If you are experiencing symptoms of coronavirus, you may be concerned about whether your insurance policy will cover related testing and treatment. Since the COVID-19 pandemic has caused commercial insurance companies to modify coverage for related and routine visits, you may also be confused about whether you will incur any out of pocket costs as a result of COVID-19 medical bills.
While developments in the health insurance industry continue to evolve, it is important to be fully informed about your policy’s coverage for COVID-19 related testing and treatment, as well as for telemedicine and non COVID-19 related visits.
Coronavirus Medical Bills
Although it may seem like all COVID-19 related treatment and testing is fully covered, it’s important to check your policy to avoid unexpected COVID-19 medical bills. While some insurance companies are waiving copays, coinsurances, and deductibles for COVID-19 testing, others aren’t eliminating cost-sharing entirely, particularly if your plan is self, or employer, funded.
Since coverages are continuing to change, it is best to contact your insurer for information concerning your specific policy and COVID-19 related coverage. Below is a summary of what many of the major insurance companies are covering.
In light of the pandemic, for Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans, United Healthcare is:
- Waiving cost-sharing for COVID-19 treatment through May 31
- Waiving cost-sharing for testing at CDC approved sites and testing related visits (ie. office visits, emergency room visits and urgent care)
- Waiving cost-sharing for COVID-19 related telehealth visits
- Waiving cost-sharing for non COVID-19 in-network telehealth visits until June 18
- Easing prior authorization requirements through May 31
- Considering coverage of out-of-network providers at in-network allowed fees
For those with health insurance policies under Oxford, the insurance company is:
- Waiving cost-sharing for treatment through May 31
- Waiving cost-sharing for testing at CDC approved testing locations
- Waiving cost-sharing for office visits, emergency room visits or urgent care visits related to testing
- Easing prior authorization requirements through May 31
Aetna’s COVID-19 related cost-sharing waivers apply for members with commercial policies, as well as Medicare and Medicaid. Aetna is also covering telemedicine visits at no cost for members who have this benefit under their plan for in-network routine visits, behavioral health and dermatology. Under the coronavirus related policies, Aetna is:
- Waiving cost-sharing for in-network hospital treatment for certain members with COVID-19 or related complications through June 1
- Waiving cost-sharing for testing and medical visits related to testing
- Waiving cost-sharing for telehealth visits related to testing
- Easing prior authorization requirements in areas such as New York and Washington
Under Cigna’s fully-funded Medicare Advantage and individual and group plans, out of pocket costs are waived for COVID-19 related treatment and testing with in-network providers. Cigna will also extend these benefits to those with self-insured plans unless they opt out. Additionally, Cigna is:
- Waiving cost-sharing for coronavirus related treatment and testing through May 31
- Waiving cost-sharing for COVID-19 telehealth screenings
- Offering free shipping on 90-day supplies of maintenance medication
- Easing prior authorization requirements for post-acute stays
Blue Cross Blue Shield is a localized system of independent companies. Although each state has their own criteria for these plans, for fully-funded plans, the health insurance company is generally:
- Waiving cost-sharing for testing in addition to in-network treatment through May 31
- Eliminating the prior authorization requirement for necessary testing and treatments
- Expanding access to telehealth services
- Waiving limits on early refills for medications
In addition to waiving the costs of FDA-approved medication and vaccines once available, Humana is covering the following for its fully-insured commercial plans, Medicare supplements, and Medicaid plans:
- Waiving cost-sharing for COVID-19 testing and treatment as well as hospital admission and telehealth visits
- Allowing members to fill prescriptions early
- Easing prior authorization requirements for patients discharged from the hospital to post-acute stays
Molina Healthcare is waiving cost-sharing for testing and treatment for Medicare, Medicaid, and marketplace policies nationwide.
For its fully insured individual, Medicaid, and Medicare Advantage plans, Anthem is:
- Waiving cost-sharing for COVID-19 related treatment, testing and visits related to testing
- Easing restrictions on early refills for 30-day prescriptions
- Waiving cost sharing for telehealth visits including mental health-related visits for three months until June 14
Self-funded plans can opt-out of this coverage.
For those who have plans under Medicare and Medicaid, treatment, tests and virtual care are also covered for a limited amount of time. Prior authorization is not required.
Centene has announced that it is:
- Waiving cost-sharing for coronavirus related testing and treatment through June 30 for Medicaid, Medicare and Marketplace members
- Eliminating prior authorization requirements for Medicare, Medicaid and Marketplace members
Medicare is waiving all cost-sharing for a broad spectrum of medical services during the current health crisis. This includes traditional audio/video telehealth services and audio-only phone consultations.
SYSTEMEDIC CAN HELP WITH YOUR COVID-19 MEDICAL BILL DISPUTE
Disputing a COVID-19 medical bill can be a complex process. Systemedic has been in the medical billing business for over 30 years and knows what it takes to dispute even the most complicated medical bills quickly and effectively.
Offering a fee-based service for those looking to dispute their medical bills, our medical bill dispute advocates are skilled in navigating the insurance maze and will not take “no” for an answer. To get started with resolving your medical bill dispute, contact us for a consultation.
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