Top 10 Payers’ Strategies for Broadening Access to COVID-19 Care

Update 4/7/2020: This article has been updated to reflect Health Net is a subsidiary of Centene and that Centene has acquired WellCare.

In light of the coronavirus outbreak, payers across America are lowering patients’ healthcare spending and enabling access to care in a variety of ways involving telehealth, cost-sharing waivers, relaxed hospital restrictions, special enrollment periods, and other strategies.

The top ten largest payers in the nation tend to attack coronavirus from multiple angles in an effort to serve their large consumer bases.

For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.

UnitedHealth Group

UnitedHealth Group waived costs for testing and treatment of COVID-19 as well as for telehealth visits related to COVID-19 testing for commercial, Medicare Advantage, and Medicaid members and beneficiaries. Cost-sharing for coronavirus treatment will be covered through May 31, 2020 for those groups as well.

Medicare Advantage, Medicaid, and fully insured individual and group market health plan members and beneficiaries also will not shoulder any cost-sharing for telehealth visits not related to coronavirus. This policy went into effect March 31, 2020 and is in place until June 18, 2020.

The payer also opened a special enrollment period from March 23 through April 6 for eligible commercial members.

Transferring coronavirus patients is a complex and urgent task. Thus, UnitedHealthcare is one of many payers that have chosen to waive prior authorizations for moving patients to post-acute care and UnitedHealth Group is also suspending prior authorizations for transfers to a new provider through May 31.

Anthem

Anthem is offering coronavirus testing, including the cost of the visit itself if it is at an in-network facility. Additionally, members who receive COVID-19 treatment through May 31 will do so without cost-sharing.

The payer is also allowing those with eligible 30-day prescriptions to receive their refills in advance.

Payers are increasingly relying on telehealth for providing access to care for members in quarantine or shelter-in-place areas. Thus, payers are looking to eradicate costs to members for telehealth.

At Anthem, telehealth visits will also be free of cost-sharing for 90 days since March 17 through Anthem. This applies regardless of the type of visit, including mental healthcare, to diagnosis for coronavirus-related symptoms, and other virtual care activities. Anthem recently expanded its LiveHealth Online team of physicians to meet the demands of the current crisis.

In the face of coronavirus, Anthem has also contributed philanthropically, from a $1 million donation to the Rapid Response Loan Fund for small businesses in central Indiana to initiating the Anthem Medical Associate Volunteer Program which empowers medically-trained professionals to volunteer in their communities to stop COVID-19.

Aetna

Aetna is waiving coronavirus-related copays and diagnostic testing for commercial, Medicare, and Medicaid members and beneficiaries as well as self-insured members if their employers do not opt-out. Commercial members have zero cost-sharing for coronavirus-related, in-network inpatient admissions until June 1, 2020.

Aetna is also waiving telemedicine fees not just related to coronavirus, but for any condition. The payer is offering virtual evaluations and monitoring visit benefits to all fully-insured members.

For members who contract coronavirus, Aetna care packages are available. Those suffering from anxiety and stress can access relevant CVS Health programs.

Cigna

For fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans, Cigna has waived coronavirus cost-sharing and out-of-pocket costs for testing and visits as well as cost-sharing and co-payments for coronavirus treatment through May 31.

The payer is also offering two phone lines, one for members dealing with stress, anxiety and mental and behavioral healthcare needs and the second for those reaching out with other health needs.

In addition to its mental healthcare phone line, the payer is offering a webinar to help provide strategies and tools for sustaining good mental health during this crisis, paired with mindfulness sessions by phone.

Express Scripts Pharmacy, Cigna’s pharmaceutical arm, will provide up to 90 days’ worth of prescription medications by delivery to help ensure medication adherence.

Cigna is also waiving prior authorization for non-coronavirus patients’ transfers to in-network long term acute care settings.

Humana

Humana is waiving out-of-pocket costs for coronavirus testing and treatment, including FDA-approved coronavirus medications or vaccines when those are developed. This applies for Medicare Advantage, Medicaid, and commercial employer-sponsored plan beneficiaries and members and self-insured plans have the opportunity to opt-out. Medicare Supplement members will also have their treatment costs waived.

The payer has not established an end date for these measures.

Members will have zero cost-sharing for telehealth urgent care services. The payer is also waiving costs for all other telehealth services, as long as the providers who deliver these services are participating or in-network.

Patients may be transferred without prior authorization or referral, as long as notification is received within 24 hours of inpatient and outpatient care.

Humana is also offering both funds and administrative support to health care providers.

Centene

Centene is covering Medicaid, Medicare and Marketplace members’ coronavirus testing, screening, and treatment.

The company is also providing new benefits for employees during the COVID-19 pandemic, offering up to three months paid leave for clinical staff who choose to join a medical reserve force, waiving cost-sharing for COVID-19 related treatment and emergency paid sick leave, and providing a one-time payment of $750 to employees in a small number of critical functions which are performed in Centene offices.

The payer is also waiving prior authorizations, certifications, notifications, and step therapy for testing and screening.

Centene is relaxing co-pay and authorization requirements for coronavirus treatment for Medicaid, Medicare and Marketplace members.

Health Net

Health Net, a subsidiary of Centene, will cover coronavirus-related testing, screening and treatment for all members.

WellCare

WellCare, which was acquired by Centene on Jan. 23, is covering Medicaid, Medicare, and Marketplace members’ coronavirus testing, screening, and treatment.

Molina Healthcare

Molina Healthcare is waiving member costs for coronavirus testing.

The payer is also lifting prior authorization requirements on any primary care, urgent care, or emergency care visits.

In an effort to boost member education regarding coronavirus, Molina Healthcare has released the Coronavirus Chatbot, which helps members assess whether they are high risk for coronavirus.

The payer is also contributing philanthropically to the coronavirus response effort by donating relief packages to the Navajo Nation. The packages incorporate medical equipment, cleaning supplies, and funds for food.

Magellan Health

Magellan Health is focusing on telehealth and virtual healthcare solutions, specifically in relation to meeting behavioral healthcare needs. Members can access its digital cognitive behavioral therapy program for free and the payer is expanding its behavioral healthcare telehealth services.