Updated Health Insurance COVID-19 Benefits
COVID-19 cases are on the rise in America. Many states, including California, recently instituted new orders in several counties to help reverse this trend. In addition, health insurers support their members with a variety of health insurance COVID-19 benefits. Since many of the insurers altered their original coverage, this article updates our earlier article about health insurance COVID-19 benefits. Because it changes, we recommend contacting your health insurer for the most up-to-date information on your specific plan. California companies covered here include: Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente and United Healthcare. Later in the article, we discuss updated health insurance COVID-19 benefits and testing requirements for group health insurance plans.
INDIVIDUAL INSURANCE COMPANY BENEFITS
Aetna extended most of its COVID-19 benefits until September 30, 2020. It waives cost-sharing and copays for COVID-19 inpatient treatments. COVID-19 doctor visits are also free. Aetna offers virtual care with telemedicine options including Teladoc® services. For specific plans, it provides free mental health counseling using telemedicine and a $0 copay for outpatient mental health visits. Aetna also provides free delivery on CVS Pharmacy® prescriptions. You can find resources to reduce stress and manage emotional health and other benefits on its website.
Anthem Blue Cross
Anthem’s website provides information on COVID-19 benefits. The benefits outlined here may not apply to all members so it is important to check your specific plan. Anthem covers COVID-19 testing and treatment without copays and cost-sharing until December 31, 2020. Note that providers and facilities must be in network. Anthem waives telehealth costs for doctors (including non-COVID-19 visits) through September 30, 2020. (Another area of the site says, “until further notice.”) There are several options listed for emotional and mental health support. Anthem encourages members to speak with their practitioners about moving from 30-day to 90-day medication supply prescriptions. It will also mail you prescriptions from Anthem Home Delivery for free. COBRA plans are now more flexible. Anthem extended the time to enroll in a COBRA plan, pay a past-due COBRA premium, and file and appeal claims.
Blue Shield of California
Blue Shield waives prior approvals as well as out-of-pocket costs for copays, coinsurance, and deductibles for COVID-19 screenings and testing recommended by a doctor. The company waives copays, coinsurance, and deductibles for COVID-19 treatment until September 30, 2020 for specific plans. The company suggests using one of its virtual care options prior to in-person care for COVID-19 symptoms. The costs of these services vary by the service and the specific plan. Depending on the plan, Blue Shield covers out-of-network providers for COVID-19 only in a medical emergency. Many members can order a 90-day supply of medications through the mail service pharmacy with no delivery fee. Members can see mental health providers virtually with the same coverage costs as in-person visits. Additional coverage from Blue Shield is outlined here.
Cigna waives out-of-pocket costs for COVID-19 diagnostic visits with in-network providers through July 31, 2020. It also waives out-of-pocket costs for FDA approved COVID-19 testing. And it waives out-of-pocket costs for all COVID-19 treatment through July 31, 2020. Virtual care for non-COVID-19 issues is covered at normal out-of-pocket costs through July 31, 2020. Cigna delivers 90-day supply medications for free from Cigna Home Delivery Pharmacy and Express Scripts PharmacySM. For additional details, visit Cigna’s Resource Center.
COVID-19 FAQs appear on Health Net’s website. Health Net waives copays, coinsurance and/or deductibles for medically necessary COVID-19 testing and screening when ordered by a licensed health care provider. Prior authorization for these services is not required. These services must be ordered, referred, and/or performed at in-network locations. Health Net covers medically necessary COVID-19 treatments.
When referred by a Kaiser doctor, you won’t pay for COVID-19 screening or testing. Kaiser waives most COVID-19 out-of-pocket costs for inpatient and outpatient COVID-19 treatment services until December 31, 2020. Kaiser encourages members to use mail order for non-urgent prescriptions and refills. Members get a 3-month supply when doing so for the price of 2 months. Kaiser has an “emotional wellness center” that offers self-care tips, tools and guided meditations. Learn more about Kaiser and COVID-19 on its website.
United Healthcare waives cost-sharing (copayments, coinsurance, or deductibles) for medically necessary COVID-19 testing when ordered by a physician. Tests must be FDA-authorized for coverage without cost-sharing. The company also waives member cost-sharing for COVID-19 treatment through July 24, 2020. United Healthcare expanded access to telehealth services and offers it for both COVID-19 and non-COVID-19 visits. Optimum Home Delivery mails prescriptions to members. United Healthcare offers a variety of emotional health services. Learn more about United Healthcare’s COVID-19 benefits here.
GROUP HEALTH INSURANCE PLANS AND TESTING REQUIREMENTS
Group health insurance plans are health plans offered by employers or employee organizations. Health and Human Services (HHS), the Department of the Treasury, and the Department of Labor dictated new testing requirements for group health insurance plans. This update is based on the CARES Act (Coronavirus Aid, Relief, and Economic Security Act). It is also based on the FFCRA (Families First Coronavirus Response Act).
New testing requirements for group health insurance plans include the following:
- Plans must provide coverage for at-home COVID-19 tests. Tests must be ordered by a medical provider and meet the FFCRA and CARES Act testing requirements.
- Plans must cover multiple COVID-19 tests on the same person. A medical provider must say the test is appropriate for this person.
- Tests must fall into one of four categories. 1) Test must be approved by the FDA. 2) Test where the developer intends to submit or has submitted a request for emergency use authorization from the FDA. 3) Test is developed in and authorized by a state that is reviewing COVID-19 tests. 4) Test is approved by HHS in other guidance.
Go here to learn more about testing requirements for group health insurance plans.
We’re Here for You
The Law Offices of Scott Glovsky specializes in insurance law and would like to help in any way we can. We can advise you about your individual policy and applicable coverage and will help address other questions you may have. Please call us at (626) 604-6973.