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Coronavirus costs: what expenses and insurance policies are associated with the pandemic

Coronavirus

A rendering of coronavirus via the CDC.

TAMPA, Fla. (WFLA) – Approximately 2.5 million Floridians don’t have health insurance.

It’s a fact that, in the midst of the coronavirus pandemic, brings worry to many as they wonder what costs are involved in being tested, diagnosed and treated for COVID-19.

In a letter to the Trump administration, nearly 800 doctors, lawyers and scientists, along with more than 15 organizations, addressed the challenge of providing care to all, including those most vulnerable.

“One of the greatest challenges ahead is to make sure that the burdens of COVID-19, and our response measures, do not fall unfairly on people in society who are vulnerable because of their economic, social, or health status.”

A new study form finance website, BankRate, said that nearly one in three families skipped medical care in 2019 due to costs.

In the study, nearly 28 percent of the 2,596 respondents with health care costs in the past year had to resort to more desperate means to deal with the expenses, such as taking on substantial debt, borrowing money from friends or family or tapping into retirement savings.

Public health labs— such as the CDC, and county and state health departments —will test patients for free, however there will likely be costs associated with a hospital stay and treatment.

In an announcement Wednesday, the IRS said insurance plans with a high deductible could cover the cost without patients having to meet their deductibles, and some major health insurance have agreed to waive co-pays.

Executives with major health insurers, including UnitedHealth Group, Anthem, Cigna, Humana, Aetna and the Blue Cross Blue Shield Association attended a White house briefing Thursday to agree to “no surprise billing,” when it comes to testing and treatment of COVID-19.

Here is what some major health insurance providers are doing to ease the potential financial blow of COVID-19, according to American Health Insurance Plans:

  • Aetna will waive co-pays for all diagnostic testing related to COVID-19, according to CVS Health. That includes all member costs associated with diagnostic testing for Commercial, Medicare, and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of the program at their discretion. Aetna is also offering zero co-pay telemedicine visits for any reason, and it is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all fully insured members. People diagnosed with COVID-19 will receive a care package. CVS Health is also offering several programs to help people address associated anxiety and stress.
  • Anthem will cover the cost of coronavirus testing with no out-of-pocket cost. Anthem also confirms that prior authorization is not required for diagnostic services related to COVID-19 testing. The company recommends using telehealth when possible to help prevent the spread of a virus. It is also encouraging its members to talk to their doctor about whether it is appropriate for them to change from a 30-day supply of their regular medications to a 90-day supply.
  • Blue Cross Blue Shield Association announced that its network of 36 independent and locally operated Blue Cross and Blue Shield companies will waive prior authorizations for diagnostic tests and covered services for COVID-19, cover those tests at no cost share to members, waive prescription refill limits on maintenance medications, and expand access to telehealth and nurse/provider hotlines. This applies to fully insured, individual, and Medicare Advantage plan members, and plans are working with state Medicaid and CHIP agencies to ensure people have access to needed testing and services.
  • Bright Health will cover COVID-19 diagnostic tests covered as preventive care at no cost to them. In addition, Bright Health members who are concerned about accessing their prescriptions during the COVID-19 outbreak can have their next prescription refilled on an as-needed basis.
  • Capital BlueCross will waive cost-sharing for COVID-19 testing, as well as prior authorization for COVID-19 testing and services. It is also waiving early refill limits on 30-day maintenance medications, and encouraging members to use telehealth services.
  • CareFirst BlueCross BlueShield will waive prior authorizations for diagnostic tests and covered services for COVID-19, cover those tests at no cost share to members, waive early medication refill limits, and encourage alternative sites of care if a member’s primary care doctor is not available.
  • Cigna is covering the cost of coronavirus testing, waiving all co-pays or cost-shares for fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans available through the Affordable Care Act. Organizations that offer Administrative Services Only (ASO) plans will also have the option to include coronavirus testing as a preventive benefit. Recognizing that health outbreaks can increase feelings of stress, anxiety and sleeplessness and sometimes loss. Cigna is also staffing a second phone line for customers.
  • Centene will cover COVID-19 testing and screening services for Medicaid, Medicare and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening. The company will not require prior authorization, prior certification, prior notification or step therapy protocols for these services.
  • EmblemHealth will waive members’ out-of-pocket costs for COVID-19 testing, including emergency room, urgent care, and office visits.
  • Florida Blue will waive all copays and deductibles for the medical testing for COVID-19 for members who are part of its commercial insurance plans, including the Affordable Care Act (ACA) Individual and Medicare Advantage plans. The company is waiving early medication refill limits on 30-day prescriptions, is encouraging the use of virtual care, and is offering mental health support for experiencing stress from COVID-19.
  • Health Alliance Plan (HAP) will waive cost-sharing for COVID-19 testing. This applies to Medicare Advantage, Medicaid, fully insured, and individual plan members. Self-insured plans have the opportunity to opt-in.
  • Health Care Service Corp. (HCSC) will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization for those tests. This applies to all members they insure; the company is working with self-insured plans on their decisions.
  • Health Net will waive co-pays for screenings and tests for COVID-19.
  • Highmark will cover coronavirus testing, when recommended by a medical professional, for members of its fully insured group customers, as well as members of its Medicare Advantage and ACA plans. Self-insured health plan sponsors will be able to opt-out of the program.
  • Humana will waive out-of-pocket costs associated with COVID-19 testing. This applies to Medicare Advantage, Medicaid, and commercial employer-sponsored plans. Self-insured plan sponsors will be able to opt-out. The company is also waiving telemedicine costs for all urgent care for the next 90 days, and is allowing early refills on regular prescription medications.
  • Independence Blue Cross will cover and waive cost-sharing (such as co-pays and coinsurance) for the COVID-19 test when performed at a hospital or an approved laboratory. This includes members enrolled in fully insured plans, employer-sponsored plans, Medicare Advantage and the individual and family plans available through the Affordable Care Act. Self-funded plans will be able to opt-out of this program. Independence has lifted prescription refill restrictions, such as the “refill too soon” limit, for members in states that have declared a state of emergency because of the virus, and is encouraging the use of telemedicine.
  • Kaiser Permanente is contributing $1 million to 10 leading public health organizations and collaborating with CDC Foundation to strengthen the United States’ public health infrastructure and response systems to stop the spread of COVID-19.
  • Molina Healthcare will waive all member costs associated with testing for COVID-19. Any related visit to a primary care doctor, urgent care or emergency care does not require prior authorization.
  • Oscar will waive cost-sharing for diagnostic testing for COVID-19, and continues to offer telemedicine services at no cost.
  • Optima Health will waive out-of-pocket costs for diagnostic testing for COVID-19 for commercial, Medicaid and Medicare Advantage members. It is also offering free telehealth visits to members for the next 90 days. Self-insured plans may opt out of this offering.
  • Piedmont Community Health Plan will waive out-of-pocket costs for COVID-19 testing, and is not requiring prior authorization for diagnostic services related to these tests. It is also waiving out-of-pocket costs for telehealth services, and is permitting online mental health counseling for all members at in-network providers. For members, CVS Caremark is waiving early refill limits on 30-day prescription medications, and CVS Pharmacy is waiving charges for home delivery where it’s available. This applies to its commercial fully insured and exchange plan members.
  • UCare will waive all copays, coinsurance or deductibles for doctor-ordered COVID-19 testing in all of its plans.
  • UPMC and UPMC Health Plan will waive any applicable deductibles, copayments, or other cost-sharing for COVID-19 testing when ordered by a member’s treating medical provider. This no-cost coverage of COVID-19 testing as a preventive service will apply for members in all of UPMC’s commercial UPMC Advantage group and individual products, UPMC for Life Medicare Advantage plans, and UPMC for You Medical Assistance plans. Self-insured or administrative services only (ASO) employer groups will be permitted to opt-out of preventive coverage at their discretion.
  • Valley Health Plan will waive out-of-pocket costs for screening and testing for COVID-19. It is also waiving other hospital, urgent care, and primary care physician fees for members showing symptoms of COVID-19. The company is waiving prescription refill limits and encouraging the use of telehealth.
  • Wellmark Blue Cross and Blue Shield will cover COVID-19 testing with no cost-sharing, and will waive prior authorization for COVID-19 services. It is also allowing for early refill of prescription medications and offering virtual health care visits.

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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