(CBSLA) – CBS Los Angeles reached out to several large insurance companies, and this is what they sent us in regard to how they are handling co-pays and deductibles for COVID-related treatment:
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The website is updated regularly with information for members on COVID co-pays and deductibles.
COVID-19 testing-related visits
You will have $0 cost-share (copay, coinsurance or deductible) for COVID-19 testing-related visits during the national public health emergency period, currently scheduled to end April 20, 2021, whether the testing-related visit is in-person or a telehealth visit.
This coverage applies to in-network and out-of-of-network visits for Medicare Advantage, Exchange, Individual and Employer-sponsored health plans. For individuals enrolled in UnitedHealthcare Community Plans, state variations and regulations may apply during this time. Benefits will be reviewed in accordance with the member’s health plan.
If your provider orders a COVID-19 diagnostic test for you, use our locator to find a testing center.
If you get sick with COVID-19, your health care provider may prescribe treatments. A summary of coverage is below. If you have questions about your benefits, sign in to your health plan account or call the number on your member ID card.
· Exchange, Individual and Fully Insured Employer-sponsored plans: For COVID-19 inpatient treatment, you will have $0 cost-share (copay, coinsurance or deductible) at in-network facilities from Jan. 1, 2021 through Jan. 31, 2021. Beginning Feb. 1, 2021, cost-sharing will be according to your benefit plan. State variations may apply. Coverage for out-of-network services will be determined by your benefit plan.
Some employer-insured health plans1 have different coverage benefits; if you have questions, please check with your human resources benefits team.
· Medicare Advantage health plans: You will have $0 cost-share for in-network and out-of-network COVID-19 treatment, including inpatient and outpatient treatment, through Feb. 28, 2021.
· For members enrolled in UnitedHealthcare Community Plans: State provisions and regulations may apply during this time.
In California, the large majority of Humana’s medical plan membership is in Medicare Advantage. For the 2021 plan year, Humana will cover out-of-pocket costs for COVID-19 treatment for all Humana Medicare Advantage medical plan members. Members will have no copays, deductibles or coinsurance out-of-pocket costs for covered services for treatment of confirmed cases of COVID-19, regardless of where the treatment takes place. This could include telehealth, primary care physician visits, specialty physician visits, facility visits, labs, home-health and ambulance services.
Beyond Medicare Advantage, Humana coverage for COVID-19 treatment varies by type of plan, and there are differences for Medicaid and commercial (employer group) plans. For example, Humana Medicaid plans will continue to follow state requirements for COVID-19 treatment and cost-share waivers. Members are encouraged to check their plan documents for details about their 2021 coverage. More information is available on our website at https://www.humana.com/coronavirus/coverage-faqs.
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To help provide some relief to our members who have been impacted, Kaiser Permanente has agreed to waive all member out-of-pocket costs for screening, testing, and treatment of COVID-19-related inpatient and outpatient services through at least April 21, 2021, or as long as the public health emergency lasts.
This means that members who are diagnosed with COVID-19 will not have to pay copays or other cost-sharing related to their care and treatment of COVID-19.
Kaiser Permanente’s elimination of member out-of-pocket costs will apply to all fully insured benefit plans, in all markets, unless prohibited or modified by law or regulation.
Outpatient pharmacy costs are not waived.
Since the start of the pandemic, Cigna has stood by its customers, taking bold, early actions to support health, well-being and peace of mind during this uncertain time. This includes customers receiving $0 cost sharing for all FDA-approved COVID-19 vaccines, as well as $0 cost sharing for COVID-19 diagnostic and pre-hospital admission testing in the U.S. In addition, through Cigna’s COVID-19 Customer Protection Program, customers are protected from unexpected costs for COVID-19 care through “surprise” or “balance” bills from out-of-network health care providers. The program is uniquely designed to:
– Ensure out-of-network health care providers who are caring for Cigna customers related to COVID-19 are promptly reimbursed at reasonable, market-based rates, as applicable.
– Work on behalf of patients to support and resolve any surprise or balance billing issues by out-of-network providers.
– Report excessive and/or egregious billing practices to state and federal regulatory officials and associations and to otherwise exercise full legal options, including appropriate litigation actions.
– Increase awareness and advocate for broader consumer protections against surprise billing for COVID-19 and beyond.
BLUE SHIELD OF CALIFORNIA:
There are no prior approvals needed for COVID-19 treatment. Blue Shield will waive copays, coinsurance, and deductibles for COVID-19 treatments received between March 1, 2020 – February 28, 2021. This applies to the following plan types:
- Plans purchased through Blue Shield of California directly
- Plans purchased through Covered California
- Medicare Supplement plans
- Fully-insured employer-sponsored plans
- Self-insured and flex-funded employer-sponsored plans where the plan sponsor has elected to pay for copays, coinsurance, and deductibles for COVID-19 treatment (These plans are not required to cover these costs)
To find out which plan you have, call the customer service number on your member ID card.
If you paid out of pocket for COVID-19 treatment that took place between March 1, 2020, and February 28, 2021, what do I need to do?
First, call Member Services at the number on your member ID card to see if your provider sent the claim directly to Blue Shield. If the claim has not been submitted by the provider directly, Member Services will help you submit a claim along with an itemized statement for processing a reimbursement.
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For information on COVID testing and treatment: https://www.anthem.com/ca/coronavirus/individual-and-family/