgent care, or emergency room.

Additionally, Arkansas Blue Cross and Blue Shield and Health Advantage is expanding access to prescription drugs and extending prior authorizations for 90-day prescription supplies.

Blue Cross and Blue Shield of Kansas City will be waiving cost-sharing and copayments for inpatient hospital visits due to COVID-19 as well as waiving prior authorizations for diagnostic tests and medically necessary treatment for COVID-19 through January 21, 2021.

The payer is also providing financial support programs to help employers manage healthcare premiums which extend into the summer of 2021.

Blue Cross Blue Shield of Wyoming has promised its members on the individual health insurance marketplace a return premium in early 2021, totaling $8 million.

Some payers are waiving certain costs through March 31, 2021, instead of through January 21.

Such payers include Highmark, which is waiving cost-sharing for COVID-19 hospital treatment as well as telemedicine deductibles and copays.

Also, Blue Cross Blue Shield of Michigan, Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of North Carolina along with many other Blue Cross Blue Shield companies are extending cost-sharing waivers for out-of-pocket healthcare spending on coronavirus treatment into March 2021.

Additionally, Blue Cross and Blue Shield of North Carolina will waive prior authorization requirements through March 31, 2021 and expand its reimbursement policy for virtual care visits through June 30, 2021. This health plan will cover telehealth visits at parity with in-person care.

Independence Blue Cross has committed to cover a specific device called a pulse oximeter that measure the level of oxygen in a person’s blood. Members will be eligible for waived cost-sharing through March 31, 2021 if the device has been prescribed by an in-network provider and purchased through an in-network supplier.

The payer will be waiving cost-sharing for in-network acute inpatient coronavirus treatment as well as waiving pre-authorizations for acute, in-network, inpatient emergency department admissions and transportation and transfers to long-term care facilities through March 31, 2021.

Independence Blue Cross also will waive cost-sharing for coronavirus-related telehealth visits through January 21, 2021.

Cigna

Cigna is waiving out-of-pocket healthcare spending for COVID-19 treatments through February 15, 2021.

Additionally, Cigna is waiving out-of-pocket healthcare spending for coronavirus-related provider visits through January 21, 2021. These visits may be covered across multiple settings including at a provider’s office, urgent care center, emergency department, or through telehealth.