Providers sometimes waive patients' cost-sharing amounts (e.g., copays or deductibles) as an accommodation to the patient, professional courtesy, employee benefit, and/or a marketing ploy; however, doing so may violate fraud and abuse laws and/or payor contracts.From a payor's perspective, waiving. Aetna self-insured plan sponsors may waive these benefits at their discretion. Free COVID-19 testing We’ll waive the cost for testing, provided you meet the Centers for Disease Control and Prevention (CDC) guidelines for testing and your doctor requests it. All copays for in-network primary care and outpatient behavioral health visits will be waived in full when not already $0 through a member’s health plan. The move represents Blue Cross NC’s commitment to help members prepare, stay healthy, and get the care. Under the already enacted Families First Coronavirus Response Act, deductibles and copays for people on Original Medicare and who have Medicare Advantage plans will be waived for medical services related to testing, such as going to the doctor or hospital.
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- What Insurances Are Waiving Copays
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Blue Cross and Blue Shield latest insurer to suspend deductibles or copays for coronavirus-related medical services
by Dena Bunis, AARP, Updated April 3, 2020 | Comments: 9
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Medical equipment sits in a hospital in New York City.
En español | Blue Cross and Blue Shield announced Thursday that its network of locally-operated BCBS plans across the country will be waiving cost-sharing for the treatment of COVID-19 through May 31. This includes coverage for testing and coronavirus treatment, including inpatient hospital stays.
The plans join a growing number of insurers that are cutting out-of-pocket costs for members. These decisions generally apply to commercial plans and individuals with Medicare Advantage plans, Medicare supplemental or Medigap policies, and Medicaid.
In a Rose Garden briefing last Sunday, President Trump announced that Humana and Cigna would be waiving treatment-related charges such as copays and deductibles. These two national insurers join seven other large and small insurers who have taken such actions in recent days.
For the latest coronavirus news and advice go to AARP.org/coronavirus.
Aetna, a division of CVS Health, was the first health insurer to waive such charges. Insurers had already waived cost-sharing for coronavirus testing.
'We know we're uniquely positioned to help our members during this unprecedented health crisis,” Bruce Broussard, president and CEO of Humana, said in a statement on Monday. “It's why we're taking this significant action to help ease the burden on seniors and others who are struggling right now. No American should be concerned about the cost of care when being treated for coronavirus.'
Humana says its waiver applies to all out-of-pocket medical costs related to the treatment of COVID-19 as well as FDA-approved medications or vaccines when they become available. The waiver is open-ended.
Cigna is waiving out-of-pocket costs for all COVID-19 treatment through May 31, including Medicare and commercial enrollees, according to an announcement on its website.
According to the Association of Health Insurance Plans (AHIP), the following plans have so far waived out-of-pocket charges for their members.
Here are the announcements from other insurers.
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- Aetnais waiving cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with the pandemic. This policy applies to all Aetna-insured commercial plans and is effective through June 1, 2020.
- AllWays Health Partners, headquartered in Massachusetts, is removing copays, deductibles, or coinsurance for testing and copays for treatment at in-network facilities; ensuring access to out-of-network providers for the initial COVID-19 test or treatment when no in-network providers are available; and removing all cost-sharing for telemedicine services, including virtual visits with primary care providers and specialists.
- CareFirst, with offices in Maryland, Virginia and the District of Columbia, is waiving copays, coinsurance and deductibles for in-network or out-of-network visits to a provider's office, as well as for telehealth, lab fees or treatments related to COVID-19 “for the duration of this public health emergency.” It is also eliminating prior authorization requirements for medically necessary diagnostic tests and covered services related to COVID-19 diagnosis.
- Fallon Health, headquartered in Massachusetts, is waiving copays for coronavirus treatment as well as relaxing administrative procedures, such as prior authorizations and out-of-network requirements, for medically necessary care.
- L.A. Care in Californiais waiving all costs associated with screening, testing and medically necessary treatment for COVID-19.
Published April 2, 2020
Follow our Medicare Coronavirus News page for related information on coronavirus (COVID-19) and its impact on Medicare beneficiaries.
The Centers for Medicare & Medicaid Services (CMS) mandated in early March that all testing for COVID-19 be covered in full by Medicare and private Medicare insurance carriers. A COVID-19 vaccine will also be covered if and when one becomes available.
Now, some private insurance carriers are going a step further by eliminating cost-sharing for COVID-19 treatment protocols as well.
Cigna, Humana and Aetna have each taken measures to reduce out-of-pocket spending for their Medicare plan members who undergo treatment for the disease. These out-of-pocket costs can include plan deductibles, coinsurance and copayments.
COVID-19 treatment can potentially include inpatient hospital stays, doctor’s office appointments, inpatient skilled nursing facility stays, home health visits and emergency ambulance transportation.
These services can typically come with costs such as copays and deductibles.
With waived coinsurance and deductibles for COVID-19 treatment, savings can add up
Cigna and Humana both waived COVID-19-related cost-sharing for their Medicare Advantage (Medicare Part C) plans.
Medicare Advantage plans cover the same inpatient and outpatient services and items that are covered by Original Medicare (Medicare Part A and Part B).
While Original Medicare is provided by the federal government, private insurance companies administer Medicare Advantage plans.
Some of the out-of-pocket costs that a beneficiary who has Original Medicare may face if they receive covered COVID-19 treatment include:
- Beneficiaries who have Original Medicare and who receive inpatient hospital treatment for COVID-19 will typically have to pay the 2020 Medicare Part A deductible of $1,408 for each benefit period that they receive inpatient care.
There are also Part A daily coinsurance costs for lengthy hospital stays that last longer than 60 days. - Beneficiaries who have Original Medicare and who receive outpatient care must pay the 2020 Part B deductible of $198 per year before Medicare covers the costs of their outpatient care.
After meeting the Part B deductible, beneficiaries typically pay a 20 percent coinsurance or copay for covered services and items.
For members of Medicare Advantage plans from Cigna and Humana, however, those costs will be waived for covered COVID-19 treatment.
“Our customers with COVID-19 should focus on fighting this virus and preventing its spread,” David M. Cordani, President and CEO of Cigna1
“While our customers focus on regaining their health, we have their backs,” David Cordani, President and CEO of Cigna, said in a statement.
Cigna’s cost-sharing waiver expires May 31, 2020.
Is Unitedhealthcare Waiving Copays
“We know we’re uniquely positioned to help our members during this unprecedented health crisis,” said Bruce Broussard, President and CEO of Humana. “It’s why we’re taking this significant action to help ease the burden on seniors and others who are struggling right now.”2
Humana’s waivers includes costs related to COVID-19 treatment by both in-network and out-of-network facilities or physicians.
Waiving Medicare Deductibles And Copays
Humana’s cost sharing waivers currently have no end date, as the company plans to readdress the situation as needed.
What Insurances Are Waiving Copays
Aetna, a CVS Health company, is also dismissing COVID-19-related inpatient cost-sharing for its members.
Co Pays Waived
“The additional steps we’re announcing today are consistent with our commitment to delivering timely and seamless access to care as we navigate the spread of COVID-19,” said Karen S. Lynch, president of Aetna Business Unit. “We are doing everything we can to make sure our members have simple and affordable access to the treatment they need as we face the pandemic together.”3
Aetna’s cost-sharing waiver for inpatient admissions to any in-network facility for treatment of COVID-19 is currently in effect until June 1, 2020.