Ideon Blog
April 03, 2020
By: Ideon
Health Insurance Carriers Launch Initiatives in Response to COVID-19
From waiving cost-sharing for testing and eliminating certain out-of-pocket costs to expanding access to telehealth services, U.S. health insurance carriers are stepping up in response to COVID-19. We are all in this together, and it is important to give credit where credit is due.Please find below an ongoing list of carrier initiatives related to COVID-19, aggregated and updated by Ideon’s team, with an assist from AHIP (America’s Health Insurance Plans).
Aetna, a CVS Health company, has extended cost-share waivers for its fully insured members through December 31, 2020. The extensions include:
- Waiving member cost-sharing for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19 for Commercial and Medicare Advantage plan members, through December 31, 2020.
- Waiving member cost-sharing for covered in-network telemedicine visits for outpatient behavioral and mental health counseling services for Commercial plan members, through December 31, 2020.
- Waiving member cost-sharing for in-network telemedicine visits for Medicare Advantage members for specialist visits, which includes mental and behavioral health providers, through December 31, 2020.
- Waiving Medicare Advantage member cost-sharing for all in-network primary care visits, whether done in-office and via telehealth, for any reason, through December 31, 2020.
- Waiving early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark, through December 31, 2020.
Aetna, a CVS Health company, will ship boxes of specially curated, over-the-counter items to all its Medicare Advantage members across the country.
As the COVID-19 pandemic continues and flu season begins, these Caring for You kits contain several items to help support Medicare members with simple self-care at home. Kits include a thermometer, hand sanitizer and two Aetna-branded face masks, among other items.
The Caring for You kits are a one-time liberalization of an Aetna Medicare Advantage member over-the-counter benefit. Kits will be sent to members who were enrolled on or before August 1, 2020. The kits began shipping last week and will continue throughout the fall.
Aetna has launched a new initiative as part of the Aetna Maternity Program. Building on a long-standing commitment to connect expectant moms with care that meets their unique needs, this initiative is focused specifically on preventing preeclampsia.
By leveraging data analytics, the Aetna Maternity Program identifies pregnant women with risk factors for developing the condition for individualized outreach and education. Women at high risk are sent a personalized prenatal care kit that contains educational materials along with an 81-mg bottle of low-dose aspirin, a low-cost intervention that may reduce the risk for developing the condition. Members receive an appointment reminder card encouraging them to speak with their pregnancy care provider about the potential benefits of low-dose aspirin and whether it is right for them. All pregnant members are also mailed information developed by the Society for Maternal-Fetal Medicine on preeclampsia and prevention steps.
The COVID-19 pandemic has presented new challenges, as many expectant moms may be attending fewer in-person prenatal care visits. In turn, they may increase their risk of developing complications that go undetected.
Texas Health Aetna and MAP Health Management have collaborated to expand telehealth support services for individuals and families struggling with substance abuse.
All of the more than 110,000 people insured by Texas Health Aetna are eligible for the telephone-based service, which connects members in recovery with peer specialists who know the challenges of addiction deeply because they have faced them personally as well. The support specialists all have been trained and certified to help guide others through recovery.
Aetna has launched Time for Care, a campaign that reinforces the importance of accessing primary health care. Throughout the COVID-19 pandemic, many Americans have appropriately focused on staying home to keep themselves and others healthy. Although this kind of physical distancing is still an essential component of preventing the spread of COVID-19, it is critical for people to continue prioritizing health care needs.
Time for Care includes a national television ad, which launched July 15, along with a microsite, digital content, and Aetna member program components that address concerns for people with chronic health conditions, including diabetes, high blood pressure and heart disease, as well as specific health issues such as high-risk pregnancies due to preeclampsia.
Aetna and Morning Consult initiated a national survey among 4,400 Americans to identify barriers to accessing care amid COVID-19.
Key findings include:
- Nearly 60% of Americans said they have canceled or delayed a health care appointment due to concerns about exposure to COVID-19 since the crisis began
- Half of Americans have concerns the crisis has negatively affected their own health or the health of someone in their household
- Nearly 60% of people with chronic conditions are concerned the crisis has negatively affected their own health or the health of someone in their household
- 50% of pregnant mothers are not confident their primary care physicians have put the necessary measures in place to prevent the spread of COVID-19
Aetna, a CVS Health company, will waive out-of-pocket costs for in-network primary care and specialist telehealth visits for all Individual and Group Medicare Advantage plan members through September 30, 2020.
Aetna is extending all member cost-sharing and co-pay waivers for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19. Additionally, given the escalating mental health crisis resulting from or amplified by the pandemic, Aetna is extending all member cost-sharing waivers for in-network telemedicine visits for outpatient behavioral and mental health counseling services. These actions, which were scheduled to expire on June 1, 2020, have been extended through September 30, 2020. Aetna will continue working with self-funded plan sponsors to provide options.
Aetna is also taking additional steps to eliminate out-of-pocket costs for primary care services for Medicare Advantage members. Effective from May 13, 2020 through September 30, 2020, Aetna is waiving member out-of-pocket costs for all in-network primary care visits, whether done in-office and via telehealth, for any reason, and encourages members to continue seeking essential preventive and primary care during the pandemic.
Aetna has also extended the following actions, which were scheduled to expire on May 15, 2020, through September 30, 2020:
- Waiving early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark.
- Continuing to encourage all members of Commercial, Medicare and Medicaid plans to take advantage of plan benefits for 90-day maintenance medication prescriptions.
The Aetna Foundation is donating $500,000 to the Americares COVID-19 Mental Health and Psychosocial Support project to help frontline health care workers, particularly those who serve low-income populations, improve their mental health awareness, knowledge and resiliency, and understand the mental health concerns impacting their patients.
The Aetna Foundation is also making a $300,000 grant to the Crisis Text Line, which provides 24/7 confidential direct mental health support for those on the frontlines, including health care workers dealing with the stress, anxiety, fear, depression and/or isolation associated with COVID-19.
Aetna, a CVS Health company, is streamlining its provider credentialing process so there can be more health care professionals caring for patients.
Aetna is also paying the amount of the cost-sharing the member would have ordinarily paid related to COVID-19 testing or inpatient treatment so there is no financial impact on the provider.
Additionally, Aetna is reimbursing all providers for telemedicine at the same rate as in-person visits for applicable telehealth codes, including for mental health care services.
Aetna is also waiving member cost-sharing for inpatient admissions at all in-network and out-of-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna Individual and Group Medicare Advantage members and is effective March 25, 2020 for any such admission through June 1, 2020.
Aetna is also offering its Resources For Living®, its employee assistance program, to individuals and organizations who have been impacted by COVID-19, whether or not they have RFL included as part of their benefits.
Aetna is working closely with partner hospitals to help transfer and discharge members with issues unrelated to COVID-19 from hospitals to safe and clinically appropriate care settings where they can continue to have their needs addressed. This will help hospitals and emergency rooms make room for more patients, especially those suffering from COVID-19.
Aetna, a CVS Health company, will waive member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.
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.
AFLAC is making a $1 million donation to Crisis Text Line, a global, not-for-profit organization that specializes in mental health intervention. Crisis Text Line provides free, 24/7, confidential support to people in crisis via SMS texting. Aflac’s donation will help fund the organization’s new campaign, For the Frontlines, aimed at helping individuals battling the COVID-19 crisis in the U.S.
AFLAC has made a $5 million donation to two organizations that are providing assistance for health care workers on the front lines of the COVID-19 pandemic.
AFLAC is donating $2 million to the Global Center for Medical Innovation (GCMI), a comprehensive innovation center using innovative 3D printing to help support medical device shortages, particularly as it relates to ventilators and protective masks. GCMI works in collaboration with Children’s Healthcare of Atlanta Pediatric Technology Center.
The additional $3 million is going to Direct Relief, a humanitarian aid organization providing personal protective equipment (PPE) and essential medical items to health workers responding to the coronavirus. Direct Relief is active in all 50 states.
Alignment Healthcare has launched two signature programs to address critical medical and social challenges Americans are now facing. The first is the AVA™ Personalized COVID-19 Risk Assessment tool, which provides personalized results and is now available to the public at www.alignmenthealthcare.com. The other is a crisis meal delivery program, providing two weeks of meals to members who cannot otherwise access food.
Alignment is also waiving Alignment Health Plan member cost-sharing (including, but not limited to, copays, deductibles or coinsurance) to zero for medically necessary screening and testing for COVID-19. Members may receive medically necessary services from any available Medicare-certified provider or facility without prior authorization from their medical group or Alignment Health Plan.
Alignment is making sure plan benefits are available to its members from their homes such as mail-order delivery of prescription drugs. Members with a monthly over-the-counter allowance can order their items for mail delivery by phone or online.
Alignment expanded access to certain telehealth services so members can connect with a doctor by phone or video in the safety and comfort of their own home.
Additionally, Alignment offers a variety of at-home video workouts through Peerfit Move at no extra cost to its Alignment Health Plan members. Additional resources and information are available for members at www.alignmenthealthplan.com.
AllWays Health Partners is removing cost-sharing (copayments, deductibles, or coinsurance) for testing and copayments 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, and through Partners HealthCare On Demand, to enable members to seek COVID-19-related care without the need to go to medical offices.
AlohaCare will fully cover medically-necessary diagnostic tests for COVID-19, according to the Centers for Disease Control and Prevention (CDC) guidelines.
Prior authorization is not needed for diagnostic tests and covered services that are medically-necessary and follow COVID-19 CDC guidelines.
AlohaCare is donating $150,000 to local non-profit organizations that are helping at-risk families and individuals impacted by the COVID-19 pandemic. The donation includes monetary contributions to food banks across the state; 28,800 KN95 masks for health care workers at community health centers; and a grant for a new online platform to help identify areas of need in Hawaii.
AmeriHealth Caritas will cover and waive cost-sharing for testing and in-network, inpatient, acute care treatment of COVID-19.
AmeriHealth Caritas has also expanded access to telehealth services by video and phone. In several markets, to aid in the enhancement of telemedicine visits, AmeriHealth Caritas plans are also providing blood pressure monitors to persons diagnosed with hypertension, including expectant mothers.
AmeriHealth Caritas is focused on improving the health and wellbeing of underserved communities at this time of crisis and is conducting “well-check” outreach to vulnerable members and helping connect them to their providers and community resources. In select communities, AmeriHealth Cartas has also expanded the delivery of medically tailored and ready-to-eat meals and groceries to the homes of members who have been confirmed to have COVID-19 and to members at highest risk for COVID-19 complications.
AmeriHealth Caritas Louisiana is helping its members stay healthy while gyms are operating at reduced capacity by providing them with a Fitbit at no cost. By giving enrollees the devices, AmeriHealth Caritas Louisiana aims to help members at particular health risk from lack of exercise continue efforts to improve their health and wellness.
AmeriHealth New Jersey will waive members’ cost for in-network, acute in-patient treatment of COVID-19 through December 31, 2020. Cost sharing will be applied to post-acute care (e.g. skilled nursing, rehabilitation and long-term acute care facilities), outpatient treatment, prescription drugs, ambulance transportation to a post-acute setting, and out of network care.
Pre-authorization is currently not required for acute, in-network, in-patient admissions from the emergency department. Pre-authorization is also being waived for transfers from an in-patient facility to long-term ambulatory care, rehabilitation, or skilled nursing facilities, and transportation between facilities. These temporary changes to our pre-authorization policy are in effect until July 31, 2020. Facilities are still required to notify AmeriHealth New Jersey.
AmeriHealth New Jersey is expanding its temporary suspension of prior authorization for acute in-network from the emergency department to include all diagnoses (including COVID-19) and for in-network transfers and transportation between facilities.
The prior authorization expansion will stay in place until June 4.
AmeriHealth New Jersey is also offering members free access to Stop, Breathe & Think, an emotional wellness app. The free access will run until June 14.
AmeriHealth New Jersey will waive cost-sharing for COVID-19 testing performed at a hospital or approved laboratory. This includes members in fully insured, employer-sponsored plans and the individual and family plans available through the Affordable Care Act. Self-funded plans will be able to opt-out of the program. The company is also waiving cost-sharing for telemedicine visits available through members’ plans for the next 90 days.
Anthem Blue Cross and Blue Shield in Connecticut and the Anthem Blue Cross and Blue Shield Foundation are committing volunteer hours and donating nearly $90,000 to address hunger in local Connecticut communities. These activities are part of a $1.4 million total commitment Anthem has made in Connecticut so far this year, with more activity to come.
Nearly 12 percent of people in Connecticut experience food insecurity, which includes 16 percent of children in Connecticut, and these numbers are likely on the rise given the impact of challenges COVID-19 has introduced.
Anthem’s commitment will support a national partnership with Feeding America, as well as sponsorships with local organizations including the Connecticut Food Bank, Foodshare and Massaro Community Farm.
MATTER, Anthem, Inc., and Blue Cross and Blue Shield of Illinois have launched the Pandemic Response Innovation Challenge. The challenge is a global call to innovators to develop creative solutions aimed at supporting the health care needs of those impacted by the COVID-19 pandemic.
The challenge is part of Anthem and BCBSIL’s broader efforts to help reduce the strain on the health care system today, while preparing consumers and health care providers for a stronger post-COVID-19 world.
Innovators can submit their solutions to either of two tracks. The first track is seeking solutions that empower people to address their behavioral health needs, such as depression, anxiety, and substance abuse, which can be exacerbated in times of uncertainty. The second track focuses on leveraging data from Anthem’s Digital Data Sandbox, one of the largest certified de-identified health data sets in the U.S., to improve patient care and outcomes during COVID-19 and in the future.
The Anthem Blue Cross and Blue Shield Foundation has granted $100,000 to Community Shelter Board, which drives strategy, accountability, collaboration, and resources to achieve the best outcomes for people facing homelessness in Columbus and Franklin County, Ohio. The grant will accelerate CSB’s rapid re-housing efforts in Central Ohio and is part of a $2 million overall commitment from Anthem Foundation to support Ohio communities through COVID-19.
Rapid rehousing has emerged as an effective solution to homelessness in cities across the country.
Anthem Blue Cross and Blue Shield of Ohio is giving $100,000 to the Ohio Association of Community Health Centers, who will disperse the funds to member health centers across the state.
Community health centers have been at the forefront of the COVID-19 pandemic, providing healthcare to medically undeserved populations in rural and urban settings.
The health centers will use the funding to support COVID-19 testing in ways as varied as the regions and populations they serve. Funds will be used to secure items such as portable generators, signage, personal protective equipment, materials for mobile testing, test kits, tents, portable hand washing stations, automated temperature monitoring systems and much more.
Anthem has launched a suite of digital tools that provide in-depth, trusted, and aggregated information for multiple stakeholders to use in making informed, data-driven decisions during the COVID-19 crisis. Led by Anthem, Inc.’s new C19 Explorer and C19 Navigator, these decision support tools are also designed to assist public health officials and business leaders as they plan for re-opening and returning to the office.
Anthem is providing $2.5 billion of financial assistance to ease the burden COVID-19 is placing on affiliated health plans’ consumers and employer customers, care providers and nonprofit partners across the country.
Anthem affiliated health plans are supporting customers by providing a one-month premium credit to members enrolled in select Individual plans and fully insured employer customers ranging from 10 to 15%. In addition, individuals in stand-alone and group dental plans will also receive a 50% credit. Consumers and employer customers will receive the premium credit in July. Anthem’s health plan affiliates are also working with some employer groups on special payment arrangements as a bridge to continue to provide insurance for their employees during this difficult time.
Anthem’s health plan affiliates will continue to waive cost sharing for in-network COVID-19 related treatment for members enrolled in fully insured employer plans, Individual plans and Medicare Advantage plans through December 31, 2020. Self-insured employers who previously chose to adopt cost sharing waivers for treatment can choose to extend the waivers.
Until September 30, 2020, Anthem’s health plan affiliates will continue to allow expanded telehealth coverage, including some physical, occupational and speech therapy, and will continue to waive cost shares for in-network telehealth visits, including telephonic visits, for medical and mental health or substance abuse disorders, for fully insured employer plans, Individual plans, Medicare Advantage plans, group retiree plans and Medicaid plans, where permissible. This will also include waiving cost shares when utilizing TeleDentists®, an in-network provider with Anthem offering online and mobile-app enabled teledentistry solutions for dental care.
Anthem and its affiliated health plans are working with state partners to accelerate funds to care providers who treat the most vulnerable, particularly those with chronic conditions, behavioral health, and other special healthcare needs. Anthem’s health plan affiliates are also reaching out to Medicaid beneficiaries to facilitate connections with state and social services, helping newly eligible and at risk members enroll in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Health plan affiliates are directly contacting hundreds of thousands of Medicare Advantage and Medicaid consumers to make sure they have necessary medications on hand, their nutritional needs are being met and critical health needs are addressed during this time of social distancing and isolation.
Anthem will continue to make a difference in improving health across the nation, including addressing health disparities facing minority and underserved communities disproportionally impacted by this pandemic and other health inequities. Anthem is focused on empowering individuals to understand and take action on the health risks that affect them, including racial and ethnic risk factors, social drivers of health and pre-existing conditions. Through efforts to collaborate with care providers, health advocates and community leaders Anthem is working to address gaps in care and provide data and resources to effect positive health outcomes for members and communities at large.
Anthem is providing funding to support care providers’ telehealth capabilities, quality-based programs and PPE, and extending additional funding to provide critical support to targeted independent primary care physician organizations and multispecialty groups who are facing financial pressure during this crisis. Additionally, Anthem is actively working with care providers to accelerate claims processing for outstanding accounts receivables, resolving claims where possible and appropriate, as well as accelerating payments to support state specific Medicaid programs.
Anthem will provide in-network dental providers a PPE Credit of $10 per patient, per visit, from June 15th through the end of August.
Anthem is simplifying access to care by temporarily suspending prior authorization requirements for respiratory services and medical equipment critical to COVID-19 treatment including Durable Medical Equipment such as oxygen supplies, respiratory devices, continuous positive airway pressure, or CPAP devices, non-invasive ventilators, and multi-function ventilators.
Anthem’s health plan affiliates are temporarily extending prior authorizations on elective inpatient and outpatient procedures, issued before May 30, 2020. This will allow more flexibility in scheduling these procedures.
Anthem launched Ortho@Home, a teledentistry and at-home orthodontia program. The services are part of Anthem’s continuing commitment to providing access to affordable services that meet a person’s whole health needs, while also providing safe, remote-care during this pandemic.
The service integrates seamlessly with orthodontic network provider options and includes discounts of up to $200 off retail pricing.
Anthem has launched a virtual dental care program through a partnership with The TeleDentist, an in-network provider of virtual dental services from board-licensed dentists. The partnership provides consumers with timely access to dental care that is available 24/7, 365 days a year in the event of an emergency, with virtual exams covered at 100% with no deductibles, copays, paperwork, or claims to file through June 30.
The Anthem Foundation has distributed more than $200,000 to local organizations across Georgia that are responding to the COVID-19 crisis.
These contributions are part of a nearly $2 million commitment recently made by the Foundation as Anthem continues to support relief efforts for communities and families as they respond to the many emerging challenges associated with this public health emergency.
The Foundation has also made $260,000 in grants to Ohio-based Boys & Girls Clubs, Feeding America organizations and the Children’s Hunger Alliance to address food insecurity in the wake of COVID-19.
Anthem has donated $200,000 to United Way and Feeding America, two organizations that are crucial frontline responders to the coronavirus pandemic in California. Funds will be cascaded to food banks, shelters and other resource centers across the state that are helping struggling individuals and families access necessities amid the pandemic.
- Anthem Blue Cross’s $100,000 contribution to the Feeding America COVID -19 Response Fund is helping Feeding America’s network of 17 food banks throughout California to secure resources, meet increased demand and implement extra social distancing precautions as they continue to serve the most vulnerable members of the community. This includes families dealing with school closures, those experiencing job disruptions, the elderly and disabled, people with low-incomes, those struggling with homelessness and other challenges.
- Anthem Blue Cross’s $100,000 contribution to the United Way’s COVID-19 Response Fund is supporting California’s low income and vulnerable populations by ensuring families stay fed and housed amid the economic shutdown. Contributions are being used to provide food assistance, cash to pay for necessities such as rent and utilities, and even broadband access to help school children continue their education from home. Funds are also supporting the United Way’s 2-1-1 programs, which connect people with needed resources and supports. Additionally, the fund is helping many of the state’s agricultural workers, many of whom are undocumented and not eligible for federal financial relief or other resources to support their families.
Anthem’s affiliated health plans and Beacon Health Options have joined with Psych Hub, mental health advocates and other national health insurers to develop a free digital resource site to help individuals and care providers address behavioral health needs resulting from the COVID-19 pandemic. This COVID-19 Mental Health Resource Hub provides a range of resources designed to help people, their families and care providers cope with pandemic-related stress brought on by social isolation, job loss and other challenges.
Anthem has also partnered with Aunt Bertha, a leading social care network, which helps connect individuals and families to free and reduced-cost social services in their communities. These programs include COVID-19-specific assistance, such as food delivery and help paying for bills. All consumers can access the more than 350,000 programs, which are available in every zip code across the U.S.
Anthem is waiving cost sharing payments for COVID-19 treatment. The expansion covers the waiver of cost share for COVID-19 treatment received through May 31, 2020.
Anthem is contributing $1 million to the Rapid Response Loan Fund, which was established by the Indy Chamber. The loan fund is intended to help the roughly 43,000 small business in central Indiana.
Anthem has launched the Anthem Medical Associate Volunteer Program, which is designed to allow associates with professional medical training volunteer and assist in their local community’s response to COVID-19.
In addition, Anthem suspended prior authorization requirements for patient transfers as well as for the use of medical equipment critical to COVID-19 treatment.
On March 17, Anthem also announced new resources for its members. First, it is working to accelerate the availability of a Coronavirus Assessment tool on the Sydney Care mobile app, which members can download at no cost. Second, Anthem’s affiliated plans will continue to waive copays, coinsurance and deductibles for diagnostic tests for COVID-19, and extending this to include waiver of copays, coinsurance, and deductibles for visits associated with in-network COVID-19 testing, whether the care is received in a doctor’s office, urgent care center or emergency department. Third, Anthem is relaxing early prescription refill limits for members who wish to receive a 30-day supply of most maintenance medications, where permissible. Fourth, for 90 days, Anthem plans will waive any cost sharing for telehealth visits, including visits for mental health care, for fully insured employer plans, individual plans, Medicare plans, and Medicaid plans, where permissible. This includes visits using Anthem’s telemedicine service, as well as care received from other telehealth providers delivering virtual care.
The Anthem Foundation continues to support the Red Cross, Direct Relief, Americares, and Feeding America, and has committed $50 million for COVID-19 response and recovery efforts to help areas of greatest need, including care provider safety, food insecurity, and mental and behavioral health resources. The company is also matching employee donations to the Anthem Foundation’s program.
Anthem is increasing physician availability through its telemedicine service, LiveHealth Online (LHO), including encouraging in-network doctors to join the platform, given the surge in demand. LHO is a safe and helpful way to use Anthem benefits to see a doctor and receive health guidance related to COVID-19, without leaving home or work.
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.
Arkansas Blue Cross and Blue Shield and Health Advantage
The voluntary, expanded COVID-19-related benefits announced for certain Arkansas Blue Cross and Blue Shield and Health Advantage fully insured health plans and individual policies will be extended to align with the federally mandated COVID-19 coverage provisions as specified in the FFCRA (Families First Coronavirus Response Act) and CARES (Coronavirus Aid, Relief and Economic Security) Act. The federal mandate currently runs through October 23, 2020.
Temporary benefit changes include:
- Covering COVID-19 diagnostic tests ordered by healthcare providers at no cost to members.
Arkansas Blue Cross and Health Advantage will cover, with no cost share to the member, the diagnostic testing services that meet primary coverage criteria for COVID-19 as defined by the CDC and ordered by the member’s healthcare provider. Currently, the only recommended screening test for COVID-19 is the RT-PCR Test, which involves swabbing the nose and/or mouth. Arkansas Blue Cross and Health Advantage will also ensure patient testing is done in close coordination with federal, state and public health authorities.
- Waiving the cost-sharing for medical services for fully insured members whose primary diagnosis is COVID-19.This includes COVID-19-specific visits to an in-network medical clinic, urgent care center and/or emergency room, and inpatient treatment where COVID-19 is the primary diagnosis.
- Temporarily enhancing access to maintenance prescription medications and extending prior authorizations on many medications for 90-day supplies. Arkansas Blue Cross and Health Advantage will also work to implement prescription drug formulary flexibility to respond to medication shortages or access issues.
- Encouraging members to access virtual health and nurse/provider hotlines.
Given the nature of the COVID-19 outbreak, seeking in-person medical care may lead to further spreading of the virus.
Usual member costs (copays, coinsurance and deductibles) are temporarily being waived for telemedicine visits with in-network physicians (M.D.s, D.O.s), advance practice nurse practitioners and physician assistants. This includes wellness/preventative visits. To schedule a telehealth visit with a physician, members should contact the physician office to see if she/he is seeing patients via telemedicine. Members who do not have a physician may visit arkansasbluecross.com and select Find Care to choose a physician.
Similarly, Arkansas Blue Cross and Health Advantage has added coverage (without copays, deductibles and coinsurance) for teledentistry.
Arkansas BlueCross BlueShield has extended its temporary COVID-19 benefits until at least August 17. The benefits include waiving member cost sharing payments for COVID-19 treatment, covering diagnostic COVID-19 testing at no cost to members, and waiving out-of-pocket costs for telemedicine counseling from in-network behavioral health professionals.
Arkansas Blue Cross and Blue Shield and Health Advantage has extended the waiver on telehealth out-of-pocket costs through July 25, 2020. The waiver for cost-sharing payments for medical services for fully insured members whose primary diagnosis is COVID-19 has also been extended to July 25, 2020.
Arkansas Blue Cross and Blue Shield and Health Advantage are covering any illness related to the coronavirus that results in a need for standard covered medical treatment. There will be no prior authorizations for COVID-19 diagnostic tests and for covered services that meet primary coverage criteria and are consistent with CDC guidance. They will cover COVID-19 diagnostic testing and testing services at no cost to members. They are waiving early medication refill limits on 30-day prescription maintenance medications and encouraging members to use their 90-day mail-order benefit. Arkansas Blue Cross will also ensure formulary flexibility if there are shortages or access issues. Members are encouraged to use virtual health and nurse/provider hotlines.
Arkansas Blue Cross and Blue Shield and Health Advantage are waiving costs their fully insured members would normally have to pay for telehealth services related to physical and/or behavioral health when received from an in-network provider.
The waivers will be in place through at least May 15, 2020.
The Blue & You Foundation for a Healthier Arkansas is donating $500,000 in support of immediate needs around food insecurity in the state and opening the “Rapid-Response COVID Relief” grant process to award up to $1.7 million in grants supporting nonprofit organizations that have experienced the consequences of COVID-19.
The Rapid-Response COVID Relief Grants program is designed to help eligible organizations lessen the impact of the Covid-19 virus on the individuals, families, and communities they serve.
Aspire Health Plan is waiving all co-pays related to COVID-19 testing. Aspire is also making its telehealth benefit available for no copay.
Avera Health Plans has extended its waiver of member cost-share payments related to COVID-19 treatment when seeking care from an in-network provider through Sept. 30, 2020.
Avera Health Plans is waiving the member cost for all applicable telehealth services through December 31, 2020. Members receiving applicable telehealth services from participating providers during this period will have their normal cost-share waived regardless if the telehealth visit is directly related to COVID-19 or not.
Avera Health Plans will waive members’ cost-share related to the treatment of COVID-19 (co-pay, coinsurance and deductible) when seeking care from an in-network provider through June 30, 2020.
Avera Health Plans is waiving member costs for all telehealth benefits through June 14.
Avera is also waiving early refill limits on maintenance drugs to allow access to an additional 30-day supply.
AvMed is extending its waivers of out-of-pocket costs for all COVID-19 treatment until Sept. 30, 2020. AvMed will also administer a waiver for self-funded group health plans at their request. The treatments covered at no out-of-pocket cost for COVID-19 are those covered under Medicare or other applicable state regulations.
AvMed is also offering zero copays and cost share for any and all types of virtual visits until Sept. 30, 2020. Additionally, where applicable, copays and cost share will be waived for telehealth visits, as well as telephone visits, members may need from their traditional healthcare providers.
AvMed is extending COVID-19 benefits and coverage until July 31, 2020. That includes zero-cost diagnostic testing, zero-cost treatment, and zero-cost virtual visits
AvMed is waiving out-of-pocket costs for COVID-19 treatments for its fully-insured commercial and Medicare Advantage members through May 31, 2020. In addition, AvMed will continue to provide its members with zero-dollar diagnostic testing, zero-dollar virtual visits, including behavioral health, and waiver of specialist referral requirements.
AvMed will cover diagnostic testing for COVID-19 at no cost-sharing if it is determined that test is needed. AvMed, in partnership with CVS Health, will also be waiving early refill limits on 30-day prescriptions for maintenance medications and providing home delivery of all prescription medications free of charge. It is also encouraging the use of telehealth services.
Blue Cross Blue Shield Association
Blue Cross Blue Shield Association’s network of 36 independent and locally-operated Blue Cross and Blue Shield companies and the Blue Cross and Blue Shield Federal Employee Program® have committed nearly $3 billion to date in support of members, health care workers and local communities to aid in the ongoing fight against COVID-19.
Independent and locally-operated Blue Cross Blue Shield companies across the country and the BCBS Federal Employee Program® (FEP®) have decided to waive cost-sharing for treatment of COVID-19 through May 31. This includes coverage for testing and treatment administered, including for inpatient hospital stays.
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.
All 36 independent and locally operated Blue Cross and Blue Shield companies are also waiving cost sharing for telehealth services for fully insured members for the next 90 days.
Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama has paid, contributed and made available $230 million in the ongoing fight against COVID-19 supporting its members, employer customers, providers, and the community across Alabama.
Blue Cross and Blue Shield of Alabama is committed to giving back to communities statewide to fight the COVID-19 pandemic. The company has made contributions in support of food scarcity, small business loans, personal protective equipment and meals for healthcare workers, and other relief efforts across the state. Some programs receiving support include: United Way Meals on Wheels, Alabama Food Bank, Birmingham Strong, American Red Cross, Alabama Department of Public Health, Jefferson County Department of Health, and other local community foundations.
Blue Cross and Blue Shield of Alabama is expanding telehealth coverage. This expansion allows physicians, physician assistants, nurse practitioners and behavioral health practitioners to provide medically necessary services via telephone consultation.
Blue Cross and Blue Shield of Alabama is also waiving prior authorizations for diagnostic tests and covered services that are medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.
Blue Cross and Blue Shield of Alabama is covering medically necessary COVID-19 diagnostic tests at no cost to members with fully insured, individual, employer-based, Federal Employee Program, and Medicare Advantage plans.
Blue Cross Blue Shield of Arizona (BCBSAZ)
Blue Cross Blue Shield of Arizona has contributed $10,000 to assist the Navajo Nation in Arizona in its efforts to slow the spread of coronavirus. The funds will help the tribe purchase critical medical supplies and personal protective equipment (PPE) that can help prevent the continued spread of COVID-19.
The reservation has one of the highest per-capita rates of COVID-19 infections in the country, with more than 4,000 confirmed cases in Arizona. Funds provided by BCBSAZ will directly benefit the Navajo Nation’s Dikos Ntsaaígíí-19 (COVID-19) relief efforts as tribal leaders continue working to reduce infection rates.
Blue Cross Blue Shield of Arizona is launching a loan program for healthcare providers, including qualifying hospitals and physicians across Arizona who have been impacted by COVID-19. The Claim Payment Advance program will allow certain providers to receive a three-month loan to help ease the strain on cash flow so they can continue to provide medical care to Arizonans.
As BCBSAZ analyzed claims payments in 2020 and compared them to the same period last year, claims costs in aggregate were actually running higher until just last week, when the first year-over-year reduction was experienced. Even though elective surgeries were down, the reduction in claims costs wasn’t immediately evident due to increased costs in other areas, including:
- 33% increase in behavioral health visits
- 3,200% spike in telemedicine visits
- 22% increase in prescription costs
- Enhanced benefit payments at 100% for telehealth and COVID-19 claims
Physician specialists are the hardest hit, with revenue declines down nearly 6%. To help stabilize the Arizona healthcare system, up to $10 million in loans will be made available to Arizona medical physicians and hospitals. Among the qualifications for the Claim Payment Advance program, providers must be in the BCBSAZ network, have experienced at least a 33% reduction in claims for fully insured plans, and be in good standing with professional licensing boards, and with BCBSAZ.
Blue Cross Blue Shield of Arizona and Sharecare are collaborating to help all Arizonans better manage stress, anxiety, and burnout. With an estimated 230% increase in worry among Americans due to the pandemic, BCBSAZ is providing all Arizonans with 90 days of free access to Sharecare’s Unwinding Anxiety,which is clinically proven to decrease anxiety within three months.
Blue Cross Blue Shield of Arizona has announced a new program to support primary care providers across the state during the COVID-19 pandemic. PCPs participating in the BCBSAZ Patient Centered Medical Home program can now receive partial prepayment of their estimated annual quality incentive payment. These advances will help BCBSAZ PCMH providers cover monetary shortfalls due to the COVID-19 crisis.
Blue Cross Blue Shield of Arizona along with Phoenix Suns Charities, donated $80,000 to purchase 5,000 COVID-19 antibody test kits for first responders.
The antibody tests are designed to help determine if first responders have been exposed to COVID-19 and developed antibodies for the disease, even if they have not experienced any symptoms. The test results will give first responders yet another piece of critical information to help them understand more about their exposure and risks of spreading the virus.
BCBSAZ will waive cost sharing for insured members who receive care for COVID-19 related treatment from in-network providers through May 2020. This impacts BCBSAZ fully insured groups, individual policies, and Medicare members.
More than 20 medically qualified Blue Cross Blue Shield of Arizona employees have volunteered to assist in providing care and treatment to COVID-19 patients in healthcare facilities. The company will support trained healthcare specialists from BCBSAZ and its subsidiary, Health Choice Arizona, in returning to practice as physicians, nurses, and pharmacists to care for those in need.
Blue Cross Blue Shield of Arizona will waive prior authorizations for medically necessary covered services for members diagnosed with COVID-19. Members will pay no cost-share for medically necessary diagnostic tests related to COVID-19. It will waive the member cost share for telehealth sessions, and expand access to telehealth and nurse/provider hotlines. It will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with a member’s benefit plan) and/or encouraging members to use their 90-day mail order benefit. BCBSAZ will also work with members to find alternative covered medications if there are shortages or access issues. Patients will not be liable for additional cost share for a non-preferred medication if the preferred medication is not available due to shortage or access issues.
Blue Shield of California announced a new “Primary Care Reimagined” program that provides in-network physician groups access to an array of latest technologies to enhance their delivery of care, and new reimbursement models that provide more predictable cash flow for the physician practices.
The program was spurred by the COVID-19 crisis that has placed significant challenges on physician practices while the health care delivery system is experiencing changes including expanded telehealth and virtual care.
The program is initially being offered to select physician groups throughout California. The reimbursement model includes set monthly payments per member as well as additional financial incentive payments for achieving quality outcomes and positive member experiences.
The new services offered to participating physician practices will include shared decision-making, virtual care, community health advocates, real-time claims payment initiative, and practice-level consulting services. These services are part of Blue Shield’s Health Reimagined initiative that seeks to transform the healthcare system with innovative ideas and technologies by working with medical providers, employers and community leaders.
Blue Shield of California has announced the “Neighborhood Health Dashboard,” an online tool to advance public health services, increase transparency around community health, and help address health disparities in California.
The Neighborhood Health Dashboard uses data intelligence from dozens of sources to create a comprehensive picture of a community’s health including: health outcomes, preventative health care, utilization and access, health behaviors, social risk factors, and environment and economic health conditions.
Most recently, the platform was used to produce California’s Vulnerability Index, which focuses on social and economic vulnerability of communities to start conversations about equitably prioritizing the allocation of resources for COVID-19 recovery efforts. In addition to the health impact of the COVID-19 crisis on different communities, the report also considers which areas are likely to have a more difficult time recovering from the coronavirus-related shutdowns, job reductions and layoffs.
Blue Shield of California’s BlueSky Initiative, in partnership with DoSomething.org – the largest organization for young people and social change – has launched a first-of-its-kind digital mental health guide for youth, created for students by students. The guide provides young people with peer-to-peer tips on self-care, managing stress from digital learning, and supporting the mental health of fellow classmates.
With COVID-19 disrupting schooling for more than 55 million students across the United States, DoSomething.org, and the BlueSky initiative called on their members to submit advice to help students during these difficult times.
Blue Shield of California is teaming up with artists in nine counties to create original artwork as part of an education and awareness campaign that offers support and encouragement during the COVID-19 crisis to members who face health-related challenges.
More than 200,000 Blue Shield members, ages 35 to 64, will receive customized-art postcards over the next two weeks that encourage them to build healthy habits, especially during the COVID-19 crisis. For example, taking advantage of the nonprofit health plan’s Wellvolution program to better manage stress, treat existing conditions, and improve mental and physical health.
Wellvolution offers members more than 50 digitally driven health programs to choose from, which address specific health goals, conditions and health risks, and the program is available to most Blue Shield members at no additional cost. This outreach campaign is the latest example of Blue Shield’s efforts to help members prioritize their health from the convenience and safety of their homes to prevent, treat or even reverse chronic conditions.
Blue Shield of California will waive copays, coinsurance, and deductibles for COVID-19 treatments received between March 1 – December 31, 2020.
Blue Shield will also continue to cover costs for virtual care (medical and behavioral) services provided by Teladoc Health through December 31, 2020.
Blue Shield of California is extending its commitment to waive co-payments, coinsurance, and deductibles for treatment for COVID-19. It will also continue to cover costs for virtual care (medical and behavioral) services provided by Teladoc Health through Sept. 30, 2020. The plan will also continue to waive cost-sharing for COVID-19 screening and testing in accordance with applicable state and federal law.
Blue Shield of California has provided $300,000 in grants to nonprofit organizations providing mental health supports in San Diego and Alameda counties. This builds on the company’s multi-year, $10 million investment in youth mental health.
The $300,000 will be divided into 18 different grants – nine each in Alameda and San Diego counties.
Blue Shield of California has teamed up with DoSomething.org, the largest organization for young people and social change in the nation, to develop a first-of-its-kind mental health guide to help youth cope with stress and anxiety during the COVID-19 crisis.
The three-month digital campaign, will include text, email, and social media activations to DoSomething.org’s millions of members, encouraging young people across the U.S. to share their tips to help combat anxiety, especially during COVID-19.The idea is to reduce stigma, raise awareness, and encourage youth to seek help.
The campaign is in addition to the resources developed and offered by Blue Shield of California’s BlueSky initiative, a multi-year effort to enhance awareness, advocacy, and access to mental health support for middle and high school students in California and beyond.
Blue Shield of California is providing $100,000 support to MedShare, a San Francisco Bay area nonprofit organization that donates personal protective equipment (PPE) supplies to nonprofit community healthcare providers.
Blue Shield of California is offering a digital tool at no additional cost for its nearly 350 in-network hospitals to help them triage the influx of patients seeking advice on coronavirus or other medical care via their websites.
Blue Shield is also donating $500,000 to the Oakland COVID-19 Relief Fund to support, among its projects, pop-up coronavirus testing sites organized by Brown & Toland Physicians that will prioritize medical providers and first responders.
Blue Shield of California Promise Health Plan, which serves Medi-Cal and Medicare beneficiaries, is giving $100,000 sponsorship funds to community health providers in Los Angeles and San Diego counties.
Blue Shield of California is providing up to $200 million in direct support to health care providers and hospitals through financing guarantees, advance payments, and restructuring of contracts.
Blue Shield is working with two financial institutions to help providers with guaranteed loans and to make advanced payments to them on anticipated healthcare costs. The plan is to offer favorable repayment terms to help providers get through the next six months.
Blue Shield of California will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020.
Blue Shield of California will waive all cost-sharing and any prior approval for COVID-19 testing for fully insured commercial and Medi-Cal plans. This includes cost-sharing for hospital, urgent care, emergency room, and office visits where the visit is to screen or test for the virus. Blue Shield also will not require prior authorization for medically necessary emergency care. Blue Shield is working closely with self-funded plan sponsors to confirm coverage levels for their employees. Blue Shield is closely monitoring impact to prescription drug supply and will take immediate steps to ensure members have access to medications. It is encouraging use of telehealth services.
Blue Shield of California also announced it will waive out-of-pocket costs for most members to use Teladoc Health’s virtual care service. Costs will be waived until May 31 in Individual & Family and employer-sponsored plans that offer Teladoc. Members enrolled in Blue Shield’s Trio, Tandem and Medicare Advantage plans, plus Blue Shield of California Promise Health Plan enrollees, already enjoy $0 out-of-pocket costs for Teladoc Health services.
Blue Cross of Idaho is extending telehealth services for its members throughout the state until December 31, 2020. Members may continue to receive telehealth services via phone or video call from all in-network providers throughout Idaho.
Additionally, Blue Cross of Idaho members can access MDLIVE, the company’s telehealth partner. MDLIVE provides a primary care platform via mobile device or computer for Blue Cross of Idaho members to access convenient, secure and cost-effective options for accessing preventive, chronic and other primary care services.
Blue Cross of Idaho has processed more than 90,500 telehealth claims since expanding telehealth access on March 19, 2020. During the week of January 27-February 2, 2020, Blue Cross of Idaho processed 108 telehealth claims. That number increased to 10,718 telehealth claims between April 6-April 19, 2020 – 118 times more than the weekly average for the first 3 months of the year.
Blue Cross of Idaho has created a program to allow independent providers, such as private-practice physician groups, an opportunity to receive advance payments to cover monetary shortfalls due to the COVID-19 pandemic. Blue Cross of Idaho will make advance payments to the provider once per month in April, May and June. The company will recover the interest-free payments during the fourth quarter of 2020.
Blue Cross of Idaho is also waiving all member cost-sharing for treatment of COVID-19. Members will not pay anything out-of-pocket – including copays, deductibles or coinsurance – for testing for COVID-19, for the medical visits related to testing, or treatment of COVID-19. Waiving of cost-sharing for coverage of treatment for COVID-19 applies through June 30, 2020.
Blue Cross of Idaho has waived all cost-sharing for doctor’s office and urgent care visits related to testing for COVID-19. This decision applies to individual and fully insured members on employer plans. Blue Cross of Idaho has also expanded access to MDLIVE, the company’s telehealth partner. The new telehealth benefits are being offered at no additional premium cost to those members.
Blue Cross and Blue Shield of Illinois
MATTER, Anthem, Inc., and Blue Cross and Blue Shield of Illinois have launched the Pandemic Response Innovation Challenge. The challenge is a global call to innovators to develop creative solutions aimed at supporting the health care needs of those impacted by the COVID-19 pandemic.
The challenge is part of Anthem and BCBSIL’s broader efforts to help reduce the strain on the health care system today, while preparing consumers and health care providers for a stronger post-COVID-19 world.
Innovators can submit their solutions to either of two tracks. The first track is seeking solutions that empower people to address their behavioral health needs, such as depression, anxiety, and substance abuse, which can be exacerbated in times of uncertainty. The second track focuses on leveraging data from Anthem’s Digital Data Sandbox, one of the largest certified de-identified health data sets in the U.S., to improve patient care and outcomes during COVID-19 and in the future.
Blue Cross and Blue Shield of Illinois has extended cost-sharing waivers for COVID-19 treatment for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through August 31, 2020.
Blue Cross and Blue Shield of Illinois has selected 75 organizations to receive $1.5 million in funding as part of the BCBSIL COVID-19 Community Collaboration Fund. The Fund supports organizations that are providing critical services in the areas of access to health care, hunger and shelter.
Of the 75 grant recipients, 25 represent and address each focus area: hunger, shelter and access to health care.
Blue Cross and Blue Shield of Illinois has opened a $1.5 million funding program to support community-based organizations with missions focused on access to health care, hunger and shelter. The BCBSIL COVID-19 Community Collaboration Fund will release $20,000 grants to organizations around the state. The program is designed to distribute the funds quickly to respond to the current health crisis.
BCBSIL is also supporting non-profit organizations that serve our most vulnerable neighbors through a $1 million donation to Governor J.B. Pritzker’s Illinois COVID-19 Response Fund and $500,000 to the Chicago Community COVID-19 Response Fund.
BCBSIL has also purchased and donated 150,000 KN95 masks, to meet the urgent need for personal protective equipment. The masks were donated to the Illinois Emergency Management Agency for distribution to providers most in need.
Blue Cross and Blue Shield of Illinois is temporarily lifting cost sharing payments for medically necessary health services delivered through telehealth. This applies to all fully insured members whose benefit plan included telehealth benefits. Blue Cross and Blue Shield of Illinois has also added 18 additional telehealth procedure codes that health care providers may use when billing Blue Cross and Blue Shield of Illinois for medically necessary health care services, including codes for behavioral health therapy.
Blue Cross and Blue Shield of Illinois also launched a dedicated microsite with information for members, providers on COVID-19.
Blue Cross and Blue Shield of Kansas
Blue Cross and Blue Shield of Kansas has extended cost-sharing waivers for telehealth services for COVID-19 treatment until December 31, 2020.
Blue Cross and Blue Shield of Kansas is also waiving cost-sharing for treatment of COVID-19 until December 31, 2020.
Blue Cross and Blue Shield of Kansas will continue waiving member cost sharing, including co-pays and deductibles, until June 30 for the following services:
- Telehealth services for any visit that is medically reasonable to be done using this technology. This includes, but is not limited to, medical visits, physical therapy, occupational therapy, and speech therapy. The visit does not have to be specific to COVID-19 testing. The use of telehealth will help to lower the spread of germs while allowing members to continue to get the care they need.
- Early refills on prescription medications will be allowed until June 30; however, they will still be subject to co-pays and deductibles.
- Treatment of COVID-19, which includes coverage for testing and treatment administered at a doctor’s office, urgent care facility and emergency room, as well as inpatient hospital stays. This only applies to fully insured members, along with those who receive their insurance through Medicare Advantage plans.
Blue Cross and Blue Shield of Kansas will also continue covering the following services with no member cost sharing for the duration of the COVID-19 public health emergency:
- Medically necessary diagnostic tests related to COVID-19 and the cost of the visit to doctor’s office, urgent care, telehealth, and emergency room used for diagnostic testing of COVID-19.
- Related services (flu tests, respiratory illness tests) provided during urgent care, emergency room, or in-person or telehealth provider visits that result in an order for or administration of a covered diagnostic test for COVID-19.
Blue Cross and Blue Shield of Kansas will expand coverage for telehealth services, which includes waiving cost-sharing for all telehealth services for members.
Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City has committed nearly $18 million in financial relief to support employer groups, members, and providers experiencing unexpected financial hardships due to the COVID-19 pandemic. This financial support supplements the measures Blue KC has put in place to ensure its members are able to receive the care they need during the COVID-19 emergency period.
Blue KC will be working with broker partners to deploy a suite of financial assistance programs for eligible employers that will include credits of certain health care premiums. Programs will be introduced starting August 2020, with others spanning into the summer of 2021 to provide more long-term relief.
Blue KC will also advance August and September 2020 value-based payments to health care providers who participate in Blue KC’s Advanced Primary Care Program. These advanced payments, which will be made in July 2020, are aimed at helping these specific provider groups as they recover from the financial burden experienced during the height of the COVID-19 outbreak.
Blue KC is also continuing to waive member cost sharing for in-network primary care physician and specialty visits for Medicare Advantage members through December 31, 2020.
Blue Cross and Blue Shield of Kansas City has partnered with The Battle Within to provide Kansas City healthcare providers, first responders, and military veterans with cost-free virtual or in-person behavioral healthcare through the Frontline Therapy Network.
The Frontline Therapy Network’s licensed providers are qualified to provide care to the Kansas City medical personnel, first responders, and veterans on the trauma, stress, discomfort, grief, or other mental health concerns they are experiencing on the frontlines of the COVID-19 response.
Blue Cross and Blue Shield of Kansas City is waiving all member cost sharing and copayments for inpatient hospital admissions due to the diagnosis of COVID-19. This policy will remain in place through June 30, 2020 and applies to insured Blue KC plans.
Blue Cross and Blue Shield of Kansas City will waive cost-sharing for COVID-19 testing and eliminate prior authorizations for COVID-19 services. The company is waiving refill limits for 30-day maintenance medications, as well as fees for urgent/sick virtual care visits. It is offering same- or next-day therapy appointments to help ease anxiety about coronavirus.
Blue Cross and Blue Shield of Louisiana
Blue Cross and Blue Shield of Louisiana Foundation has granted more than $4 million to 95 nonprofits across the state working to meet the needs of communities in response to COVID-19 since mid-March.
Efforts supported through Foundation grant funding include:
- Providing food to kids, financially insecure families and seniors
- Supporting healthcare needs, including securing critical supplies for providers, connecting individuals to care and mental health resources
- Funding direct economic support , housing assistance and keeping families financially stable
- Sustaining essential services disproportionately affected by stay-at-home orders, such as sober housing, services for sexual assault victims and a limited scope of education-related services
- Supporting regional groups organizing disaster response in communities across Louisiana, and supporting nonprofits through community relief funds operated by local community foundations
Blue Cross and Blue Shield of Louisiana has created an online, multimedia toolkit for Louisiana employers to address common questions about returning to work and share information from medical directors and others.
Blue Cross and Blue Shield of Louisiana has made more than $3.1 million in grants to 70 non-profit organizations since mid-March.
The grants have included:
- $1 million for providing food to kids, financially insecure families and seniors
- $160,000 to support healthcare needs, including securing critical supplies for providers, connecting individuals to care and mental health resources
- $780,000 to provide support for direct economic support funds, housing assistance and keeping families financially stable
- $630,000 for regional groups organizing disaster response in communities across Louisiana, and support of nonprofits through community relief funds operated by local community foundations
Blue Cross and Blue Shield of Louisiana data and analytics team members have worked closely with the Louisiana Department of Health to aggregate, analyze and model diverse data for Blue Cross members and members of state Medicaid plans, representing two out of three Louisianans. This lets them make projections about rates of hospitalization and death, healthcare facilities’ capacity and proper allocation of crucial medical resources. This information is shared with state officials to assist in planning COVID-19 mitigation measures.
Blue Cross and Blue Shield of Louisiana is making medical or behavioral health online visits with BlueCare, the insurer’s signature telehealth platform, available for $0.
Blue Cross Blue Shield of Massachusetts
BlueCross BlueShield of Massachusetts will return $101 million in premium refunds and anticipated rebates to its customers and members as a result of lower than anticipated health care costs during the COVID-19 public health emergency. The refunds are in addition to the $116 million Blue Cross has invested to support its members, customers, clinical partners, and the community throughout the crisis, bringing the company’s COVID-related financial commitments to more than $217 million.
Credits will be applied in September and reflected on the next invoice for fully insured employer groups and members (including under-65 direct pay and Medex members) and will total 15% of their May 2020 medical premium. Before the end of the year, Medicare Advantage members will receive a one month “premium holiday” during which they will not be charged their monthly premium.
Blue Cross Blue Shield of Massachusetts will waive copayments, co-insurance, or deductibles for all medically necessary COVID-19 related care, care received at doctor’s offices, urgent care centers, and emergency departments, for the duration of the Massachusetts health emergency.
Blue Cross Blue Shield of Massachusetts will also waive member cost share (copayments, co-insurance, and deductibles) for COVID-19 related inpatient care at both in- and out-of-network acute care facilities for our fully insured members, also for the duration of the Massachusetts health emergency.
Member cost sharing for telehealth service with in-network providers has also been waived for the duration of the Massachusetts health emergency.
- Blue Cross Blue Shield of Massachusetts has launched a series of new initiatives to ensure that members have timely access to high-quality, affordable mental health care. Access to mental health services is a serious issue across the country and has become even more pronounced during the COVID-19 pandemic.The initiatives include:
- Supporting newer, more convenient mental health care options by reimbursing telehealth sessions performed by mental health specialists at the same rate as in-person visits beyond the current COVID-19 public health emergency. This includes both video and telephonic telehealth services.
- Expanding member access to telehealth coverage for psychiatric care on the national telehealth platform.
- Expanding the number of child psychiatrists available to members by increasing reimbursement rates by 50% for child psychiatrists who participate in a new incentive program.
- Offering new financial incentives for primary care physicians to integrate mental health care into their practices with the goal of improving members’ physical and mental health outcomes.
- Expanding access to an innovative online program to help members better manage anxiety and stress.
- Adding 2,000 new clinicians to the Blue Cross mental health network to provide members with more options for their care.
- Committing $550,000in relief grants to nonprofits providing frontline aid including access to food, basic needs and critical support for first responders, health care and retail workers;
- Lifting funding restrictions on $520,000of committed funds to ensure nonprofits have the flexibility to address critical challenges; and
- Leveraging a $300,000 commitment to Blue Cross’ Healthy Living Collaborative partners, including Codman Square Health Center and East Boston Neighborhood Health Center, to meet pressing community health challenges.
Blue Cross Blue Shield of Michigan
Blue Cross Blue Shield of Michigan is donating $1 million for the procurement and distribution of emergency personal protective equipment (PPE) to support dentists and patients statewide amid the ongoing COVID-19 crisis.
The funds will be used to acquire $1 million worth of PPE for the assembly and distribution of safety kits to help protect dentists, dental staff and patients against the transmission of COVID-19 while dental care services are being performed. Each kit will contain NIOSH-approved KN-95 masks, disposable isolation gowns with cuffs and bouffant hair caps. The kits will be shipped to dentists who practice and primarily serve patients throughout Michigan.
Blue Cross Blue Shield of Michigan will waive 30% of one month of health and dental plan premiums for more than 180,000 active, commercially insured individual health plan subscribers this fall. Totaling more than $21 million, the refunds will be delivered in the form of premium credits on November invoices, pending approval of plans filed with state regulators this week. The credits are a response to lower than expected health care claims resulting from the disruption in the delivery of health and dental services caused by the COVID-19 crisis.
Blue Cross Blue Shield of Michigan and Blue Care Network will provide their members no-cost treatment for COVID-19 disease through Dec. 31, 2020. The cost share waivers apply to members in fully insured commercial PPO and HMO plans, as well as individuals in fully insured Medicare Advantage plans. BCBSM will work with employer group customers that are self-insured to make decisions regarding their own benefits.
BCBSM estimates that it will spend between $23 million to $43 million in providing these additional benefits – bringing the company’s total investment in additional benefits for members to nearly $150 million during the pandemic.
Blue Cross Blue Shield of Michigan and Blue Care Network will be returning more than $100 million to many fully insured customers this year. The refunds are in addition to $494 million that BCBSM has invested in expanding the availability of no-cost benefits for members and to support health providers in response to COVID-19 – bringing the BCBSM enterprise’s commitment in response to the crisis to nearly $600 million.
BCBSM will be providing the following relief to customers and members with Blue Cross and Blue Care Network health plans:
- Fully insured small group customers with 50 or fewer employees will receive a 30% credit on their July premium invoice. All told, BCBSM is providing about $37 million back to small group customers for their medical plans.
- Low rate adjustments for small group customers. BCBSM filed 2021 small group rates last week with state regulators that average 0.9% more for PPO plans and 1.95% more for HMO plans.
- Blue Dental and Blue Vision employer group customers will be sharing a total refund of about $10.5 million. All fully insured groups with dental and vision coverage will receive a one-month premium refund to be credited on their July invoice. BCBSM also will not increase rates for fully insured customers renewing dental and vision plans for 2021.
- Individual health plan members from 2019 will receive a one-time rebate resulting from lower than expected health care claims. Altogether, about $45 million will be paid directly to these 2019 individual plan subscribers in September. Rebates are determined based on each subscriber’s plan and premiums paid in 2019. Rebate amounts will vary by subscriber.
- Medigap (Medicare Supplement) and individual Medicare Advantage members in a plan with a premium above $0 will receive a 15% premium refund for the months of March and April to be applied to their July premium bill. This refund totals about $15 million to Medigap and Individual Medicare Advantage members. For Individual Medicare Advantage members this includes their Optional Supplemental Buy-up (if applicable).
BCBSM is also providing $494 million in additional support to members and providers:
- Medicare Advantage member cost share waivers will be provided through December 31 for BCBSM and BCN Medicare Advantage members. On May 7, BCBSM became the first health plan in Michigan to announce that it would waive cost sharing for Medicare Advantage members for all services provided during in-person primary care visits, for in-person behavioral health services and for telemedicine access. The projected value of these no-cost services will save BCBSM and BCN Medicare Advantage members $10 million.
- COVID-19 testing and treatment cost share waivers and no-cost telehealth services will continue to be provided through June 30 to enable free access to physician-directed COVID-19 testing and treatment for commercially insured members. The projected value of these no-cost services will save members $97 million. BCBSM was the first health plan in Michigan to announce testing and treatment for COVID-19 at no cost, along with no-cost telehealth access for both medical and behavioral health services during the first wave of the pandemic period.
- Advance funding for health providers. BCBSM pulled forward $87 million in earned incentive payments to Michigan physicians to enable them to operate, purchase testing supplies, enhance treatment services for COVID-19 patients and expand telehealth services. BCBSM also decided to continue planned payments to health systems, totaling about $300 million, despite disruptions in claim volume. This enabled Michigan health systems to continue operating with a stable revenue stream during a time of significant disruption in their ability to deliver services.
Blue Cross Blue Shield of Michigan and Blue Care Network are launching new telehealth programs with behavioral health providers, so Blue members who are interested in participating in group sessions to discuss the impacts of the COVID-19 pandemic on their mental health can share their experiences with others under the guidance of a trained therapist. The programs are available for free to members with Blue Cross and Blue Care Network behavioral health coverage through June 30.
Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will waive cost-sharing for Medicare Advantage members through December 31 for certain specific services that enable seniors to consult with their doctors and therapists about their health needs, both in-person and virtually. Members in BCBSM and BCN Medicare Advantage plans will be assured of no copays, coinsurance or deductibles for the following in-network services, from May 1 through Dec. 31, 2020:
- In-person primary care services
- Behavioral health office visits
- Telehealth services for both medical and behavioral health
Blue Cross Blue Shield of Michigan is offering full salary and benefits to employees with medical backgrounds who volunteer to work in the coronavirus field hospital being constructed at the TCF Center in Detroit.
Blue Cross Blue Shield of Michigan is accelerating payments to Michigan-based physician organizations and practices to support their efforts for treating patients with COVID-19. Additionally, BCBSM is relaxing some of its administrative requirements to allow Michigan’s physician organizations and health systems to spend more time treating patients and hasten their diagnoses and treatment.
The accelerated funding is available to the more than 40 physician organizations that are a part of Blue Cross’ Physician Group Incentive Program (PGIP), including over 20,000 primary care and specialist physicians throughout Michigan.
Blue Cross Blue Shield of Michigan and Blue Care Network are waiving all member copays, deductibles and coinsurance for COVID-19 testing and treatment. The coverage applies to commercial PPO, Medicare Advantage PPO and HMO plans.
Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will further expand access to prescription drug refills for members in order to comply with an executive order issued by Gov. Gretchen Whitmer to expand access to prescription drug refills during the COVID-19 public health crisis. Governor Whitmer’s executive order expands BCBSM and BCN efforts by requiring all insurance providers to waive any limits on early refills, so Michigan residents can obtain a 90-day supply of prescription drugs necessary to manage their medical conditions during the COVID-19 crisis.
Blue Cross Blue Shield of Michigan 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 and Medicare Advantage plan members. Blue Cross Blue Shield of Michigan will also work to support self-insured customers who choose to take similar actions.
Blue Cross and Blue Shield of Minnesota
Blue Cross and Blue Shield of Minnesota is providing more than $38 million in premium relief for thousands of Medicare members, individual and family plan members, and fully insured businesses throughout the state. All of these one-time credits, which will range from 10% to 25%, will be applied to an upcoming monthly bill before the end of 2020. Additionally, Blue Cross recently completed an accelerated mailing of rebate checks totaling more than $31 million to thousands of members who had individual and family coverage with the insurer in 2019. The combined $70 million in financial relief comes at a time when many Minnesota residents and employers continue to face significant challenges resulting from the economic downturn that began with the onset of the COVID-19 pandemic.
All temporary telehealth coverage changes currently in effect will be extended through December 31, 2020. This includes coverage for behavioral health services, in addition to physical, speech and occupational therapy, and medication management.
Additionally, Blue Cross is extending its cost-share waiver for COVID-19 testing, related office visits and in-network treatment through the end of the year, ensuring members will not need to pay any out-of-pocket expenses for COVID-19 related care.
Blue Cross and Blue Shield of Minnesota will also accelerate approximately $80 million in advance payments to providers for quality and cost standards achieved in 2019 — previously scheduled for payment in late-2020. In addition, Blue Cross will provide advance payments to providers for achievements made in the innovation and transformation of care delivery through value-based care partnerships.
Blue Cross and Blue Shield of Minnesota and Blue Plus has committed $60,000 in funding to support the Arrowhead Health Alliance (AHA), a collaboration between the Health and Human Services agencies of Carlton, Cook, Lake, Koochiching and St. Louis counties in northeastern Minnesota. The funding will support the AHA’s Arrowhead Telepresence Coalition, enabling the organization to purchase and distribute Internet devices and hardware to individuals in the region who are most in need of access to telehealth services. The AHA is anticipating as many as 300 to 400 new telehealth users due to COVID-19 related concerns about in-person visits to health care clinics and hospitals.
Blue Cross and Blue Shield of Minnesota has become the first health insurer to join the state’s latest public health initiative to slow the spread of COVID-19. More than 140 Blue Cross associates from across Blue Cross will volunteer as contact tracers for the Minnesota Department of Health.
Blue Cross volunteer investigators will interview individuals who have been diagnosed with COVID-19 in order to determine who among their social contacts may also have been exposed to the virus. The investigator will then reach out to those identified contacts and relay the state’s suggested policies and procedures for self-quarantine and testing.
Blue Cross and Blue Shield of Minnesota is reducing barriers to care for Medicare Advantage members by waiving member cost-sharing for in-network primary care, mental health and substance use office visits for the duration of the public health emergency in 2020. Additionally, Medicare Advantage members will have expanded access to in-home wellness care and home test kits for some preventive screenings.
Blue Cross and Blue Shield of Minnesota announced partnerships with WellShare International and the Minnesota Community Health Worker Alliance designed to strengthen and extend the community health work infrastructure in Minnesota communities, reduce health disparities, and bridge cultural and language barriers in efforts to limit the spread of COVID-19.
Blue Cross and Blue Shield of Minnesota Foundation has granted more than $825,000 to community organizations through its COVID-19 rapid response fund, on top of earlier efforts that include contributing $100,000 to both the Minnesota Disaster Recovery Fund and the Headwaters Foundation for Justice’s Communities First Fund, $100,000 to the Coalition of Asian-American Leaders (CAAL) as part of their anti-racism campaign and $15,000 to both the Minneapolis American Indian Center and NorthPoint Health and Wellness for their emergency food shelf efforts.
Blue Cross and Blue Shield of Minnesota has joined with North Memorial Health to create mask covers made of surgical wrap material that can be worn over N95 masks. One sheet of wrap can make 24 mask covers, and thousands of mask covers will be sewn for this campaign.
Blue Cross and Blue Shield of Minnesota is waiving all patient costs related to in-network COVID-19 treatment and care, including hospitalization. The treatment cost waiver applies to all members in fully insured commercial plans, Minnesotans who purchase Blue Cross coverage on their own, and seniors enrolled in Medicare. The waiver will be in effect through May 31, 2020.
Blue Cross and Blue Shield of Minnesota announced a new community-based initiative with Allina Health to enable skilled volunteers to assist with the shortage of personal protective equipment for health care workers.This initiative asks skilled volunteers throughout the state to sew CDC-approved reusable face masks that health workers can use as they treat patients.
Blue Cross and Blue Shield of Minnesota 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 employer, individual and Medicare members. Self-insured employers will have the flexibility to apply the same no-cost structure.
Blue Cross and Blue Shield of Mississippi
Blue Cross and Blue Shield of Mississippi has expanded telehealth coverage for members through December 31, 2020.
Blue Cross and Blue Shield of Mississippi is covering medically necessary diagnostic tests consistent with CDC guidance related to COVID-19 at no cost share (deductible, copay, coinsurance) to members.
Blue Cross and Blue Shield of Mississippi is also waiving member cost sharing for medically necessary covered services for COVID-19 treatment through May 31, 2020.
Medically necessary covered telemedicine services are also being provided with no member cost sharing payments.
BlueCross BlueShield of Montana
BlueCross BlueShield of Montana is extending cost-sharing waivers for COVID-19 treatment through October 23, 2020. The waivers are offered for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans.
BlueCross and BlueShield of Montana is extending cost-sharing waivers for COVID-19 treatment for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through Aug. 31, 2020.
BlueCross BlueShield of Montana will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization. This applies to all members except those in self-insured plans; those plans are making their own coverage decisions.Blue Cross and Blue Shield of Montana is temporarily expanding its telemedicine visit coverage to include phone calls and eliminating cost sharing for clinically appropriate, covered medical and behavioral health services delivered through telemedicine in response to the COVID-19 pandemic.The expansion is effective through April 30, 2020.
BlueCross and BlueShield of Montana also launched a dedicated microsite with information for members, providers on COVID-19.
Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of Nebraska (BCBSNE) launched a pilot program to recruit work-from-home customer service representatives in Norfolk, Columbus and greater Omaha, demonstrating its commitment to Nebraska’s economic development, a sustainable remote-working environment and localized member support. As part of the pilot, 10 new employees started August 31, with more to follow soon.
Prioritization of both employee safety and uninterrupted customer service spurred BCBSNE leadership to quickly get employees set up to work from home at the onset of the COVID-19 crisis. The company ensured a smooth transition to work from home, with requirements including equipment reliability, high-speed internet connectivity, information security and continued employee engagement.
BCBSNE is hiring at least 16 more customer service representatives in Norfolk, Columbus and greater Omaha in September, and plans to continue expanding hiring to other parts of Nebraska.
Blue Cross and Blue Shield of Nebraska is extending the waiver of member cost shares for in-network COVID-19 testing and inpatient/outpatient treatment, including telehealth, through Sept. 30, 2020. During the pandemic, the company has seen a significant increase in telehealth usage. BCBSNE began waiving member cost shares for telehealth in early March.
Telehealth claims among BCBSNE members were up 963% in March, and 3612% in April, compared to February 2020. Over half of these telehealth visits – 53% – were for behavioral health.
Blue Cross and Blue Shield of Nebraska has also donated $20,000 to the Open Door Mission. The donation will support the nonprofit in providing shelter and care for men, women and children experiencing homelessness during the COVID-19 crisis.
Blue Cross and Blue Shield of Nebraska will cover testing for COVID-19 with no cost-sharing and is waiving early refill limits on 30-day prescription medications. It will also cover the cost of all telehealth visits with no cost-sharing for all members.
Blue Cross and Blue Shield of New Mexico
Blue Cross and Blue Shield of New Mexico has made a $20,000 grant to the Adelante Development Center, a nonprofit that supports people with disabilities and seniors across New Mexico. The grant will help Adelante’s direct support professionals meet the increased demands of delivering personal care to vulnerable populations during the COVID-19 crisis.
Blue Cross and Blue Shield of New Mexico is waiving cost-sharing for COVID-related treatment for Medicare (excluding Part D) and Medicare Supplement members, through August 31, 2020.
For fully insured and Interagency Benefits Advisory Council members, there is no projected end date for the cost-sharing waivers for COVID-19 related testing and treatment.
Blue Cross and Blue Shield of New Mexico is contributing $1 million to address the needs of New Mexicans impacted by the COVID-19 pandemic.
The BCBSNM COVID-19 Community Collaborative Grant Fund will help support the health and wellness of our communities by focusing on areas where communities need it the most, including aid for food security, child and senior care, providers, and health care access.
Blue Cross and Blue Shield of New Mexico will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization. It is working with self-insured plans on their decisions.
Blue Cross and Blue Shield of New Mexico also launched a dedicated microsite with information for members, providers on COVID-19.
BlueCross BlueShield of North Carolina
Blue Cross and Blue Shield of North Carolina has invested $400,000 in the American Red Cross’ Sound the Alarm program for home fire prevention, preparedness, and recovery, and to help create disaster-ready kits for its shelters in the wake of the COVID-19 pandemic.
National Preparedness Month is recognized each September to promote disaster planning, and this year Blue Cross NC has committed $100,000 to support the Red Cross’ efforts to create 10 pandemic-ready shelter kits to keep residents and volunteers safe as they navigate disasters during the evolving public health crisis.
Each kit includes enough PPE and other essential supplies to enable 150 workers and residents (and those seeking safe shelter from threats such as hurricanes and flooding to monitor and address basic health and wellness and social distancing needs for up to two weeks.
Blue Cross and Blue Shield of North Carolina and the Charlotte Hornets are teaming up to support Project BOLT, a nonprofit whose mission is to enhance the quality of life for marginalized citizens of the Charlotte community. The Hornets and Blue Cross NC are committing to a weekly donation of 300 meals for children in Charlotte over the next six weeks, along with a $10,000 donation to Project BOLT.
Since the COVID-19 crisis began in March, Project BOLT has been delivering food and school supplies to children ages 2-18 across seven neighborhoods to ensure that children who normally get their primary meals and basic nutrition covered through school were fed and had the necessary supplies to do their school work at home.
BlueCross BlueShield of North Carolina is waiving cost-sharing for all COVID-19 related treatments for both in-network and out-of-network providers through October 31, 2020. All doctors providing COVID-19 care will be paid as in-network – whether they are or not.
BlueCross BlueShield of North Carolina is also waiving all copays for in-network primary care and behavioral health visits for Medicare advantage members through the end of 2020.
Blue Cross and Blue Shield of North Carolina is lowering how much members pay for a 90-day supply of maintenance medications through the end of 2020. The move is designed to help ease financial burdens caused by COVID-19, and help people stay home by encouraging them to order 90-day supplies of their medications.
Effective July 15, all Blue Cross NC commercial, fully insured customers will receive up to a 33% discount on their copays for maintenance medications. The company will only require the equivalent of two copays versus three for a 90-day supply.
This benefit will be available at both retail and mail-order pharmacies. Members on an individual under-65 health plan will receive the discount immediately. Fully insured group members who get a 90-day fill between July 15, 2020 and Sept. 1, 2020 will receive a check for refunded amounts in October. Group members will get the discount at their retail or mail-order pharmacy starting Sept. 1, 2020.
Blue Cross and Blue Shield of North Carolina is expanding its support of primary care by creating Accelerate to Value, a program to help independently owned primary care physician practices remain financially viable and move to value-based care. The program helps ensure long-term access to high-quality care for Blue Cross NC members while enabling primary care practices across the state to weather the financial crisis created by the COVID-19 pandemic.
The program, open to independently owned primary care practices in North Carolina, includes:
- Financial stabilization: Blue Cross NC will provide significant financial support by making payments to participating practices, based on 2019 revenue, to improve financial stability in 2020 and 2021. These payments will begin by September.
- Transition to value-based care: Participating practices will commit to joining Blue Premier, Blue Cross NC’s value-based care program, by the end of 2020. Practices will have the option of joining an existing accountable care organization through a Blue Premier clinically integrated network or through Aledade, a company that helps primary care practices move to value-based care. Blue Premier jointly holds providers and Blue Cross NC accountable for meeting quality and cost standards.
- Capitated payments: Under a payment model known as capitation, beginning in 2022 the practices will be eligible to receive fixed monthly payments for meeting the health needs of their entire patient population. This replaces the fee-for-service method of getting paid for each patient encounter. Capitation encourages doctors to spend as much time as they need with each patient, helping them to improve their health.
Blue Cross and Blue Shield of North Carolina will speed up payments to providers as they deal with potential short-term cash flow challenges from COVID-19. The company is also fast-tracking proactive steps to support hospitals, physicians, nurses and thousands of other health care providers across North Carolina.
Blue Cross NC is enhancing claims payment processes to speed payments to providers to help alleviate revenue and potential short-term cash flow challenges during the pandemic. These measures mean that 90 percent of claims will be paid within 14 days. A significant portion of these will be paid in seven days or less.
Blue Cross NC is also speeding up its credentialling process to help meet the demand for clinicians related to the COVID-19 pandemic. Blue Cross NC will credential physicians and physician assistants applying due to COVID-19 treatment needs within 72 hours of receipt of the necessary application, consistent with the North Carolina Medical Board’s processes.
Commitments made by Blue Cross and Blue Shield of North Carolina to provide financial support to members, employers, providers, and community organizations to address the COVID-19 pandemic are projected to reach up to $593 million with $318 million in projected costs to improve access to care and $275 million projected to address cash flow challenges facing members, employers and providers.
BlueCross and BlueShield of North Carolina is waiving member cost-sharing – including deductibles, co-payments, and coinsurance – for treatments related to COVID-19 if a member is diagnosed with the virus.
Blue Cross NC will waive member cost-sharing for COVID-19 related treatments for both in-network and out-of-network providers.
BlueCross BlueShield of North Carolina will cover members’ cost for COVID-19 testing and will not require prior approval for COVID-19 testing. The company is also expanding virtual access to doctors and will waive early medication refill limits. These changes apply to fully insured, Medicare Advantage and Federal Employee Program members. Self-funded employer groups will be given the option to apply these changes to their employees’ plans.
BlueCross BlueShield of North Carolina also announced that it will cover virtual doctor visits, including those done by phone, the same as face-to-face visits according to a member’s health plan. This is an expansion of the telehealth benefits Blue Cross NC has previously offered.
BlueCross BlueShield of North Dakota
BlueCross BlueShield of North Dakota Caring Foundation has given $150,000 to nonprofits working to address the COVID-19 crisis. $75,000 will go to the eight United Way agencies across the state of North Dakota, as well as $75,000 to nonprofits dedicated to serving homeless populations, feeding families, providing childcare, and offering other basic needs to individuals most affected by the novel coronavirus.
BlueCross BlueShield of North Dakota is waiving out-of-pocket costs for the treatment of COVID-19, including hospital stays and outpatient treatment. This applies to BCBSND members on fully insured employer sponsored plans and individual plans.
BlueCross BlueShield of North Dakota is allowing customers to have 62 days to pay their premiums (which is an extension from the current 31-day requirement) for all members with individual plans or small group coverage (businesses with under 50 employees).
BlueShield of Northeastern New York
BlueShield of Northeastern New York has distributed $411,000 in relief for nearly 30 local primary care provider (PCP) groups through its COVID-19 Provider Relief Program (PRP).
BlueShield is also finalizing plans on a new reimbursement program for doctors and nurse practitioners to help cover the cost of personal protective equipment (PPE) within their practice.
PRP funds were recently dispersed to qualifying independent PCP practices who experienced a reduction in revenue compared to baseline metrics, among several other factors stemming from the pandemic. This included operational impacts, such as staffing and costs incurred to improve telehealth capabilities. The local health plan also considered whether the provider continued to serve patients during the pandemic, including through telehealth, as part of the criteria.
BlueShield of Northeastern New York employees collected over 2,000 pounds of food for The Regional Food Bank of Northeastern New York at a drive-through food drive it hosted at its headquarters. Notably, with employees working remotely, they made a special trip to participate in the event.
The employee driven support is in addition to the health plan’s recent $5,000 donation to local organizations recovering from the COVID-19 pandemic. In addition, BlueShield employees sent thousands of healthy snack-packs and meals to those serving on the frontlines of the pandemic.
BlueShield of Northeastern New York is also extending telehealth coverage at no cost share or co-pay for fully insured Commercial and Medicare Advantage members through Dec. 31, 2020.
Since March, the local health plan has seen five times more utilization of telehealth services, compared to all of 2019.
The increase has been experienced across all age groups, with nearly 21% of telehealth use in 2020 coming from members 65+, up from just 6% in 2019. In addition, more than 33% of members used telehealth for the first time during the height of the pandemic.
BlueShield of Northeastern New York is waiving all copays, coinsurance and deductibles (including deductibles on HSA plans) for COVID-19 treatment received by fully-insured Commercial and Medicare Advantage members through September 9, 2020.
BlueShield of Northeastern New York is also extending its telehealth cost-sharing waiver through September 9, 2020.
BlueShield of Northeastern New York is targeting at-risk New Yorkers for wellness check-ins, increasing engagement and support during the COVID-19 crisis.
The COVID-19 Member Well-being Outreach Program provides members with personalized outreach calls offering telehealth support, assistance with online prescriptions, education, and additional resources focused on improving their health as members continue following stay-at-home guidance.
BlueShield of Northeastern New York is offering its members free access to a digital behavioral health app, myStrength. MyStrength, powered by Livongo®, is a highly interactive application that empowers users to combat anxiety, stress, depression, chronic pain and sleep challenges. The app features modules that can help manage heightened stress and feelings of social isolation due to COVID-19, as well as manage their overall health.
Blue Cross and Blue Shield of Oklahoma
Blue Cross and Blue Shield of Oklahoma is extending cost-sharing waivers for COVID-19 treatment through October 23, 2020. The waivers are offered for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans.
Blue Cross and Blue Shield of Oklahoma is waiving cost-sharing for COVID-19 treatment for members of all fully-insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through August 31, 2020.
Blue Cross and Blue Shield of Oklahoma will authorize any member who was receiving treatment outside of Oklahoma prior to March 15 to continue receiving care closer to home if they prefer not to travel during the COVID-19 crisis through July 31. This date is an extension from the original end date of June 30. Members can transition to an in-network provider in Oklahoma or BCBSOK will cover the costs to see an out-of-network provider in Oklahoma at the in-network rate.
Blue Cross and Blue Shield of Oklahoma will authorize any member who was receiving treatment outside of Oklahoma prior to March 15 to continue receiving care closer to home if they prefer not to travel during the COVID-19 crisis. Members can transition to an in-network provider in Oklahoma, or BCBSOK will cover the costs to see an out-of-network provider in Oklahoma at the in-network rate.
MyHealth Access Network is providing its secure health records portal to all qualified providers in Oklahoma. These services are being made available to all qualified Oklahoma providers through September 1, 2020, thanks to a grant from Blue Cross and Blue Shield of Oklahoma. The new program will enable front line health care providers to use MyHealth to reference patient health data, including any test results for COVID-19, in real-time.
Qualified providers for this program will include the first responders, doctors, hospitals, agencies and long-term care providers who come into contact with patients before their COVID-19 status is known or who may encounter these patients later and need to verify testing status.
Blue Cross and Blue Shield of Oklahoma will temporarily lift cost-sharing for medically necessary medical and behavioral health services delivered via telemedicine in response to the COVID-19 public health emergency.
Blue Cross and Blue Shield of Oklahoma also launched a dedicated microsite with information for members, providers on COVID-19.
Blue Cross and Blue Shield of Oklahoma has partnered with DispatchHealth, a mobile medical care unit, to deliver on-demand health care services at members’ homes. The service is intended to prevent overcrowding at emergency rooms and other health care facilities during the COVID-19 pandemic.
Blue Cross and Blue Shield of Oklahoma will waive co-pays and deductibles for COVID-19 testing and will not require prior authorization.
Blue Cross and Blue Shield of Rhode Island
Blue Cross and Blue Shield of Rhode Island will provide an additional $11 million in medical and dental premium relief to its fully insured large group and small group customers, as well as individuals who purchase insurance through BCBSRI or HealthSource RI. The announcement follows the $13.8 million medical premium relief and 25% dental premium credit that BCBSRI announced in June.
Subject to approval by the Office of the Health Insurance Commissioner, premium relief will range from 10 to 30% (depending on market segment) for employers and members with premium relief being provided for one month in the fourth quarter of 2020.
Blue Cross and Blue Shield of Rhode Island has expanded no-cost Medicare Advantage benefits through December 31, 2020.
The benefits include:
- $0 primary care provider copays – now across all plans
- $0 mental health/substance use disorder copays
- $0 inpatient hospital, mental health, and observation stays
- $0 diagnostic labs, X-rays, and imaging – now across all plans
- $0 physical therapy, occupational therapy, and speech therapy
- $0 pulmonary and cardiac rehabilitation
- $0 Tier 1 prescription copays
- $0 most insulin drugs, most inhalers, and dementia drugs (
- $0 Part B infusion and injection drugs
- An additional $100 over-the-counter (OTC) benefit for the 4th Quarter (October through December)
BCBSRI is also making it easier for Medicare Advantage members to access care virtually. Members can temporarily receive treatment for $0 over the phone or through video from providers typically seen in person, when clinically appropriate.
Blue Cross and Blue Shield of Rhode Island has awarded Local Initiatives Support Corporation (LISC) Rhode Island a grant of $75,000. The funds will support LISC’s Neighborhood Development Fund, which provides funding, training, resources and technical assistance in an effort to strengthen the operations of community development corporations (CDCs) to produce affordable housing while addressing broader community revitalization issues.
Blue Cross and Blue Shield of Rhode Island is providing a 25% dental premium credit for fully insured customers and is extending teledentistry services with in-network dentists through July 31, 2020.
The dental premium credit will cover March, April and May 2020 and will appear as a one-time credit on July invoices. This applies to employers and individuals who purchase dental coverage directly from BCBSRI. For employers and individuals who purchase BCBSRI dental coverage through HealthSource RI, they will receive a check directly from BCBSRI in July.
Blue Cross and Blue Shield of Rhode Island is streaming virtual fitness classes every weekday at 10 a.m. as a way to meet Rhode Islanders where they are during the COVID-19 pandemic. The classes, which are typically offered only to BCBSRI members at Your Blue Store locations, include balance and strength, core, strength and tone, stretch and relax, and cardio dance.
Blue Cross and Blue Shield of Rhode Island has awarded $500,000 to nine local organizations committed to improving access to affordable housing. This is in addition to $200,000 BCBSRI awarded to five housing-related agencies at the end of 2019.
The organizations receiving funding in 2020 are each finding creative ways to make healthy and affordable housing a reality for those most in need, as well as helping them to become self-sufficient, whether through building vocational skills, learning how to negotiate with a landlord and understand tenant rights, or, in the case of formerly incarcerated individuals, receiving case management assistance and reentry support.
Blue Cross and Blue Shield of Rhode Island waived all member cost sharing (copays and deductibles) for telehealth whether provided by an in-network provider or through the Doctors Online telehealth platform.
Blue Cross and Blue Shield of Rhode Island has also waived member copays and cost sharing for diagnostic testing related to COVID-19 consistent with CDC guidelines, and has removed administrative barriers by waiving prior authorization and referral requirements for testing and medically appropriate treatment of COVID-19.
BlueCross and BlueShield of South Carolina
BlueCross and BlueShield of South Carolina, the South Carolina Hospital Association and the South Carolina Medical Association are joining together in an effort to persuade the public to limit potential exposure to COVID-19.
The groups are also looking to support South Carolina-based physicians by providing free access to an online continuing medical education module with updates on the most current COVID-19 treatment information. This effort is being supported in part through K2P, a Maryland-based company dedicated to using digital technology to personalize on-demand learning that measurably improves clinical judgment, critical thinking and patient care. The company is donating nearly $1 million worth of online, COVID-specific educational material.
BlueCross and BlueShield of South Carolina and Charleston County Medical Society have joined together to bring 300,000 PPE supplies to independent physicians in South Carolina.
BlueCross and BlueShield of South Carolina and the BlueCross BlueShield of South Carolina Foundation have joined together with Senior Resources to provide emergency food assistance beginning now into early summer in counties throughout the state.
The health insurer and its foundation are combining resources and providing nearly $1.6 million to expand Senior Resources’ emergency senior nutrition program, which is giving five free meals weekly to eligible homebound elderly. The contribution is anticipated to provide 245,000 meals.
BlueCross and BlueShield of South Carolina is waiving all out-of-pocket costs related to in-network COVID-19 medical treatment for members, through June 1.
BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee Foundation is investing $1 million in the HCS EdConnect initiative, which will provide no-cost internet access to 28,500 students in the Chattanooga area.
Students who qualify for the program will receive 100 Mbps home internet service with symmetrical speeds and no data caps, and a WiFi router.
In Hamilton County, approximately 28,500 students qualify for free and reduced lunch assistance, a measure the school system uses to determine financial need. Many of these students also don’t have internet access in their homes, which makes learning challenging, and COVID-19 has made it even more so.
While many students are participating in virtual learning and online classes to keep up with their schoolwork, those without internet access risk falling behind.
BlueCross BlueShield of Tennessee will waive Medicare Advantage member costs for doctor’s office and virtual visits to in-network primary care and behavioral health care providers from May 19 through September 30, 2020.
BlueCross BlueShield of Tennessee has made permanent its coverage of virtual visits with in-network providers.
BlueCross BlueShield of Tennessee began covering telephone and video visits with in-network providers in March. The change initially included primary care providers, specialists and behavioral health providers and was later expanded to include occupational, physical and speech therapy as well as ABA therapy services. All of these services will now be covered on an ongoing basis.
BlueCross BlueShield of Tennessee is offering enhanced support for its members by:
- Waiving all member cost-sharing for COVID-19 treatments, including hospitalizations, from in-network providers through May 31, 2020
- Waiving member costs for any appropriate, FDA-aligned COVID-19 testing
- Adapting prior authorization requirements and billing processes for emergency care through May 31, 2020
- Allowing early prescription refills and 90-day prescriptions to avoid increased risk of exposure
- Expanding access to telehealth services by making PhysicianNow visits available at no cost and by covering virtual visits with other network providers for many services
- Sharing key public health information, such as promoting social distancing and warning of potential scam activity
- Working with community news partners to help educate on and address health care disparities
In addition, the BlueCross BlueShield of Tennessee Foundation donated a total of $3.25 million to six food banks across the state to help them meet increased community needs. And the foundation has provided grants to support testing for uninsured residents in partnership with local governments.
BlueCross has also made donations of personal protective equipment (PPE) to some Tennessee health systems.
Blue Cross and Blue Shield of Texas
Blue Cross and Blue Shield of Texas has extended cost-sharing waivers for COVID-19 treatment through Oct. 23, 2020. The waivers are offered for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans.
Blue Cross and Blue Shield of Texas has launched a home screening initiative that has the potential to reach thousands of members who may not otherwise get screened for colorectal cancer this year because of disruption caused by the COVID-19 crisis.
About 8,000 eligible members in Texas soon will receive a free home test, a fecal immunochemical test (FIT), to screen themselves for colorectal cancer.
Blue Cross and Blue Shield of Texas is extending cost-sharing waivers for COVID-19 treatment for members of all fully insured group, individual, Medicare (excluding Part D), Medicare Supplement, and Medicaid plans through Aug. 31, 2020.
Blue Cross and Blue Shield of Texas made a $1 million grant to the Texas Restaurant Association’s TX Restaurant Relief Fund. Established in response to the COVID-19 pandemic, the TX Restaurant Relief Fund provides immediate financial support to Texas’ independent restauranteurs and their employees.
This grant will be used to keep restaurant operations open and employees working, while also providing first responders across Texas with meals to show appreciation for all they are doing during this unprecedented crisis.
In addition to providing more than 150,000 meals to first responders, the BCBSTX grant will provide support to more than 100 independently owned restaurants, 670 Whataburger, and more than 220 Chipotle stores across Texas.
Blue Cross and Blue Shield of Texas has made a $1 million donation to the Communities Foundation of Texas to help with COVID-19 relief efforts. The donation will support nonprofits statewide providing critical services such as: personal protective equipment (PPE) for first responders, childcare for first responders and healthcare professionals, and services for senior adults, including meal and grocery delivery.
Blue Cross and Blue Shield of Texas is waiving member cost-sharing, including deductibles, copayments and coinsurance, related to treatment for COVID-19. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies. The policy is effective for treatment received April 1 through May 31, 2020.
Blue Cross and Blue Shield of Texas will offer a special enrollment period (SEP) for its insured group customers. Employees of fully insured group customers who did not opt in for coverage during the regular enrollment period will have an opportunity to get coverage for their health care needs.
The SEP launched April 1 and will conclude April 30, 2020.
Blue Cross and Blue Shield of Texas as is temporarily lifting cost sharing for medically necessary medical and behavioral health services delivered through telemedicine. This applies to all fully insured members who receive covered in-network telemedicine services.
Blue Cross and Blue Shield of Texas also launched a dedicated microsite with information for members and providers on COVID-19.
Blue Cross and Blue Shield of Texas will not apply co-pays or deductibles for testing to diagnose COVID-19, and will not require preauthorization.
BlueCross BlueShield of Vermont
BlueCross BlueShield of Vermont is waiving the costs associated with diagnosis and treatment of acute COVID-19 through the duration of the state of Vermont’s emergency order.
BlueCross BlueShield of Vermont opened an emergency COVID-19 special enrollment period starting on March 20, 2020 for the uninsured to enroll in health plan coverage. This special enrollment period is for all qualified health plans offered through the exchange and will be for 30 days until April 17, 2020.
BlueCross BlueShield of Vermont is also covering COVID-19 testing performed by the Centers for Disease Control, the Vermont covered COVID-19 testing performed by the Centers for Disease Control (CDC), the Vermont Department of Health (VDH), or a laboratory approved by CDC or VDH, with no co-payment, coinsurance, or deductible requirements.
This coverage includes telephone triage, office visits with your provider, or urgent care visits and emergency service visits to test for COVID-19.
BlueCross BlueShield of Western New York
BlueCross BlueShield of Western New York has distributed $2.1 million in relief for nearly 150 local primary care provider (PCP) groups through its COVID-19 Provider Relief Program (PRP).
BlueCross BlueShield is also finalizing plans on a new reimbursement program for doctors and nurse practitioners to help cover the cost of personal protective equipment (PPE) within their practices.
PRP funds were recently dispersed to qualifying independent PCP practices who experienced a reduction in revenue compared to baseline metrics, among several other factors stemming from the pandemic. This included operational impacts, such as staffing, and costs incurred to improve telehealth capabilities.
BlueCross BlueShield of Western New York employees collected over 5 tons of food and nearly $2,000 for FeedMore WNY at a drive-through food drive it hosted at its headquarters. Notably, with 95% of BlueCross BlueShield employees working remotely, they made a special trip to deliver the most needed food items, 10,441 pounds in total.
The employee driven support is in addition to the health plan’s recent $80,000 donation to 16 local organizations recovering from the COVID-19 crisis. In addition, BlueCross BlueShield employees sent thousands of healthy snack-packs and meals to those serving on the frontlines of the pandemic.
BlueCross BlueShield of Western New York is also extending telehealth coverage at no cost share or co-pay for fully insured Commercial and Medicare Advantage members through Dec. 31, 2020.
BlueCross BlueShield of Western New York ‘s Blue Fund has made a corporate donation of $900,000 to the WNY COVID-19 Community Response Fund, bringing the Blue Fund’s total investment to $1 million.
As a founding corporate funder of the WNY COVID-19 Community Response Fund, BlueCross BlueShield’s initial $100,000 contribution helped launched the fund in March 2020— in collaboration with other philanthropic organizations—to address the most immediate community needs. Now, as the crisis continues to unfold, BlueCross BlueShield of Western New York is pivoting its traditional 2020 Blue Fund grant cycle to support recovery and rebuilding efforts in Buffalo-Niagara through an additional $900,000 donation to the WNY COVID-19 Community Response Fund.
BlueCross BlueShield of Western New York is offering members free access to a digital behavioral health app, myStrength.
The app empowers users to combat anxiety, stress, depression, chronic pain and sleep challenges. The app features modules that can help manage heightened stress and feelings of social isolation due to COVID-19, as well as manage their overall health.
BlueCross BlueShield of Western New York is sending healthy snack-packs and meals from local companies, Buffalo Strive and Jakes Cafe, to 1,500 Western New York heroes, on behalf of their 1,500 employees— a symbolic effort to support the dedicated individuals who are on the frontlines serving our community during the COVID 19 pandemic.
BlueCross BlueShield of Western New York has also donated $100,000 to the Western New York COVID-19 Community Response Fund to address the most critical and immediate community needs related to the coronavirus as well as other efforts.
BlueCross BlueShield of Western New York is eliminating any and all costs for our members related to COVID-19 testing and treatment. The policy is effective April 1 through May 31, 2020.
Blue Cross Blue Shield of Wyoming
Blue Cross Blue Shield of Wyoming has extended its commitment to waive all member cost sharing and copayments for treatment, and inpatient hospital admissions for the treatment of COVID-19, effective through December 31, 2020.
Blue Cross Blue Shield of Wyoming has extended waivers for all member cost sharing and copayments for COVID-19 treatment and inpatient hospital admissions, effective until September 1, 2020.
Blue Cross Blue Shield of Wyoming has extended its waiver of out-of-pocket costs for telemedicine services and necessary treatment for COVID-19. Extended benefits apply to fully insured groups and individuals but is optional for self-funded groups.
Blue Cross Blue Shield of Wyoming has donated $100,000 to support local anti-hunger programs throughout the state.
Blue Cross and Blue Shield of Wyoming is waiving members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through June 30, 2020. Cost sharing payments for COVID-19 testing and related services, including office visits, urgent care or emergency department, have also been waived.
Blue Cross Blue Shield of Wyoming is also temporarily waiving member cost-share for services provided through telemedicine by phone, video or other means.
Blue Cross Blue Shield of Wyoming has also waived the early refill limitation for prescription drugs and waived the prior authorization requirement for refill.
Bright Health will cover COVID-19 diagnostic test and associated office as a preventive care service, so it is available at no cost to members, regardless of network. The company is also authorizing early medication refills for members who might be impacted by the outbreak. Non-emergency transportation is being made available to all members, and ride limits are being waived for non-emergency visits to and from their doctor. All telehealth services (online and virtual care) obtained in connection with COVID-19 testing and diagnosis is now covered, at no cost to members.
CalOptima has committed more than $629,000 in a grant for a new program that improves infection control training. The Orange County Nursing Home COVID-19 Prevention Team program is a collaborative effort by UC Irvine, the Orange County Health Care Agency (HCA) and CalOptima.
The new COVID-19 program will operate concurrently with other infection control efforts by HCA and CalOptima. HCA’s public health team responds with a targeted intervention when a cluster of COVID-19 cases is identified in a nursing home. Separately, CalOptima’s Post-Acute Infection Prevention Quality Initiative (PIPQI) reduces the impact of multi-drug resistant organisms, such as MRSA, among nursing home residents.
CalOptima has committed more than $629,000 in a grant for a new program that improves infection control training. The Orange County Nursing Home COVID-19 Prevention Team program is a collaborative effort by UC Irvine, the Orange County Health Care Agency (HCA) and CalOptima.
Asuris Northwest Health is providing up to $1.4 million in financial relief to commercial health plan customers through a premium credit. Select fully insured group and individual Asuris health plan customers will receive a credit for a portion of their health care premium on upcoming bills.
Cambia has extended coverage for COVID-19 treatment without any out-of-pocket costs for fully insured Asuris Health Northwest members through Dec. 31, 2020. In addition, Asuris will continue paying providers for virtual care services at the same rate as in-person visits through Sept. 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members.
Cambia Health Foundation has invested more than $3 million to meet emerging needs created by the COVID-19 crisis. The investments will go to four community health associations that support the work of Federally Qualified Health Centers across Idaho, Oregon, Utah, and Washington. The new funding also supports the development of tools and resources for health care providers on the front-lines of the pandemic.
Cambia is fully covering the cost of testing and associated office visits for COVID-19, and also covering the cost of COVID-19 treatment at no cost to members through June 30.
Cambia is also supporting early refills of needed medication and ensuring that care related to COVID-19 is not restricted by preauthorization requirements.
Cambia is promoting telehealth options, and in-network providers can provide telehealth services at the same cost as an in-person visit.
Capital BlueCross is extending member cost sharing waivers for any provider visits that result in a COVID-19 test through the end of the federal public health emergency, which is currently scheduled to end October 24, 2020.
Capital BlueCross is also temporarily waiving early refill limits on prescription drugs, whether filled at a retail pharmacy or through home delivery, through October 23, 2020.
For members with the Capital BlueCross Virtual Care benefit, Capital BlueCross are waiving member fees through October 23, 2020 for medical, psychiatry, and counseling visits using the Virtual Care app. That means members are not responsible for paying a copay, coinsurance, or deductible for a Virtual Care visit through October 23, 2020.
Capital BlueCross is also waiving member fees for certain in-network teledentistry consultations through December 31, 2020.
Capital BlueCross is also speeding up its issuance of rebate checks to eligible members, sending them several weeks earlier than expected. Nearly 40,000 members will receive checks from the insurer that average $800 per member, but range as high as $3,000, depending on the member’s policy.
Capital BlueCross is speeding up these rebates, typically issued in September, so members can receive them much earlier in light of COVID-19.
Capital BlueCross is waiving member costs for in-network, inpatient hospital treatment for COVID-19 through July 31, 2020.
Capital BlueCross is offering advance payments to independent health care providers in an effort to address the financial strain some providers face due to the COVID-19 pandemic.
Under Capital BlueCross’ program, advance payments are available to eligible health care providers who had at least a 40% decrease in average payments for services provided to Capital BlueCross members during March and April, 2020. These providers can receive funding advances based on their average monthly payments from 2019.
Capital BlueCross is making advance payments available through July 15. Providers can apply by contacting the insurer directly.
Capital BlueCross is increasing funding to food banks and other community organizations—as well as providing meals to healthcare workers, first responders, and nursing home staff and residents—as part of its efforts to help communities and front line workers during the COVID-19 pandemic.
The Central Pennsylvania Food Bank, the Second Harvest Food Bank serving Lehigh and Northampton counties, and the Helping Harvest Food Bank serving Berks and Schuylkill counties have all received funds. These food banks collectively provide more than 45 million meals annually.
Capital BlueCross is waiving member cost share (copays, coinsurance, and deductibles) through May 1 for in-network, inpatient hospital treatment for COVID-19. This cost waiver applies to Medicare and fully insured individual and commercial group members. (Large, self-insured groups may choose to offer this waiver for their employees.)
BlueCross Dental plans will cover in-network teledentistry consultations with no member cost share through May 15. During this time, frequency limits for eligible evaluations will be waived and covered teledentistry exams will not count toward a member’s annual oral exam frequency allowance. BlueCross Dental members may use teledentistry to consult with a dentist through video conference or by sending images for review about pain, an abscess or other urgent issues.
Capital BlueCross is waiving member cost sharing for telehealth visits with in-network providers through April 15.
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.
Capital District Physicians’ Health Plan
Capital District Physicians’ Health Plan will continue its support for local not-for-profit organizations and communities hit hard by the effects of the COVID-19 crisis by extending weekly lunch deliveries. Over the last month, CDPHP was able to distribute 2,000 lunches to those in need.
Capital District Physicians’ Health Plan, MVP Health Care, CDPHP, and Quick Response have partnered to provide the cities of Albany, Schenectady, and Troy with essential sanitation equipment to protect local first responders from COVID-19. Each city will receive two Defense Soap Cordless Electrostatic Hand or Backpack Sprayers for use by the police and fire departments. Each sprayer provides up to 23,000 square feet of disinfectant in a single tank.
Capital District Physicians’ Health Plan has partnered with Brook Health to offer the Brook Personal Health Companion to members and non-members for free during the COVID-19 crisis. The Health Companion is a smartphone app that can provide patient support in areas including healthy meal ideas, blood pressure management, and sleep support.
Capital District Physicians’ Health Plan Patient Care Team, which moved into a virtual setting as a result of the COVID-19 pandemic, is reaching out to patients and their family members to assist with the following:
- Providing emotional support to members, families, and caregivers;
- Providing daily communication updates between hospital staff, patients, and families;
- Collaborating with hospital care teams to customize discharge planning;
- Identifying any barriers to care, such as access to food, medication, and transportation;
- Identifying any community resources/support services needed post-discharge; and
- Facilitating post-discharge phone calls and support.
Capital District Physicians’ Health Plan is waiving cost sharing (copays, coinsurance, and deductibles) for all coronavirus (COVID-19) related treatment with in-network providers. This change is retroactive for all COVID-19 treatment, including hospitalizations, testing, and office visits with in-network providers.
Capital District Physicians’ Health Plan is also providing members access to telemedicine services with no cost sharing. Members have access to ER Anywhere and Doctor on Demand.
CareFirst BlueCross BlueShield
CareFirst BlueCross BlueShield has invested $1 million in the distribution of care packages including masks, hand sanitizer and no-touch tools for high-risk members in Maryland, the District of Columbia and Northern Virginia. This initiative is one of several actions CareFirst is taking to provide ongoing coronavirus (COVID-19) relief to the communities it serves.
As restaurants, shops, workplaces and other services reopen, CareFirst recognizes the importance of providing its members with resources that enhance their safety during the pandemic. To alleviate this concern, CareFirst will distribute over 100,000 care package items to its most vulnerable member populations including Medicaid members, individuals over 65-years-old, individuals under 65-years-old with underlying medical conditions and student health plans.
CareFirst BlueCross BlueShield has launched a $5 million public-private sector philanthropic endeavor, “Care, delivered”, that will distribute personal protective equipment at no-cost to healthcare and social service organizations on the front lines of the pandemic. This initiative is part of CareFirst’s ongoing commitment to support the communities it serves as they navigate the complexities of this public health crisis.
CareFirst will distribute 1.6 million gowns, gloves, masks and face shields to community-based organizations, federally qualified health centers and independent primary care providers in Maryland, the District of Columbia, and Northern Virginia who are on the front lines of the COVID-19 crisis.
CareFirst will provide premium credits to many fully insured customers as a result of treatment disruptions related to the COVID-19 crisis, extend the waiver of cost sharing for telehealth services and COVID-19 testing and treatment, and return rebates from 2019 as a result of lower than expected use of medical care by its members. These latest benefits, combined with other relief CareFirst has offered, result in over $300 million made available to CareFirst’s members, providers, and communities during the COVID-19 crisis.
CareFirst will provide the following relief:
- Premium credits totaling $25 million for fully insured small and large group customers, to be reflected on their August premium invoice;
- Premium credits totaling over $4 million for small and large group fully insured dental customers, to be reflected on each group’s August premium invoice;
- Rebates totaling over $80 million for individual members and fully insured small and large group customers who had CareFirst coverage in 2019 due to lower utilization of medical care than anticipated; and,
- Extension of waiver for cost share expenses related to telehealth services to July 24, 2020, and extension of waiver for cost share expenses related to COVID-19 testing and treatment through September 30, 2020, reflecting in total an anticipated $45 million commitment to our members.
CareFirst and the Maryland State Medical Society (MedChi) announced a partnership to provide MedChi independent physician practices with five or fewer members, a year of complimentary access to DrFirst’s Backline Telehealth platform for physicians who enroll between March 1st and December 31st of 2020. DrFirst is a Maryland-based company that offers secure telehealth services. This partnership will equip additional Maryland physicians with the technology they need to provide needed virtual care during the COVID-19 pandemic and beyond.
CareFirst BlueCross BlueShield will offer a new accelerated payment program to an array of healthcare providers experiencing financial strain due to the coronavirus (COVID-19) pandemic. This initiative is part of CareFirst’s ongoing commitment to support the communities it serves as they navigate the complexities of this public health crisis. CareFirst’s combined provider-focused efforts will result in over $170 million in direct support of the healthcare delivery system during the pandemic.
CareFirst is accelerating funds that would otherwise not be available during the pandemic or have been paid later in 2020 and 2021. CareFirst will offer a combination of:
- Advance lump-sum payments, increased fee schedules and monthly cash advances for qualifying PCMH panels;
- Monthly cash advances for pediatricians and rural primary care physicians who need additional assistance, independent practices in certain specialty areas, and dentists; and,
- Cash advances to select hospitals demonstrating need in Maryland, the District of Columbia, and Northern Virginia.
CareFirst BlueCross BlueShield is offering financial flexibility for members and groups that are experiencing economic hardship. Customers can request a deferral of up to two months of premium with due amounts carried forward with no interest or penalty. The deferred premium would be satisfied over time through scheduled periodic payments.
CareFirst also created a volunteer program available for the company’s licensed clinicians in response to the coronavirus (COVID-19) pandemic. This initiative offers CareFirst employees, who are licensed nurses and behavioral health practitioners, the opportunity to volunteer their time, resources and expertise during this public health crisis.
CareFirst BlueCross BlueShield is offering employees who are licensed nurses and behavioral health practitioners the opportunity to volunteer their time, resources and expertise during the COVID-19 pandemic.
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.
CareFirst is waiving cost sharing for in-network or out-of-network visits to a provider’s office, lab fees or treatments related to COVID-19. It is eliminating prior authorization requirements for medically necessary diagnostic tests and covered services related to COVID-19 diagnosis. It is also waiving early medication refill limits on 30-day maintenance medications, encouraging the use of its 24/7 nurse phone line, and encouraging the use of telemedicine and virtual sites of care. For telemedicine accessed through a CareFirst Video Visit, copays, coinsurance, and deductibles will be waived for the duration of this public health emergency—including behavioral health, lactation support, nutrition counseling and urgent care services. CareFirst has also rapidly expanded the scope of its contracted lab partners to support access to testing as it becomes available.
CareFirst Community Health Plan of DC
CareFirst Community Health Plan of DC (formerly Trusted Health Plan) will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible enrollees, in accordance with federal and state guidance. No prior authorization is required for COVID-19 testing.
CareOregon is strategically reallocating $1.5 million of funding through its Community Giving Grant program to assist local organizations and help them continue to offer food security, shelter and rental assistance to our communities.
CareOregon is also expediting approvals for temporary housing support for members suspected to have COVID-19, including helping secure hotel/motel stays for houseless members who are at risk for virus transmission.
CareOregon is also working with providers to supply flip phones and simple smartphones to members. With many providers moving to delivery of services via telehealth, CareOregon wants to ensure that members have access to a phone so they can still get the care they need.
CareOregon is also taking actions to support providers during the COVID-19 crisis, expediting $25 million in payments to support provider operations including:
- Offsetting lost revenue by paying providers a lump sum advance for visits that would have been conducted in March, April, May and June 2020.
- Releasing the majority of state incentive payments earlier than normal to give clinics needed access to money for COVID-19 mitigation.
- Delaying the implementation of new alternative payment methodology (APM) contracts and maintaining PMPM payments at current respective clinic levels.
CareSource is committing $50 million in investments to affordable housing projects across the United States. All of the investments in the portfolio will be focused in locations with either a high density of CareSource members, underserved populations, or hard to serve geographies.
In the U.S. on average, for every 100 extremely low-income people searching for affordable housing, there are only 36 affordable units available. The COVID-19 pandemic has only worsened the number of families who are housing insecure.
CareSource is partnering with The Foodbank, Inc., as part of its response to COVID-19. CareSource is committing up to $128,000 to allow The Foodbank to prepare 1,200 supplemental food boxes to distribute to seniors who live with an income below 200% of the poverty line. Each home will be provided with a 14-day supply of food, covering three meals per day for a total of 50,400 meals.
CenCal Health has procured and is now in the process of delivering 100,000 disposable face masks, 100,000 disposable gloves and 20,000 protective gowns in order to protect and support local healthcare workers during the COVID-19 public health emergency.
Centene is working with Samsung Electronics America to expand access to telehealth for individuals living in rural and underserved communities. The initiative will supply providers with Samsung Galaxy A10e smartphones to disseminate to patients who would not otherwise have the ability to receive their health care virtually. Additionally, some providers will receive Samsung Galaxy tablets to use to conduct telehealth visits.
With this initiative, Centene and Samsung will deploy 13,000 Galaxy A10e smartphones, with 90 days of free wireless service, to approximately 200 federally qualified health centers (FQHCs), other providers and community support organizations throughout Centene’s markets, with a particular focus on rural and underserved areas. The providers and organizations will then determine which of their patients need the devices and distribute them accordingly.
Centene previously announced the creation of a Medicaid Telehealth Partnership with the National Association of Community Health Centers (NACHC) to help FQHCs quickly ramp-up their capacity to provide telehealth solutions to meet the needs created by the COVID-19 crisis.
As of mid-July, a CDC survey found that 44.4 percent of respondents reported delaying or not receiving care for various reasons, including concerns and challenges around COVID-19. Meanwhile, prior to the COVID-19 outbreak, rural residents already exhibited higher mortality rates and higher incidences of preventable inpatient and emergency room admissions than their counterparts in urban areas.
Centene and Quartet Health have expanded their existing partnership to help members quickly and easily access the behavioral health care they need.
The nationwide expansion will enable members to seamlessly access quality behavioral health care from providers located in their areas who serve their unique clinical needs. To support members who want access to care from their homes during the COVID-19 crisis, all scheduled appointments will be with providers who support virtual care.
Centene has formed a research partnership with the National Minority Quality Forum to assess the impact of COVID-19 on racial minorities and underserved communities across the country. The Minority and Rural Health Coronavirus Study will examine the risk factors associated with the disproportionate impact that coronavirus is having on racial minorities and rural communities.
Centene has donated $500,000 to the National Domestic Violence Hotline, which aims to support and advocate for those affected by relationship abuse. The shelter-in-place orders across the country during the COVID-19 crisis have led to an increase in incidents of domestic violence.
Centene is waiving all cost sharing for in-network primary care, behavioral health, and telehealth visits for the remainder of the calendar year for Medicare Advantage members.
Medicare Advantage members may also be eligible for the following expanded benefits for the remainder of 2020:
- Extended Meal Benefits – Members eligible for meal benefits due to a chronic condition or recent discharge may receive an additional 14 meals delivered to their home at no cost.
- Annual Wellness Visit Incentives – Members will be eligible for an increased incentive for completing their Annual Wellness Visits, a benefit offered at no cost to the member.
- Additional Over-The-Counter (OTC) Benefits – Plans with an OTC benefit may now receive additional allowance dollars in monthly or quarterly increments, adding up to as much as $150 for the remainder of 2020, depending on plan.
Centene has convened a group of medical, non-profit and community leaders to form the Centene Health Disparities Task Force. The task force will further enhance Centene’s leadership and commitment to ensuring underserved populations have access to quality health care.
The Task Force will meet on a regular basis to provide advice and recommendations to Centene through the pandemic and beyond.
Centene is making three investments to support communities that are experiencing elevated levels of stress and mental strain caused by an increase in grief, loss, economic pressure, unemployment and social isolation due to the COVID-19 crisis.
Centene is partnering with Allegheny Health Network and the CARES Institute at Rowan University to fund 25 virtual Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training cohorts, which will enable up to 600 clinicians nationally to receive this highly effective training. TF-CBT is an evidence-based treatment for the impact of traumatic experience on child and adolescent mental health.
Centene is also directing funds to the Crisis Text Line to support their ‘For the Frontlines’ initiative. For the Frontlines provides fast, free, text-based crisis support to individuals on the frontlines of the COVID-19 pandemic response, including doctors, nurses, pharmacists, and other essential workers.
Additionally, Centene is partnering with peer warmlines, which are dedicated call centers for mild to moderate behavioral health needs, in states hardest hit by COVID-19, including California, Michigan, New York, New Jersey, Louisiana, Illinois, and Florida. As part of this partnership, Centene will allocate funds to assist warmlines in meeting the demand for increased capacity brought on by the pandemic.
Centene is also donating to the National Council for Behavioral Health’s COVID-19 Relief Fund, specifically for the provision of Mental Health First Aid. Mental Health First Aid teaches citizens to recognize signs that someone might be experiencing a mental health crisis, suicidal thinking, or abusing substances.
Advancing States, in collaboration with Centene, is releasing www.ConnectToCareJobs.com for wide dissemination and use in all 56 states and territories. This new website serves as a tool to solve the critical problem many healthcare facilities face during the COVID-19 crisis – how to fill critical staffing gaps in a timely fashion.
The first release allows nursing homes, assisted living facilities, residential care facilities, and long-term acute care hospitals to identify gaps in specific staffing needs they have on particular days. At the same time, healthcare professionals who are licensed and/or trained for the various roles needed by these facilities can register their availability and willingness to fill shifts. An algorithm then matches the workers to the facilities – in real time. States and territories have the ability to manage which facilities are included (to enable preference for those in crisis) as well as to monitor the matching process.
Centene is collaborating with Quest Diagnostics to increase access to real-time reverse transcription polymerase chain reaction (rRT-PCR) COVID-19 testing in critical areas of need across the country. Through this collaboration, Centene will facilitate the distribution of 25,000 Quest COVID-19 test kits each week to Federally Qualified Health Centers in ten states or districts across the country.
Centene has created a Medicaid Telehealth Partnership with the National Association of Community Health Centers to help Federally Qualified Health Centers quickly ramp-up their capacity to provide telehealth solutions to meet the needs created by the COVID-19 crisis.
Centene is dedicating $5 million to the partnership’s efforts, which will be used to purchase equipment and provide training and technical assistance to FQHCs. Centene has expanded membership access via Telehealth and has been supportive of provider practices to ensure care continuity during the COVID-19 crisis.
Centene has created a provider support program to assist its network providers who are seeking benefits from the Small Business Administration (SBA) through the CARES Act. As part of the provider program, the company has launched a dedicated online portal where providers can research benefits they may be eligible for and work directly with experts to apply for them. The company will provide resources to aid providers in grant writing and business loan applications, among other key activities.
The program will help providers apply for various benefits including small business loans, a paycheck protection plan and various grants they may be eligible for. In addition to the online portal, the Company will provide partners with access to webinars and one-on-one consulting with key experts.
Centene has also made a series of investments to address the social determinants of health for vulnerable populations during the COVID-19 crisis. Centene is partnering with Feeding America’s network of food banks to donate1 million meals a month for 12 months to feed communities all over the country.
Centene is also purchasing 50,000 gift cards for use on essential items. The cards will be delivered to local providers and other community resources for distribution to individuals in need. The gift cards, which will have $35 of value each, can be used to purchase essential healthcare and educational items including diapers, over-the counter medicines, cleaning supplies, and books.
Centene has released resources on improving health care access for people with disabilities during the COVID-19 pandemic, as well as maintaining their access to personal attendants.
Centene is supporting the disability community affected by the COVID-19 pandemic by:
- Establishing an emergency registry for members with long-term services and supports. Centers for Independent Living partners will recruit, train, and deploy a specialized emergency in-home care workforce for members with disabilities who self-direct their personal attendants.
- Establishing onsite disability liaisons at COVID-19 super sites. Disability liaisons provided by local CILs within treatment facilities will advocate for and assist with functionality for patients with physical disabilities.
- Addressing social determinants of health to support the unique needs of members with disabilities by:
- Augmenting service coordination activities through peer supports and skills training for members with disabilities provided by the CILs. Supports include personal protective equipment distribution, multiple weekly contacts for problem solving, and sourcing
- Providing grants to Area Agencies on Aging for groceries and meal deliveries for members with disabilities who have had a disruption of natural supports
- Matching funds in partnership with organizations, such as, workforce development boards and other safety net organizations, to train the direct care workforce and support unemployed individuals by preparing them for a career in health care
- Offering access to the Provider Accessibility Initiative COVID-19 Web Series to provide timely recommendations from experts with disabilities on how providers and organizations can deliver disability-competent care during the pandemic and future emergencies
Centene has created a provider support program to assist its network providers who are seeking benefits from the Small Business Administration (SBA) through the CARES Act. As part of the provider program, the company has launched a dedicated online portal where providers can research benefits they may be eligible for and work directly with experts to apply for them.
The company will provide resources to aid providers in grant writing and business loan applications, among other key activities. The program will help providers apply for various benefits, including small business loans, a paycheck protection plan and various grants for which they may be eligible.
Centene has also created a comprehensive financial aid package in response to the unprecedented needs of safety net providers including Federally Qualified Healthcare Centers, behavioral health providers and community-based behavioral health organizations, and long-term service and support organizations operating on the front lines of the pandemic.
Centene is creating a Medical Reserve Leave policy to support clinical staff who want to join a medical reserve force and serve their communities during the COVID-19 pandemic. The new policy will provide paid leave and benefits for up to 3 months of volunteer service.
Centene will cover the cost of COVID-19-related treatments for Medicare, Medicaid and Marketplace members. Centene is also eliminating the need for providers to collect co-pays and removing authorization requirements for COVID-19 related treatment.
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.
Chinese Community Health Plans
Chinese Community Health Plans (CCHP) will waive co-pays, deductibles, or coinsurance for all medically necessary screening and testing for COVID-19 for its Individual/Family plan members and Employer group plan members. This includes hospital (including emergency department), urgent care visits, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.
CCHP is offering Special Enrollment Period until June 30th, 2020. Uninsured individuals and those who are affected by income changes, reduced hours and layoffs to apply for health coverage.
Cigna has extended member cost-sharing waivers and other enhanced benefits through Oct. 31, 2020. The extension includes:
- Cost share waivers for COVID-19 diagnostic testing, related visit and treatment
- Cost share waivers for COVID-19 related virtual medical visits
Cigna Dental will reimburse contracted network dentists for PPE when providing dental services for Cigna customers.
In addition, Cigna is helping dental providers overcome the stress and anxiety of returning to work by offering mental health resources and support for in-network dental office employees. Network dentists and office staff can speak to a qualified representative 24 hours a day, seven days a week through July 31 by calling 1.855.287.8400.
Cigna group dental clients will also receive a one-month premium credit applied in July for clients who were active in May 2020. The employer can pass through the premium credit to employees if they are responsible for their dental premiums. No action is required by clients to receive this credit.
In addition to the one-month premium credit for eligible clients and customers, Cigna Dental has implemented dental care solutions to assist employers and their employees during the COVID-19 pandemic, including no-cost virtual dental care for employees through July 31, 2020.
The Cigna Foundation is inviting nonprofits working to create greater access to mental health services to apply for funding through its Healthier Kids For Our FutureSM grant program. The program will provide up to a total of $5 million in grants to community organizations over the next year.
Healthier Kids For Our FutureSM is a five-year, $25 million global initiative to improve the health and well-being of children that launched in 2019. Phase I focused on reducing childhood hunger and improving nutrition, awarding more than $4.5 million in grants to-date. In Phase II, the program will add an additional focus area, addressing the mental health and well-being of children. Nonprofits working to improve childhood hunger can still apply as well.
Many families across the country are facing increased stress and anxiety right now. Prior to COVID-19, up to 20 percent of children and adolescents worldwide experienced mental illness, and the crisis is shedding light on a worsening mental health crisis – as both children and adults are struggling with anxiety, loneliness, and isolation.
Cigna is expanding its support for customers during the COVID-19 crisis by eliminating cost-sharing for all primary care, specialty care and behavioral health care in-office or telehealth visits for COVID-19 and non-COVID-19 care. This expansion applies to all U.S. customers enrolled in Cigna’s Medicare Advantage and Individual and Family Plans, including those sold on the Individual Marketplace. Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits to further protect customers during the crisis and underscore the company’s continued commitment to enabling access to simple, affordable and predictable health care.
Cigna has launched the Cigna Care Card to help clients provide financial assistance to keep employees healthy and supported during the COVID-19 crisis. The new offering will make it easier for employers to support the well-being and peace of mind of employees and their families by designating a tax-free dollar amount to cover expenses incurred as a result of COVID-19.
The Cigna Care Card is a debit card powered by Alegeus that allows clients to pre-load funds that employees can use for qualified disaster relief payments, such as medical payments, groceries, child care, and wellness services. Payments are tax-free to employees and fully deductible to the employer.
Cigna is adding Talkspace to its behavioral provider network for customers seeking a more convenient therapy option. With private messaging (text, voice, and video), Talkspace connects Cigna customers to dedicated licensed therapists who engage daily through a secure app. Customers can also schedule live video sessions based on personal preference.
Cigna is expanding its digital capabilities to help customers with COVID-19 by providing real-time, personalized support. These new virtual solutions will help rapidly identify and assist Cigna customers who arrive in emergency room settings with COVID-19 symptoms, and support those who are actively recovering at home.
Cigna has partnered with Collective Medical to identify customers, in real-time, checking into emergency care settings with COVID-19 symptoms. With this information, Cigna Care Advocates can quickly engage these customers and connect them with programs to support whole person health, such as care management, remote patient monitoring and behavioral health support.
Customers with mild to moderate COVID-19 symptoms can now access an interactive digital tool while they safely shelter and recover at home. Cigna has partnered with Medocity to create a simple solution, Medocity for Cigna, which allows customers to track their symptoms, connect with care advocates and access behavioral and emotional supportive resources.
Cigna Foundation and New York Life Foundation have partnered to launch the Brave of Heart Fund to help the spouses, domestic partners, children, and parents of the frontline healthcare workers who gave their lives in the fight against COVID-19. Cigna Foundation and New York Life Foundation will make initial seed contributions of $25 million each and both CEOs will work to garner additional support from other corporate and private citizens.
In addition to the financial assistance, Cigna will provide behavioral and emotional health support to the families to help them cope. These offerings are an expansion of Cigna’s efforts to support both front-line healthcare workers and the general public during the ongoing COVID-19 outbreak.
Cigna has launched Dental Virtual Care, which will be available through Cigna’s growing network of dental providers who offer teledentistry.
Cigna Dental Virtual Care will be available this month to over 16 million dental customers enrolled in Cigna’s employer-sponsored insurance plans at no cost through May 31, 2020.
Cigna is also partnering with The TeleDentists, a national virtual care dental provider with more than 300 dentists. Through a video consultation, licensed dentists can triage urgent situations such as pain, infection, and swelling and guide the customer on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers.
Cigna is providing medications to Washington University School of Medicine in St. Louis to initiate a clinical trial that will evaluate antimalarial and antibiotic treatments for COVID-19. The researchers plan to enroll 500 patients, over the course of the study, hospitalized with the novel coronavirus at Barnes – Jewish Hospital in St. Louis, MO.
Cigna is launching a pilot program to increase social connectivity among its Medicare Advantage (MA) customers during the COVID-19 pandemic.
Through the pilot, Cigna is reaching out proactively to many of its Medicare customers to monitor their general health and well-being as well as daily needs during COVID-19, including food, housing and transportation. Customers will be able to opt-in to receive follow-up calls from the same Cigna representative to help cultivate meaningful connections. Cigna will also leverage its comprehensive data and analytics to identify MA customers who may be at higher risk for health issues and complications for additional proactive outreach to help answer questions about COVID-19, conduct regular health checks and triage care to a medical professional, if necessary. The pilot program will initially reach 24,000 customers with plans for rapid expansion.
Cigna and Express Scripts are working with Buoy Health to provide an early intervention screening tool to help customers and members understand their personal risks for COVID-19. The digital tool immediately triages symptoms and recommends next steps for care, while also relieving demand on an over-burdened health care system.
Cigna is waiving customer cost-sharing and co-payments for COVID-19 treatment through May 31. The policy applies to customers in the U.S. who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage, and Individual and Family Plans. Cigna will also administer the waiver to self-insured group health plans.
Cigna will waive prior authorizations for the transfer of its non-COVID-19 customers from acute inpatient hospitals to in-network long term acute care hospitals to help manage the demands of increasingly high volumes of COVID-19 patients.
Cigna announced it will waive customers’ out-of-pocket costs for COVID-19 testing-related visits with in-network providers, whether at a doctor’s office, urgent care clinic, emergency room or via telehealth, through May 31, 2020. This includes customers in the United States who are covered under Cigna employer/union sponsored group insurance plans, globally mobile plans, Medicare Advantage, Medicaid and the Individual and Family plans. Employers and other entities that sponsor self-insured plans administered by Cigna will be given the opportunity to adopt a similar coverage policy. The company is making it easier for customers with immunosuppression, chronic conditions or who are experiencing transportation challenges to be treated virtually by in-network physicians with those capabilities, through May 31, 2020. Cigna’s Express Scripts Pharmacy offers free home delivery of up to 90-day supplies of prescription maintenance medications. Additionally, Cigna will offer a webinar to the general public raising awareness about tools and techniques for stress management and building resiliency, along with the ability to join telephonic mindfulness sessions.
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.
ConnectiCare has extended no-cost telehealth benefits for members through Sept. 9, 2020. Telehealth visits apply to any illness or injury, not just COVID-19, and all are available without any copays, deductibles, or coinsurance.
ConnectiCare has launched a “Peace of Mind” initiative to provide members with additional support during the coronavirus pandemic. ConnectiCare nurse care managers are calling members who may be more vulnerable to the coronavirus due to medical conditions or their age and giving them critical information to help keep them safe. ConnectiCare’s service team is making similar calls to members that have previously visited a ConnectiCare center.
The initiative has led to calls to nearly 10,000 members who may be at heightened risk for COVID-19 and has assisted with a variety of needs ranging from prescription drugs to billing questions and telemedicine services to dealing with stress and anxiety caused by the member’s current situation.
ConnectiCare is covering telehealth visits for covered medical and mental health services at no cost through May 31, 2020.
CommunityCare is covering all allowable costs for treatment of COVID-19 for fully insured employer groups, Medicare Advantage, and individual/family members. This policy will waive all copays, coinsurance and deductibles to cover treatment of COVID-19 through August 30, 2020.
CommunityCare is covering all allowable costs for treatment of COVID-19 for our fully insured employer groups, Medicare Advantage, and individual/family members. This policy will waive all copays, coinsurance and deductibles to cover treatment of COVID-19 through May 31, 2020.
CommunityCare members also have 100% coverage when accessing their in-network providers who are participating in providing telemedicine services and will not be subject to any copayment, coinsurance or deductible.
Cox HealthPlans (CHP) is waiving any member cost-sharing for the CDC approved COVID-19 diagnostic test for all of its commercial, fully-insured and level funded plans and will work with each of its self-funded groups to determine their stance.
Telehealth (Virtual Visits) is covered in all of CHP’s plan designs.
For dates of service beginning March 30th, Cox HealthPlans will waive the member cost share for medically qualified telehealth (video+audio) visits conducted by in-network providers for our fully insured individual plans, employer plans, short-term plans and level-funded plans for 60 days.
This includes visits for mental health or substance abuse disorders but excludes therapy visits (PT, ST, OT).
Cost sharing will be waived for members utilizing CoxHealth’s Virtual Visit platform and eVisits for this period.
CVS Health is planning to add more than 2,000 new COVID-19 drive-thru test sites at select CVS Pharmacy locations across the country to support the company’s ongoing efforts to increase access to testing and help slow the spread of the virus.
CVS Health currently manages the largest number of independently run COVID-19 test sites in the country, and with these new locations the company expects to have more than 4,000 operating by mid-October. The new locations will open in waves over the next several weeks and build on the company’s ability to support testing in 33 states and Washington, DC, beginning with the opening of more than 400 sites this Friday.
CVS Health has announced that children 12 years and older are now eligible for COVID-19 testing at more than 2,000 drive-thru testing sites.
In recent weeks, CVS Health has expanded its network of independent third-party lab partners in an effort to help improve turnaround time for the delivery of test results. As a result, the majority of test results from specimens collected at CVS test sites across the country will generally be available within 2 to 3 days.
CVS Health has expanded its COVID-19 testing program by deploying 77 additional test sites at select CVS Pharmacy drive-thru locations across Florida. The opening of these new test sites on Friday, August 21 add to the 221 locations previously opened in Florida.
The 77 additional test sites opening across the state this week are among the more than 1,900 locations CVS Health has opened since May and expand the company’s overall testing capacity.
In addition to increasing the number of drive-thru sites, CVS Health has expanded its network of independent third-party lab partners in an effort to help improve turnaround time for the delivery of test results. Given the steps CVS Health has taken, the majority of test results across the country will generally be available within 2 to 5 days.
CVS Health has launched Return Ready™, a comprehensive, customizable COVID-19 testing solution for employers and universities. The solution helps return employees to worksites and students, faculty and staff to campuses, and integrates COVID-19 testing for ongoing business continuity. With flexible technology options for on-site testing and/or drive-thru testing at CVS Pharmacy locations, organizations can design a customized testing strategy to meet their unique needs. Return Ready builds on CVS Health’s commitment to helping the country on its path forward by making COVID-19 testing available to consumers, the business community, universities and vulnerable populations impacted by the virus.
CVS Health opened additional COVID-19 test sites at select CVS Pharmacy drive-thru locations on Friday, May 29 to establish a total of 1,000 sites across more than 30 states and Washington, DC.
More than half of the company’s 1,000 test sites will serve communities with the greatest need for support, as measured by the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index.
CVS Health is working with Piedmont Healthcare in Georgia to support their solutions for increasing hospital bed capacity. This expands a recently launched strategy of Coram, the company’s infusion care business, to help transition eligible IV-therapy patients to home-based nursing care in response to COVID-19. Specifically, Coram has enhanced its clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies.
The CVS Health MinuteClinic, the company’s retail medical clinic, is now offering expanded telehealth options to help patients access safe, affordable and convenient non-emergency care.
In addition to traditional in-clinic patient visits, patients are now able to select a virtual E-Clinic visit with a local MinuteClinic provider for a wide variety of routine health care needs. This new telehealth option is available in Washington, D.C. and the 33 states where MinuteClinic currently operates, and is contracted with most health insurance plans.
CVS Health is working with hospitals and providers, including UCLA Health, to support solutions for creating much-needed hospital bed capacity during the COVID-19 crisis. Coram, CVS Health’s infusion care business, has enhanced its existing home infusion capacity and capabilities to help transition eligible IV-therapy patients to home-based care. This includes enhanced clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies.
Dean Health Plan is covering in-network hospitalizations for COVID-19 treatment with no member cost sharing.
Dean Health Plan is waiving in-network cost-sharing, including copayments, coinsurance and deductibles, for COVID-19 diagnostic testing. Dean Health Plan will cover the test and doctor visit at no cost to members when the basis for the visit is related to testing for COVID-19.
Decent offers unlimited usage of telemedicine with the patient’s primary care physician at no cost prior to the COVID-19 outbreak and will continue to do so.
Decent is waiving the cost of the test and classifies new “pop-up” facilities like drive-by testing and surge hospitals as Urgent/Emergency care.
Delta Dental of Iowa and the Delta Dental of Iowa Foundation have committed $10.5 million in grants to COVID-19 relief programs to help Iowa dentists and nonprofits.
Delta Dental of Arizona has also partnered with the Arizona Department of Administration to provide 30,000 toothbrushes and 30,000 tubes of toothpaste to homeless shelters and organizations serving vulnerable populations.
Delta Dental of Arizona’s Interim PPE Support Program is designed to help offset the cost of PPE supplies, equipment and technology needed to safely reopen and scale up practices to provide dental services to Delta Dental of Arizona members amid COVID-19.
A $10 PPE support payment will be calculated for all Delta Dental of Arizona member claims paid to a dental office from April 1 through July 31, 2020, with a maximum of one PPE support payment per patient per day.
PPE support payments will be made as separate, monthly lump-sum payments that reflect the total number of Delta Dental of Arizona claims paid to the dental office for the period. Claims paid during the timeframe of the program are the only claims eligible for the PPE support payment.
Delta Dental Plan of Arizona, through its foundation, is donating $500,000 to the 23 federally qualified health centers (FQHCs) across the state.
Delta Dental of Arizona plans to provide a 25% premium credit to its fully-insured group dental clients. The move provides more than $3 million in relief to more than 2,900 companies statewide. Delta Dental of Arizona has also frozen rates for clients with 2-199 enrolled employees that renew PPO dental and/or vision plans May 1 through August 1, 2020. As a result, approximately, 650 small- to medium-sized businesses will not get an increase in rates and will continue to benefit from the same competitive premium rate for another 12 months.
Delta Dental of Arizona is offering claims advances to network dentists affected by the novel coronavirus (COVID-19). The newly launched Advance Claim Payment Program will allow Arizona dental offices to receive an advance of up to $50,000 from the dental insurance company.
Delta Dental of Arkansas is providing financial assistance to its business clients and network dentists as Arkansans continue to feel the impact of COVID-19 on their businesses. The Pandemic Relief Credit gives a credit in the amount equal to 100% of the monthly premium billed to Delta Dental’s commercial business clients with dental and/or vision insurance. This premium “holiday” amounts to almost $15 million in credits to over 4,000 Arkansas business clients.
Delta Dental of Arkansas has committed a total of $6.5 million in emergency financial assistance to dental practices in Arkansas. The new program – the Delta Dental of Arkansas Advance Receipts Program – will provide financial support to dental practices, who are limited to providing only emergency services during the COVID-19 outbreak. In addition, the Delta Dental of Arkansas Foundation, which is the organization’s charitable giving arm, will offer a total of $500,000 in grants to community organizations for projects directly related to COVID-19.
Delta Dental of California is making available an additional $100 million in loan funding to its independent provider network across 15 U.S. states and the District of Columbia for economic assistance and COVID-19-related relief. The increase in financial support brings to $300 million the total amount of the loan program, which is administered by Lendeavor, a leading digital lender that provides financial solutions to healthcare practices. The additional loan funding offers expanded ways for providers to use the funds, including practice acquisitions, new-location expansions, commercial real estate and equipment purchases, practice buildouts – which may include investment to support new health and safety standards – and refinancing existing practice and commercial real estate debt.
This second phase also offers favorable loan terms including the first 12 months of interest covered by Delta Dental.
Delta Dental of California is establishing a $200 million loan program to provide economic assistance and post-COVID-19 pandemic relief for its independent provider network across 15 U.S. states and the District of Columbia. As part of this aid, Delta Dental’s co-sponsored loan program will include interest subsidies, principal deferment and enable providers to refinance other business loans and get working capital.
Delta Dental Community Care Foundation is providing $2 million funding for organizations in New York state helping vulnerable populations affected by COVID-19. The funding will be in the form of unrestricted grants for organizations that provide critical services to underserved individuals, including medical clinics and community service organizations.
Delta Dental Community Care Foundation is making $5 million in funding available to organizations across its 15-state service area that are at the forefront of helping the communities most impacted by COVID-19. Funds will support a variety of response activities for at risk populations.
Of the $5 million total, $3.5 million will support increasing access to care across the Foundation’s 15-state area. The majority will be provided to federally qualified health centers, which are government-funded clinics that provide primary care services in underserved areas and must offer a sliding fee scale based on a patient’s ability to pay, and other community health centers that serve on the front lines of this public health crisis and are working tirelessly to protect and treat those affected by the COVID-19 virus.
The Delta Dental Community Care Foundation will make $1 million of this funding available to organizations responding to the unparalleled public health emergency and to current partners experiencing significant increases in expenses and/or budget shortfalls as a result of the COVID-19 pandemic.
The Delta Dental Community Care Foundation will also be providing $500,000 in disaster response funding to California organizations that provide assistance to seniors, those living with food insecurity, those experiencing homelessness and homebound individuals.
Delta Dental of Colorado and the Delta Dental of Colorado Foundation (DDCOF), have collectively committed $30 million in the form of billing and premium credits, loans, relief funds, and grants to customers, oral health care providers, and local community organizations.
The Delta Dental of Illinois Foundation has provided $1.5 million to help ensure Illinoisans continue to receive vital health services during the COVID-19 pandemic. The Foundation has provided $500,000 to support the Illinois State Dental Society Foundation and is also launching a $1 million emergency grants program to Federally Qualified Health Centers in Illinois.
Delta Dental of Iowa will provide a 25% premium relief credit for employer customers offering fully-insured dental and vision plans. The credit will cover April and May premiums and be applied to July premiums.
A $10 payment will also be applied to claims for Delta Dental of Iowa members who have services between May 1 through August 31, 2020. In total, more than $4 million in additional support has been dedicated to Delta Dental network dentists through this program.
Delta Dental of Iowa DeltaVision members with individual and family plans will also receive a 25% premium relief credit for April and May premiums. Members can choose to donate their premium relief credit to the Iowa Food Bank Association, which serves food banks in all 99 Iowa counties and Delta Dental will match members’ donations up to $250,000.
Delta Dental of Iowa and the Delta Dental of Iowa Foundation have committed $10.5 million in grants to COVID-19 relief programs to help Iowa dentists and nonprofits.
Delta Dental of Kentucky’s new Provider Advance Payment Program is making approximately $5 million available to help supplement Kentucky dental practices that have lost income following Gov. Andy Beshear’s March 18 executive order stopping all non-emergency medical and dental procedures.
Delta Dental of Massachusetts has donated $2 million to the Massachusetts Dental Society Foundation COVID-19 Recovery Fund, established to support the continued viability of community dental offices and dentists across the state following the extended COVID-19 shutdown.
Delta Dental of Massachusetts will provide a 30% credit on premiums paid for April and May coverage, following approval by the Massachusetts Division of Insurance for individual subscribers who signed up directly and through the Massachusetts Health Connector.
Additionally, DDMA will provide free access to its Delta Dental Patient Direct® card discount plan from June 1 through the end of the year for employees of DDMA’s clients, who have been furloughed or laid-off and lost their dental insurance coverage.
For patients who choose to return to the dentist for preventive cleanings, DDMA will provide each member of a fully insured group plan who completes a preventive cleaning visit between June 1 and August 31 with a free electronic toothbrush.
Delta Dental of Massachusetts has made three contributions totaling $200,000 to support Massachusetts non-profits in their response to community needs during the COVID-19 outbreak.
Delta Dental of Michigan, Ohio, and Indiana
Delta Dental of Michigan, Ohio, and Indiana will provide every licensed dentist in the three-state region a $1,000 credit for dental products and services beginning May 26, 2020 so they can maintain care and keep their communities healthy as patients begin seeing their dentists again.
Since March, Delta Dental of Michigan, Ohio, and Indiana along with the Delta Dental Foundation, the philanthropic arm of the company, have committed about $88 million to assist local communities and partners through the pandemic.
Delta Dental of Missouri is donating $500,000 to organizations providing COVID-19 relief efforts in Missouri, and in South Carolina, where the company does business as Delta Dental of South Carolina.
Delta Dental of New Mexico donated $75,000 to support UNM Hospital crisis relief funds. A majority of the donation, $50,000, will support the UNM Hospital Crisis Relief Fund, which provides funds for equipment, supplies and other needed resources to care for patients and protect healthcare workers during the COVID-19 health emergency. The remaining $25,000 will support the UNM Hospital Employee Crisis Relief Fund, which provides funds for food and lodging for healthcare workers during this time of crisis.
Delta Dental of Rhode Island is providing $1 million in financial support to help participating dental practices meet the unforeseen expense of acquiring personal protective equipment (PPE). The amount of support is based on Delta Dental patient volume in each practice.
Delta Dental of Tennessee has announced more than $325,000 in collective donations to the state’s seven children’s hospitals as part of Delta Dental’s ongoing COVID-19 response initiative, Operation #SmilesMatter. As the COVID-19 crisis hit, children’s hospitals suspended elective care, stockpiled supplies, and developed contingency surge plans to support their adult counterparts.
Many children’s hospitals are nonprofit organizations and rely heavily on fundraising events to further their missions. With a large number of these events cancelled due to the pandemic, donations from the community have been crucial during this time.
Delta Dental of Tennessee made a $50,000 commitment to support COVID-19 relief efforts across Tennessee through The Salvation Army Nashville Area Command and Second Harvest Food Bank of Middle Tennessee. The nonprofits will receive $25,000 each to distribute across the state based on need.
Delta Dental of Tennessee also announced a commitment of more than $3.3 million for Operation #SmilesMatter, a grant program to help Tennessee dentists acquire much-needed supplies, equipment, and technology as they prepare to reopen their practices following COVID-19-related closures. Delta Dental will be funding a $1,000 “allowance” or credit available to all dentists in Tennessee, regardless of whether they participate in Delta Dental’s network, to purchase dental products.
Delta Dental of Virginia and the Delta Dental of Virginia Foundation have donated $3 million to help alleviate the financial burden on practices and their patients and to increase patients’ confidence in seeking oral health care. The funds will be distributed to the more than 4,500 dentists in the Delta Dental of Virginia network. Dental practices may use these donated funds to cover operating expenses associated with safety guidelines, including acquiring personal protective equipment.
Delta Dental of Virginia has made a $1 million contribution to support Virginia’s dental practices and their patients, provide financial assistance for safety net dental clinics, and support local non-profits working to meet needs in their communities.
Delta Dental of Wisconsin Foundation Cool Water Program has awarded $100,000 to 27 schools in Wisconsin for water bottle filling stations this year.
Traditionally, the Cool Water Program grant has covered the installation cost of new filling stations at 20 schools and provided toothbrushes and dishwasher-safe water bottles for all students and staff.
This year, though, the Wisconsin Department of Public Instruction recommended that schools discontinue the use of shared drinking fountains. So, the Foundation decided to forego the water bottles and toothbrushes and fund seven more schools instead.
The Delta Dental of Wisconsin Foundation has provided $800,000 in grants to safety-net clinics in Wisconsin as well as an additional $100,000 for food security programs.
Delta Dental of Wyoming has committed more than $300,000 for Operation #WyomingSmiles, a grant program to help Wyoming dentists acquire much needed supplies, equipment and technology as they reopen their practices following COVID-19-related closures.
Delta Dental will fund a $1,000 “allowance,” or credit, available to all participating dentists in Wyoming, to buy dental products and services.
DentaQuest has contributed $300,000 to the OneStar Foundation Texas COVID Relief Fund, which is raising and distributing funds to eligible organizations working to support the economic recovery of Texas communities impacted by the coronavirus. The DentaQuest donation is the largest received to date.
The Fund will provide grants of up to $150,000 to support projects that address the unmet needs of vulnerable populations and underserved communities in the areas of community and economic development, healthcare, and education.
DentaQuest is also committing an additional $100,000 to support dentists throughout the state with contributions to Dentists Who Care, Texas Dental Association Smiles Foundation and Texas Academy of Pediatric Dentistry.
The DentaQuest Partnership for Oral Health Advancement is offering free online continuing education credit courses for dentists, hygienists, dental assistants and other dental care team members, including a COVID-19 Education Series designed to help educate in the areas of infection control and other best practices for the re-opening of dental clinics.
The DentaQuest Partnership’s online learning center offers engaging resources – free of charge – for dentists and other healthcare providers looking to implement practice improvement initiatives and prevention-focused care. All courses are designed and delivered by expert faculty members, including clinicians, academics, data scientists, government and nonprofit leaders and oral health educators.
EmblemHealth is waiving cost sharing for all COVID-19 diagnostic tests and associated office, urgent, or emergent visits for both in and out of network providers, and has also waived prior authorization and concurrent review for all inpatient admissions.
EmblemHealth is also waiving prescription refill limits on maintenance medicines, helping members convert to 90-day mail order prescriptions, and entering into a new partnership to provide same day home-delivery of prescriptions providing access to pharmacists seven days a week and servicing customers in more than a dozen languages. EmblemHealth has provided special training to associates to ensure that consumers are aware of the Special Enrollment Period and informed about how to obtain coverage during this uncertain time.
EmblemHealth also has expanded telemedicine benefits for members, waiving all cost sharing for telehealth services and expanding services available via telehealth.
In addition to extending the Grace Period for non-payment of premium, EmblemHealth Neighborhood Care has been connecting members to social supports like food pantries, unemployment benefits and housing assistance. The plan launched a comprehensive effort to support small business owners to assist any displaced employees. EmblemHealth has launched an outreach campaign to its most vulnerable members, offering a human connection to those who may be suffering from extended periods alone and anxious for and to offer assistance with accessing care. EmblemHealth is supporting the local food banks it partners with through Neighborhood Care through donations and has amended its paid time off policy for clinically trained qualified employees to answer the state’s call to serve.
EmblemHealth has extended the waiver on prior authorization and concurrent review for all inpatient admissions to Medicare, covering all hospital admissions.
EmblemHealth has also taken internal steps to expedite payments to ensure that revenue is moving to hospitals on the frontline as quickly as possible.
EmblemHealth is partnering with Medly Pharmacy to provide direct, at-home delivery of prescriptions to members, as part of its COVID-19 response.
Empire BlueCross BlueShield will cover COVID-19 treatments for enrollees with individual and family plans with no copays or cost-sharing through December 31, 2020, as long as members receive treatment from doctors, hospitals, and other health-care professionals in their plan’s network.
Costs are also waived for Medicare Advantage enrollees seeking COVID-19 treatment through December 31, 2020, including inpatient and outpatient services, respiratory services, durable medical equipment, and skilled-care needs.
Empire BlueCross BlueShield has launched Ortho@Home, a teledentistry and at-home orthodontia program. The services is part of Empire’s continuing commitment to providing access to affordable services that meet a person’s whole health needs, while also providing safe, remote-care during the COVID-19 crisis.
Consumers with orthodontic benefits will have access to at-home clear aligner therapy, remote oversight of care, teeth whitening, and retainers at completion of treatment with an average cost up to 60% less than traditional orthodontia and three times faster. This offering helps improve member access to orthodontic care – especially in rural areas where over half of the counties in the United States do not have access to orthodontists’ offices.
The Empire BlueCross BlueShield Foundation has committed more than $200,000 to organizations on the frontlines of providing New Yorkers with critical access to food during the ongoing COVID-19 pandemic. Of the $200,000 dedicated to fighting food insecurity, Empire has made contributions of $50,000 each to City Harvest and Food Bank for New York City, which will support local families during the COVID-19 outbreak.
Excellus BlueCross BlueShield will continue to waive out of pocket costs for COVID-19 diagnosis and treatment for its fully insured employer groups, individual market qualified health plans and Medicare Advantage members through September 7, 2020. This waives the member’s copayment or cost share for diagnosis and treatment, even if that treatment is delivered in the hospital. Excellus also provides coverage in full for medically appropriate COVID-19 testing.
Excellus BlueCross BlueShield estimates that New Yorkers used telehealth benefits about 290,000 times last year. In the first four months of 2020, a time period marked by the global spread of COVID-19, the number skyrocketed to an estimated 2.6 million times. According to Excellus BCBS’s claims-based review of services delivered, more than one-third of telehealth visits are for mental health services.
Excellue BlueCross BlueShield member out-of-pocket costs such as copayments, co-insurance and deductibles have been waived on all COVID-19 related testing and diagnosis where medically necessary and consistent with federal guidelines. This includes the cost share for the office visit, urgent care visit or emergency room visit.
The member out-of-pocket expense is also being waived for all telemedicine visits during the state of emergency for plans that have a telemedicine benefit. Telemedicine is alternative way to access care if a person can’t reach their physician.
Excellus has also waived preauthorization requirements for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.
Fallon Health has converted one of its senior care facilities in Worcester into a residential coronavirus care center. Nine patients have been admitted to the center so far for COVID-19 care and treatment.
Fallon Health has waived cost-sharing for all COVID-19 and non-COVID-19 related medically necessary telehealth services for all members. This will also be effective while Massachusetts is under a state of emergency.
Fallon Health is relaxing administrative procedures, such as prior authorizations and out-of-network requirements, for medically necessary care, waiving copayments for medically appropriate coronavirus treatment, and waiving early refill limits on non-scheduled control drug prescriptions for all Fallon members who fill their maintenance medications at any in-network pharmacy.
Florida Blue is more than tripling its COVID-19 community investments to over $7 million. In March, the insurer provided an initial $2 million to organizations across the state to address urgent health and safety needs. Florida Blue will invest an additional $2.5 million to provide access to testing and health care, food security and other essential needs for Floridians. Additionally, the insurer plans to contribute more than $2.6 million to United Way organizations across Florida.
More than $1 million of the additional funding is dedicated to providing COVID-19 testing and access to health care for underserved Floridians. Florida Blue will work with its partners at organizations such as the Florida Association of Free and Charitable Clinics, Federally Qualified Health Centers and others to identify opportunities across the state to address areas in need.
A three-year grant of $220,000 to UF Health will help provide necessary technology for the development of a model for COVID-19 diagnostic tests called pooled testing. The model allows more people to be tested at a substantially reduced cost and will be exportable to other labs with similar technology.
Over $1.3 million will also address food security for seniors, children and disadvantaged families, support the mental health of those impacted by the COVID-19 crisis and provide essential needs to those struggling due to the pandemic.
Florida Blue is extending the premium due date through the end of June for customers who needed extra time to pay premiums as a result of the COVID-19 health crisis and would otherwise have been subject to termination of coverage. The payment extension applies to Individual – Affordable Care Act (ACA) and non-ACA – plans, Fully Insured Employer Group health plans and Medicare Supplement plans.
Additionally, all member cost sharing payments for in-network primary care office and telehealth visits, as well as behavioral health-related office, outpatient and telehealth visits, will be waived for Florida Blue’s Medicare Advantage plan members through December 2020.
Florida Blue will also waive cost-sharing for its members who must undergo testing and treatment for COVID-19, including in-patient hospital admissions, through August 1, 2020.
Florida Blue is offering a dedicated COVID-19 virtual assistant on its public websites at www.FloridaBlue.com and www.FloridaBlue.com/COVID19, free and available to anyone.
The assessment function of the new virtual assistant pops up automatically on the websites, and guides users through educational content or through a series of questions to check for COVID-19 symptoms and related risk factors. Based on the assessment results, the tool directs users to contact their primary care provider for next steps, to the Florida Blue Center nurses for answers to commonly asked questions about COVID-19 and connection to community resources, or to immediate care options as needed.
Florida Blue will waive cost-sharing through June 1 for its members who must undergo treatment for COVID-19, including in-patient hospital admissions. The announcement impacts all Florida Blue members with Affordable Care Act, Medicare Advantage (excluding Part D drug plans) and other individual plans, as well as all fully insured employer group health plans.
Florida Blue is allowing groups and individual members more time to pay through May 31, 2020 for customers unable to pay premiums as a result of the COVID-19 health crisis that would otherwise have been subject to termination of coverage.
Florida Blue is adding a free-to-member virtual care partner, Teladoc, for seniors and others on its Medicare Advantage plans, and waiving the virtual care copay for many commercial and Affordable Care Act members to encourage use of Teladoc if it is offered as part of their plan. Additionally, during this pandemic, Florida Blue’s network of primary care doctors and specialists will be able to treat patients virtually at their normal office visit rates.
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.
Fidelis Care has expanded access to telehealth services, covering virtual visits with providers from the safety, comfort, and convenience of a member’s home for a $0 copay.
Members have access to telehealth through network providers or specialists, or through Teladoc.
Fidelis Care has also waived allCOVID–19 relatedprior authorization requirements, and member cost sharing for related screening, testing, and treatment – including telehealth visits.
First Choice Health is covering the cost of telehealth services for its self-funded employer customers via on-demand primary care service 98point6.First Choice Health will provide its employer customers complimentary access to 98point6 for 60 days.
Friday Health Plans is covering testing and treatment of COVID-19 at no cost to members–no coinsurance and no copays.
Friday Health Plan is now offering $0 Teladoc visits. Members can use Teladoc to speak with a doctor by phone or video 24/7 at no cost. Doctors can answer member’s questions about the coronavirus, evaluate their health risk, and support members to help relieve symptoms, addressing both physical and mental health.
Friday Health Plans is offering a SEP enrollment periods on both group and individual through 4/30.
Gateway Health is committing more than $1 million to support non-profit organizations, community partners and social determinants of health causes in 2020.
Many of the areas where Gateway Health members live have been hit especially hard by the economic challenges associated with COVID-19, including food insecurities. Gateway Health’s donation to this important relief effort will assist communities across Pennsylvania. They will be able to expand access to much needed heathy food options in light of the ongoing COVID-19 crisis. The donation also supports ongoing nutrition education and resources in these areas.
Gateway Health is waiving all member co-payments, co-insurance and deductibles associated with COVID-19 testing and medical treatment. This applies to in-network and out-of-network inpatient, outpatient and emergency department services related to COVID-19 treatment. The decision to waive member cost-sharing affects all Gateway members participating in Pennsylvania Medicaid HealthChoices and Medicare Assured Part C plans.
Geisinger Health Plan has launched a new mobile app to connect patients with their care providers and monitor their symptoms as they recover from COVID-19 at home.
Through Epic’s MyChart Care Companion, patients report their symptoms, temperature, and oxygen levels twice a day to a team of nurses. If symptoms worsen, an automated alert is sent, and the patient is quickly contacted by a clinical nurse for further evaluation and a video encounter with a physician if needed. The clinical team can help get patients who have particularly concerning findings to the emergency room.
Geisinger Health Plan is offering new virtual and telephonic services to members. These include health coaching, population health programs, behavioral health services, and online health resources.
Geisinger is also providing tools, information and guides to help employers keep their staff and patrons safe and healthy.
This online resources center is available at go.geisinger.org/businessresources and includes frequently asked questions, best practices, guidance for screening employees, signage kits promoting handwashing and social distancing at the workplace, and more. Virtual consultations are also available upon request.
Geisinger Health Plan has expanded telemedicine services to include primary care and 70 other specialties. The service allows patients to speak to providers in real-time about colds, the flu, rashes, diabetes, mental health conditions, neurological conditions, and much more- providing necessary care while maintaining social distancing.
Geisinger Health Plan is waiving all out-of-pocket costs for members receiving in-network, inpatient treatment for COVID-19.
Geisinger 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. We are relaxing refill quantity and frequency restrictions to offer 90-day maintenance medication prescriptions for Commercial and Medicare members and allowing members to refill their prescriptions early. Its large TPA groups may opt out of these programs at their discretion.
Geisinger is also making telehealth services available for all members at no cost through June 15. Services are provided via Teladoc online or by phone, and may be used for any routine medical need.
Geisinger has partnered with the Central Pennsylvania Food Bank, Harrisburg, and Weinberg Northeast Food Bank, Pittston, to distribute emergency food boxes to health plan members, patients and those in need in the community. These boxes are being delivered from Geisinger’s Fresh Food Farmacy locations and include shelf stable supplies, recipes, educational information and other resources. Geisinger is targeting food insecure health plan members, however, any patient or community member in need is eligible. To ensure the safety of the community and prevent potential exposure to COVID-19, staff will be doing curbside or front porch deliveries.
Gold Coast Health Plan has awarded $20,500 in sponsorships to seven community organizations that are helping county residents during the COVID-19 crisis. Sponsorships have included $2,500 to the American Heart Association to support the telemedicine efforts of community clinics by providing blood pressure monitors to patients who have an increased risk of heart disease and stroke due to COVID-19.
Gold Coast Health Plan has launched a 24/7 emergency hotline for members to consult a medical professional about COVID-19 or other health issues. The service is available to Medi-Cal beneficiaries and will help them to decide if they need urgent medical care or can take care of symptoms at home.
Harvard Pilgrim Health Care will be providing $32 million in premium credits to all its fully-insured employer groups, as well as to Medicare Supplement members. Harvard Pilgrim is awaiting regulatory approval for this action in Connecticut which it expects to receive shortly. Additionally, the nonprofit health plan announced it will provide $3 million in financial support to independent primary care physicians, $3 million to support community health centers, and the insurer will waive all primary care and specialty care copays for office visits for Medicare Advantage members through the end of the year.
Harvard Pilgrim will be providing the following relief and support to members, customers, independent primary care physicians and community health centers:
- Fully-insured Employer Groups regardless of size or location, will receive a 15% credit on their September premium invoice ($30 million total).
- Medicare Supplement Members will receive a 15% credit on their September invoice ($2 million total).
- Medicare Advantage members copays for all primary and specialty care office visits will be waived starting July 1stuntil the end of 2020.
- Independent Primary Care Practices will have access to $3 million in financial support to assist with aspects of reopening their practices. To support the provider community, Harvard Pilgrim provided over $40 million in financial advances to providers throughout the region.
- Community Health Centers, focusing on those providing care to predominately black and brown communities, as well as centers that provide care for vulnerable populations, will receive $3 million to support equity and equality in accessing health care, and address health disparities.
- COVID-19 testing and treatment cost-share waiving and no out-of-pocket expense for telehealth services will continue to be provided through September 30, 2020. Harvard Pilgrim will reassess these policies as circumstances warrant.
Harvard Pilgrim Health Care Foundation and Convenient MD have partnered to open a drive-thru COVID-19 testing site at Harvard Pilgrim Health Care’s Quincy headquarters’ parking lot, located at 1600 Colony Drive.
Harvard Pilgrim Health Care is waiving member cost-sharing related to treatment for COVID-19. The waiver applies to medical costs associated with COVID-19 treatment at in-network facilities and out-of-network emergencies.
Harvard Pilgrim has also donated over $3 million to COVID-19 relief efforts by supporting community organizations in Connecticut, Maine, Massachusetts, and New Hampshire. The money will help select restaurants throughout the region to provide and deliver take-out meals to families in need and help to put people back to work. Additionally, these resources will assist communities in facilitating access to COVID-19 testing.
Harvard Pilgrim Health Care will cover the costs of diagnostic testing for COVID-19, waive cost sharing for all telemedicine visits and allow early refills for prescription medications. Self-insured groups will have the ability to opt-in at their discretion.
Hawaii Medical Service Association
Hawaii Medical Service Association will pay for any medically necessary care related to COVID-19 from a participating provider at no cost to members. HMSA will cover medically necessary COVID-19 testing and treatment from a participating doctor, urgent care facility, or emergency room. If a member is admitted to the hospital, HMSA will also cover the hospital stay.
HMSA will also cover medically necessary diagnostic tests for COVID-19 according to CDC guidelines with no copayment for members.
Health Alliance Medical Plan members, as part of an integrated health system, can now learn about an old treatment that’s being applied to bring hope to the sickest COVID-19 patients.
Carle Health and Community Blood Services of Illinois are collaborating on an investigational treatment to treat hospitalized COVID-19 patients. First Community Blood Services of Illinois collects plasma from a recovered COVID-19 donor and physicians use it treat the sickest COVID-19 patients. Carle is the first hospital in the region to administer the plasma to patients.
Health Alliance Plan has extended member cost-sharing waivers for treatment of COVID-19, which includes deductibles, copays and co-insurance associated with treatment for the virus. This cost-sharing waiver is for inpatient or outpatient treatment from an in-network provider and is currently in effect for services rendered through December 31, 2020.
Health Alliance Plan has been conducting personalized outreach to its most vulnerable members, many of whom are Medicare Advantage members. HAP has worked with its technology partners to identify those members most at risk for experiencing negative effects of loneliness and isolation, including food insecurity and behavioral health issues. During April and May, HAP conducted more than 8,500 phone calls to its members to determine if they are in need of food or other services. For those in need of mental health support, HAP has provided access to behavioral health resources. For Medicare members who lack access to nutritious meals, HAP has expanded its partnership with Mom’s Meals to have two weeks’ worth of frozen, ready-to-heat balanced meals delivered to their home.
Health Alliance Plan has extended its cost-sharing waiver for telehealth services through the end of the year. All cost-sharing is waived for HAP’s individual, fully-insured employer group, Medicare, Medicaid and MI Health Link members using telehealth services through December 31, 2020, even if the service is not related to COVID-19. Self-insured employer group customers control their own health benefits, and HAP is working with its self-insured customers to determine how they will cover telehealth services.
For its individual members and small employer group customers, HAP will decrease monthly premiums by 5% through the end of the year. A small group is defined as an employer with fewer than 50 employees. These decreases will be reflected in monthly premium bills beginning July 1 and will be in effect through December 2020.
For its Medicare Advantage members, HAP will waive copays for all in-person primary care visits and behavioral health visits through the end of the year. In addition, HAP will waive all member cost-sharing for telehealth visits for its Medicare Advantage members through the end of the year. This means that HAP Medicare Advantage members will not be charged any copays, deductibles or co-insurance for telehealth visits made through December 31, 2020, even if it is unrelated to COVID-19.
Health Alliance Plan will waive member cost-sharing for testing and treatment of COVID-19, according to state and federal guidelines, which includes deductibles, copays and co-insurance associated with treatment for the virus. This cost-sharing waiver is currently in effect for services rendered through June 30, 2020.
Health Alliance Plan is also waiving cost-sharing for individual, fully-insured group and Medicare members using telehealth services through June 30, even if the service is not related to 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)
Health Care Service Corp. will launch the Employed Clinician Volunteer Program for more than 3,000 doctors, pharmacists, nurses, behavioral health specialists and other clinicians with varied specialty backgrounds.
Through this program, HCSC will pay eligible and approved HCSC employees, who are medical clinicians, to volunteer for patient care in their field for up to 80 hours of paid time during their regular scheduled work hours.
HCSC is waiving member cost-sharing, including deductibles, copayments, and coinsurance related to treatment for COVID-19. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies.
HCSC will also offer a special enrollment period for its insured group customers. Employees of fully insured group customers who did not opt in for coverage during the regular enrollment period will have an opportunity to get coverage for their health care needs. The special open enrollment period begins April 1 and will end April 30, 2020.
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.
Healthfirst, Inc. is waiving co-pays for all diagnostic testing and evaluations related to coronavirus. This means that if a primary care physician or in-network provider orders a coronavirus test, the person’s Healthfirst health plan will cover the cost for the test and the in-network provider visit related to the coronavirus evaluation. Members will not be subject to any cost sharing for the test or the in-network provider visit.
Health Net is collaborating with scientists, healthcare companies and the Los Angeles Unified School District on a contact and tracing program that aims to bring school back to the classroom more safely.
This initiative’s goals are:
- Providing school staff, students and their families with regular COVID-19 testing and contact tracing to make informed decisions.
- Initial testing of staff at schools.
- The next phase will involve testing to all staff and students when they start to return to the classroom. Currently, the spread of COVID-19 in the Los Angeles area still far exceeds guidelines from the State of California governing the possible return of students to school campuses. Any decision about the return of students to schools is some time away.
Health Net will dedicate resources in four areas to help ensure the initiative is successful:
- Financial support for a portion of testing-related costs.
- Work with the District to ensure enrollment of eligible families into Medi-Cal or Covered California.
- Coordinate routing of claims for students and staff with existing health coverage.
- Explore how to share de-identified information about the health impact of the virus.
Health Net will provide $5.9 million in immediate assistance to support Medi-Cal providers impacted by the outbreak of the novel coronavirus (COVID-19). Health Net’s investment will enable the expansion of telehealth capacity and capability at California safety net clinics, Federally Qualified Health Centers (FQHC), and independent provider practices serving the state’s most vulnerable patient population and facing increased challenges amid the COVID-19 pandemic.
Health Net, a subsidiary of Centene, will cover coronavirus-related testing, screening and treatment for all members.
Health New England is covering the cost of diagnostic tests for COVID-19 for fully insured and Connector members (including high deductible health plan members), and Medicare members. These members will pay no copay, co-insurance or deductible for these tests.
Health New England is working with self-funded employer groups to implement the same measures or those of their choosing.
Health New England is waiving out-of-pocket costs for medically necessary emergency department and inpatient services, including professional, diagnostic and laboratory services, related to COVID-19 at both in-network and out-of-network providers.
Health New England is covering the cost of vaccination when a COVID-19 vaccine is available.
Health New England is waiving and reimbursing copays for telehealth services for all conditions with providers, and for members with access to Teladoc®. 24/7 Nurse Advice Line is also available for free at (866) 389-7613.
Connector and Health Service Administrators have a Special Enrollment Period for Individuals until May 25th.
HealthPartners is also waiving the cost for fully insured members for the treatment of COVID-19 when getting care from an in-network provider, effective March 1 through September 30, 2020. This includes copays, coinsurance and deductibles.
HealthPartners is waiving Medicare member cost-sharing for all in-network primary care and behavioral health visits, effective July 1-Dec. 31, 2020. This will provide members with financial relief and encourage members to seek important and necessary care during the COVID-19 crisis.
Cost-sharing will be waived for in-person, phone and video primary care and behavioral health visits, including visits for substance abuse when services provided are in-network. This applies to all HealthPartners Medicare Advantage, Cost and group retiree plans in Minnesota, North Dakota, South Dakota, Iowa, Illinois and Wisconsin.
HealthPartners is offering an innovative solution to provide consultation and direct support for businesses as they work to reopen, safely return workers and welcome back customers during the COVID-19 pandemic.
The new “Back to Business” COVID-19 employer preparedness solution is based on medical expertise and the latest scientific evidence and offers personalized support to businesses, including:
- COVID-19 preparedness planning. An employer assessment with personalized recommendations and best practices that support COVID-19 preparedness plan requirements
- Medical consultation on business preparedness. Medical expertise on how to safely resume business operations
- Absence policies consultation. Recommendations and best practices for employer absence policies regarding Family and Medical Leave Act expansion and Emergency Paid Sick Leave legislation related to COVID-19
- Employee communications consultation. Support for communicating employer preparedness plans to employees and customers
- Employee screening. Recommendations and implementation of COVID-19 screening best practices such as temperature, questionnaire or attestation screening as appropriate
- Employee testing. Recommendations and implementation of COVID-19 testing best practices for both symptomatic and asymptomatic employees
- Follow-up care support. Support for employees who screen at-risk of COVID-19 or test positive, connecting them to available resources
- Absence management. Case management for various leave types to keep employers compliant with regulations, minimize risk and reduce costs associated to employee leaves
The HealthPartners Dental Plan will provide monetary relief to network providers as they face the cost of acquiring PPE to care for patients.
Beginning June 17th the HealthPartners Dental Plan will reimburse network providers the amount of $10 per visit through the use of the CDT code “D1999 – unspecified preventive procedure, by report” to document and report the use and cost of additional PPE.
Dentists can use this code once per patient visit/claim/day to attempt to offset the heightened cost of PPE.
HealthPartners Institute and researchers at the University of Minnesota have teamed up with developers to create a mobile app that provides users with data about the health of their neighborhood, helping them avoid potential COVID-19 hotspots.
The SafeDistance app crowdsources data down to the level of people’s census block groups. These census block groups usually contain around 1,500 people and most accurately reflect neighborhoods.
HealthPartners is providing coverage with no cost share for the administration of the COVID-19 laboratory test (regardless of where the test is performed). It is also providing coverage with no cost share related to an in-network office visit or urgent care visit associated with the test.
HealthPartners will waive fully insured members’ cost-share for the treatment of COVID-19 – including copays, coinsurance and deductibles–when getting care from an in-network* provider, effective March 1 through May 31, 2020.
Health Plan of San Joaquin worked with the San Joaquin County Medical Society to plan for the distribution of medical-grade PPE from California Medical Association. Over 140 local small and medium-sized practices were able to safely receive boxes of medical-grade PPE, including N95 and surgical masks, gowns, gloves and face shields.
There is no cost to Health Plan of San Joaquin members for receiving medically-needed screening, testing, and treatment for COVID-19.
Highmark is extending a waiver of cost-sharing – such as deductibles, coinsurance and copays — for members who require in-network, inpatient hospital care for COVID-19 through Dec. 31.
Highmark is also extending a waiver of telehealth services through Dec. 31. The waiver for in-network telehealth visit cost-sharing will also be extended through Dec. 31. As with COVID-19 treatment, self-funded employer groups for which Highmark administers benefits may also opt-out of this waiver.
Highmark’s Medicare Advantage members will have no cost-sharing for inpatient hospital care for COVID-19 and telehealth visits for both in- and out-of-network care through Dec. 31.
Highmark is donating Back-to-School Toolkits containing personal protective equipment and resources to school districts across Pennsylvania and Delaware.
School districts with Highmark coverage will receive adjustable face coverings to fit a wide age range of students, face shields for teachers and staff members, disinfectant hand wipes, large one-gallon pumps of hand sanitizer, signage containing best practices, and resource guides to assist with the transition to the new school year, courtesy of Highmark. Signage and resource guides are also available for download on the Highmark Employer Back-to-School Toolkit website. School districts will be given the option to schedule when and where they will receive the supplies to align with their current and future reopening plans.
In addition to supplies and resources, Highmark hosted a Back-to-School webinar in collaboration with clinical leaders from Allegheny Health Network (AHN) on August 5 for school districts to provide current information on COVID-19 to school decision-makers.
Highmark Blue Cross Blue Shield, Latino Connection, the Pennsylvania Department of Health, and the Independence Blue Cross Foundation have partnered to create the first-in-the-nation COVID-19 Mobile Response Unit to provide testing and education targeting minority and underserved communities throughout Pennsylvania.
In total, this testing effort costed $498,000. The department Epidemiology and Laboratory Capacity Enhancing Detection fund contributed a $331,000 grant. In addition, specimens will be collected and taken to the Pennsylvania Bureau of Laboratories for testing after each event.
Known as CATE, Community-Accessible Testing & Education, the unit is equipped to conduct COVID-19 testing on-site through a mobile RV vehicle while also educating the public on how to stay healthy and safe. The mobile response unit’s tagline is “Sharing knowledge to erase fear,” which it intends to do through widespread community healthcare and health education offered with no insurance required.
Highmark is sending cloth face coverings to Direct Pay Medicare members in Pennsylvania and West Virginia as part of its 1 million face covering initiative. Members who have individual Highmark Medicare Advantage plans can expect to receive one face covering per member at their residence through the remainder of August and early September. In total, nearly 150,000 face coverings will be distributed across both states.
Highmark is waiving all virtual medicine and telehealth costs through Sept. 30, 2020. Highmark is also waiving all costs for care if a patient is in the hospital being treated for COVID-19 through Sept. 30, 2020.
Highmark is joining forces with four small and diverse Pittsburgh-based businesses to design, manufacture and donate over 1 million cloth face coverings throughout the summer months. The face coverings will be distributed to at-risk and vulnerable Highmark members, community organizations in need, health care professionals, and employer groups across Pennsylvania, Delaware and West Virginia.
Highmark has collaborated with the CDC Foundation and Microsoft to develop and launch the COVID-19 Symptom Checker Healthbot. Anyone can use the Healthbot to check their symptoms, which will then provide guidance on seeking appropriate medical care when necessary during the COVID-19 pandemic.
Highmark has announced that its commercial, Affordable Care Act and Medicare Advantage members in Pennsylvania and Delaware now have access to a comprehensive, technology-enabled opioid use disorder (OUD) program. The program, which was first rolled out to Highmark’s West Virginia members in January of 2020, will help preserve treatment access and promote recovery during the COVID-19 pandemic and beyond.
Highmark is waiving deductibles, co-insurance, and copays for members who require in-network, inpatient hospital care for COVID-19. The waiver will continue through May 31 as Highmark continues to monitor and evaluate the rapidly changing nature of this crisis.
Highmark has also introduced an additional 30-day grace period on late premium payments allowing members the ability to maintain their coverage and avoid cancellation for a more extended period of time.
Highmark will assist local primary care physicians by advancing payments made through the True Performance reimbursement program. The reimbursement payments would have been made in June, but will begin going out the week of April 6 as many physician practices are being affected financially by stay-at-home orders and other COVID-19 related issues.
More than 1,700 primary care practices or associated entities in Pennsylvania, West Virginia and Delaware will receive the advanced payments based on achievement in the True Performance program.
More than $30 million in advanced payments will be made during this extremely challenging time.
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.
Highmark has also waived member cost sharing for all covered telehealth services for 90 days and expanded access to telehealth vendor platforms for Medicare Advantage and Medicaid members.
Highmark Health has expanded coverage for telehealth to all members, including self-funded customers who had previously opted out of telehealth coverage.
Highmark Health is also covering COVID-19 testing, both in-network and out-of-network, up to charges for out-of-network providers.
Highmark Health is ensuring access to teleaddiction services for members in PA, WV and DE who are in addiction treatment and need immediate help, but may not be able to access their regular provider during this time. These services are covered for both in- and out-of-network without cost sharing for members for 90 days.
Home State Health is collaborating with Quest Diagnostics to increase access to real-time reverse transcription polymerase chain reaction (rRT-PCR) COVID-19 testing in critical areas of need in St. Louis. Through this collaboration, Home State will facilitate the distribution of up to 1,000 Quest COVID-19 test kits each week to Affinia Healthcare and People’s Health Centers, which are both Federally Qualified Health Centers.
Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey has extended through December 31, 2020 the cost-sharing waiver for covered services related to inpatient or outpatient treatment when the primary diagnosis is COVID-19.
The waiver applies to all fully insured members, including those covered through Medicaid, Medicare Advantage, Individual and Small Group policies, as well as members covered by the State Health Benefits Program (SHBP) and the School Employees’ Health Benefits Program (SEHBP).
Horizon Blue Cross Blue Shield of New Jersey has extended the waiver of member cost sharing for treatment of COVID-19 through August 31, 2020. This means that members will pay no deductible, copay or coinsurance for inpatient and outpatient care when claims indicate treatment was directly related to treatment of COVID-19 as the primary diagnosis.
Horizon Blue Cross Blue Shield of New Jersey has launched Horizon Neighbors in Health, a comprehensive program to address social determinants of health. The state’s largest health insurer is investing $25 million and partnering with some of New Jersey’s most respected health organizations over the next three years on a model that employs local Community Health Workers to connect members with a wide-array of services that make good health more possible.
Addressing social determinants of health has become even more critical in light of the COVID-19 pandemic. Individuals whose access to services and care was challenging in the best of circumstances, now face even greater challenges.
Horizon Blue Cross Blue Shield of New Jersey has partnered with AbleTo to offer its members free access to AbleTo’s individual teletherapy services. This partnership builds on Horizon BCBSNJ’s larger initiative to provide in-network telemedicine services to members with zero out-of-pocket costs until at least June 30, 2020.
Horizon Blue Cross Blue Shield of New Jersey has donated $2 million to The New Jersey Pandemic Relief Fund, the response and support organization established by Tammy Murphy, New Jersey’s First Lady.
With the donation, Horizon has contributed $4.35 million for protective equipment for health care workers, food, and social services in response to the COVID-19 outbreak.
Horizon has also expanded paid-time-off for volunteer service to provide those employees answering New Jersey Governor Phil Murphy’s Healthcare Professionals Call to Serve with 40 hours of compensated volunteer time. 72 doctors, nurses, pharmacists, and clinicians from Horizon have volunteered and are awaiting deployment.
Horizon Blue Cross Blue Shield of New Jersey is extending its previously announced waiver of all member cost-sharing obligations to include all covered benefits associated with treatment for COVID-19. The policy, retroactive to March 1, 2020 and in place through at least June 30, 2020, means that members will pay no deductible, co-pay, or coinsurance for inpatient and outpatient care when their claim indicates treatment was related to COVID-19.
Horizon Blue Cross Blue Shield of New Jersey is also is spending $2.35 million to donate 500,000 N95 respirator masks and 81,000 face shields to Governor Murphy’s coordinated response effort.
Horizon Blue Cross Blue Shield of New Jersey will waive prior authorizations for diagnosis of COVID-19, cover the full cost of diagnostic testing for COVID-19, waive early medication refill limits for 30-day prescription medications, and provide access to telehealth services at no cost.
Humana will mail more than 1 million in-home preventive care screening kits to members in 2020, helping increase access to routine screenings that many members have put off during the COVID-19 crisis. Humana’s new initiative, which triples the number of screening kits sent to members, comes as many people have postponed all but the most necessary health procedures during COVID-19, limiting doctors’ appointments and emergency room visits.
Humana announces at-home and drive-through COVID-19 testing: Humana is proud to be the first insurer to offer LabCorp® at-home COVID-19 test kits and drive-thru COVID-19 testing at hundreds of Walmart Neighborhood Market pharmacies across the country. Testing is available for all eligible medical plan members, including Medicare Supplement.
If testing is recommended, members can opt to have a testing kit mailed to their homes within one business day. If members prefer a drive-thru test, Humana has teamed up with Walmart, Quest Diagnostics, and PWNHealth to offer drive-thru testing at Walmart Neighborhood Market pharmacies. The pharmacy staff will give members a test kit and help complete the process correctly.
Humana is continuing to waive all member costs related to covered COVID-19 testing and treatment.
The Humana Foundation has awarded $2.2 million to nonprofit organizations in Louisville as part of its ongoing Community Partners Program. The initiative began in 2018 and has since awarded more than $6 million to local nonprofits addressing social determinants of health and creating greater health equity in Humana’s corporate hometown.
The most vulnerable are disproportionately experiencing the economic and health implications of COVID-19. These challenges are compounding issues many were dealing with before the pandemic, including hunger and financial instability.
As of June 1, Humana will pay an additional $7 per Humana member dental claim – for all fully insured Humana dental members. At the end of each month, Humana will send a stipend to its dental provider partners, based on the total number of claims for Humana members that month. In addition to this financial support, Humana is also offering 24/7 access to its EAP and Work-Life Services to providers in its dental networks. These actions are a part of the company’s wide-ranging proactive approach to supporting a better health care experience for its members, especially during this unprecedented health crisis.
Humana is eliminating out-of-pocket costs for office visits so that Medicare Advantage members can reconnect with their healthcare providers. To reduce barriers, Humana is waiving in-network primary care costs, not only for COVID-19 costs, but all primary care visits for the rest of 2020. In addition, the company is waiving member costs for outpatient, non-facility based behavioral health visits through the end of year.
Humana is also extending telehealth cost share waivers for all telehealth visits—PCP and specialty, including behavioral health, for in-network providers through 2020.
The Humana Foundation will deploy $50 million in immediate short-term and long-term relief and partner with national and community service organizations to help those disproportionately impacted by the COVID-19 health crisis. The commitment will be split between organizations that support essential workers, food security, behavioral health and community-based organizations.
The Humana Foundation will distribute $34 million of the $50 million commitment to the immediate short-term response efforts of service organizations on the frontlines of the COVID-19 health crisis.
The remaining $16 million will go toward long-tern recovery and rebuilding support for service organizations that are fighting COVID-19.
Humana is providing financial and administrative relief for the health care provider community facing unprecedented strain during the coronavirus pandemic.
Humana is also expanding its policy of suspending prior authorization and referral requirements, instead requesting notification within 24 hours of inpatient (acute and post-acute) and outpatient care.
Humana is waiving consumer costs for treatment related to COVID-19-covered services. Costs related to treatment for COVID-19, including inpatient hospital admissions, will be waived for enrollees of Medicare Advantage plans, fully insured commercial members, Medicare Supplement, and Medicaid.
The waiver applies to all medical costs related to COVID-19 treatment, as well any FDA-approved medications or vaccines.
There is no current end date for the waiver.
Humana is waiving member cost share for all telehealth services delivered by participating/in-network providers, including telehealth services delivered through MDLive to Medicare Advantage members and to commercial members in Puerto Rico, as well as all telehealth services delivered through Doctor on Demand to commercial members.
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 is offering medical and dental premium credits to fully insured employers, as well as providing premium rebates due to the effective management of medical costs. The premiums being returned to Independence employers total nearly $120 million. Independence is also extending payment options for certain fully insured employers.
Independence will give its fully insured group employers a one-time premium credit in their September invoices totaling more than $35 million. The medical premium credit is calculated using member enrollment figures as of July 1, 2020. In addition, in partnership with United Concordia Dental (UCD), a one-time dental premium credit will be issued to fully insured, small group clients with Blue-branded stand-alone dental coverage and fully insured, large group, UCD-branded dental plan clients. The dental credit will be issued with September invoices.
Independence will also be issuing premium rebates exceeding $84 million to many of these same customers due to the effective management of medical costs.
Independence will extend its payment flexibility and continue to accept credit card payments from fully insured employers with up to 500 enrolled employees through September 30, 2020. Independence’s credit card flexibility option was originally announced in April in tandem with the company’s Deferred Payment Plan. The program provided an extended period for customers to pay their April or May invoice with no interest and no penalty.
Independence Blue Cross Foundation, Highmark Blue Cross Blue Shield, Latino Connection, and the Pennsylvania Department of Health have partnered to create the first-in-the-nation COVID-19 Mobile Response Unit to provide testing and education targeting minority and underserved communities throughout Pennsylvania.
In total, this testing effort costed $498,000. The department Epidemiology and Laboratory Capacity Enhancing Detection fund contributed a $331,000 grant. In addition, specimens will be collected and taken to the Pennsylvania Bureau of Laboratories for testing after each event.
Known as CATE, Community-Accessible Testing & Education, the unit is equipped to conduct COVID-19 testing on-site through a mobile RV vehicle while also educating the public on how to stay healthy and safe. The mobile response unit’s tagline is “Sharing knowledge to erase fear,” which it intends to do through widespread community healthcare and health education offered with no insurance required.
Independence Blue Cross is waiving member cost sharing payments for in-network, acute in-patient treatment of COVID-19 through Dec. 31, 2020.
Independence Blue Cross is also waiving cost sharing payments for telemedicine services with a primary care doctor or specialists through Dec. 31, 2020, as well telemedicine visits for behavioral health.
In addition, Independence Blue Cross will cover consumer grade pulse oximeters that are prescribed by an in-network doctor and purchased through an in-network supplier. Member cost sharing will be waived through July 31, 2020.
Independence Blue Cross recently launched a comprehensive COVID-19 Provider Hub website. The site provides information on clinical and business initiatives taken by Independence to support doctors, hospitals, health systems, and other health care professionals during the pandemic.
Independence Blue Cross has developed a new initiative called “Calls of Kindness.” The initiative involves Independence employee volunteers making proactive check-in calls to Medicare members. The purpose of the calls is to give comfort and support to those who need it during the COVID-19 crisis. So far volunteers have made “Calls of Kindness” to more than 2,000 Medicare members.
Independence Blue Cross and Philadelphia-based United By Blue, a sustainable outdoor apparel and accessories brand, today announced the launch of a new program that offers four weekly grocery deliveries at no cost to Independence Medicare Advantage members. Each delivery contains fresh, local, and organic groceries, homemade soups, and household supplies.
The program is targeting 7,700 Medicare Advantage members who are enrolled in Independence’s Keystone 65 Individual HMO plans and have chronic obstructive pulmonary disease (COPD) and at least one of the following diagnosis: hemoglobin A1c level greater than 9, asthma, hypertension, congestive heart failure, end-stage renal disease, or ischemic heart disease.
Independence Blue Cross is expanding its temporary suspension of prior authorization for acute in-network inpatient admissions from the emergency department to include all diagnoses (including COVID-19) and for in-network transfers and transportation between facilities. The change, which is for fully insured members, takes effect immediately and will remain in effect until June 4, 2020.
Independence Blue Cross is offering members access to an emotional wellness app, Stop, Breathe & Think, at no cost until June 14, 2020. The app provides effective ways to alleviate feelings of anxiety, reduce stress, and find peace of mind.
Independence Blue Cross is offering a comprehensive COVID-19 preparedness tool developed by Quil to some Independence members at no cost.
Quil, the digital health joint venture of Independence Health Group and Comcast, is updating content in the tool daily based on new information and best practices. The tool includes resources for ways to support healthy living at home and help individuals adjust to new work/life balance realities.
Independence Blue Cross is waiving member cost-sharing for in-network, inpatient, acute care treatment for COVID-19. This means members will pay no co-pay, co-insurance or deductible in this scenario.
Independence is also waiving cost-sharing for emergency department visits when members are admitted to the hospital under these same conditions. These changes are effective March 30, 2020 and will extend through May 31, 2020.
Independence is also temporarily suspending prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through April 30. In addition, prior authorization requirements are temporarily suspended for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required.
Independence is waiving cost sharing payments for all primary care telemedicine visits through June 4.
Independence is also expanding coverage for telemedicine services to reimburse visits with specialists and ancillary service providers and expanding existing behavioral health telemedicine coverage to ensure that members with autism spectrum disorder receive Applied Behavior Analysis support.
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. Independence Blue Cross is also supporting the new PHL COVID-19 Fund, which will provide grants to Greater Philadelphia nonprofit organizations that serve vulnerable populations.
Independent Health is expanding its partnership with Brook, a Seattle-based health-technology company that helps individuals take better care of their health. The new feature will allow members to log their meals, instantly receive detailed nutrition information about their food, and get expert advice from registered dietitians, certified diabetes educators, and nutritionists.
Independent and Brook also confirmed that they will continue to provide the Western New York community with free access to the Brook Personal Health Companion app during the COVID-19 crisis.
Independent Health is expanding its partnership with Brook, a Seattle-based technology company, to offer the Western New York community free access to the Brook Personal Health Companion App for the duration of the COVID-19 health emergency.
Independent Health has waived copayments and cost-sharing for COVID-19 medical testing, diagnosis and treatment for its fully insured employer groups, Medicare Advantage, Medicaid and individual plan members.
In addition, Independent Health is covering in-network telehealth/telemedicine services, whether or not COVID-19 related, to encourage social distancing and help reduce the risk of spreading the coronavirus. There will be $0 copay or cost-sharing for these services as well.
Independent Health implemented a global payment reimbursement model to help primary care practices during the pandemic. By compensating practices through an all-encompassing global payment, Independent Health helped keep cash flow similar to a “typical” month prior to the pandemic. This way, practices were not solely dependent on office or telehealth visits for reimbursement to stay afloat.
For its members who do not have a primary care physician, Independent Health partnered with several primary care practices to connect these members with a doctor right away.
Independent Health is also allowing members who are considered to be at higher risk as defined by CDC guidelines to obtain an early refill of their medication if needed.
Indiana University Health is accelerating payments for purchased products and services. The initiative aims to boost cash flow for the many Indiana-based businesses that supply needed goods and services to health care providers and other Central Indiana companies during the global COVID-19 crisis.
IU Health is expediting the processing of over $5 million a week in billings into the accounts of its in-state vendors. The dozens of Indiana vendors who will see expedited payments from IU Health include many small businesses and women- and minority-owned enterprises.
Indiana University Health is expanding testing for the SARS-CoV-2 virus, which causes COVID-19, to any health care worker or first responder in Indiana who may have been exposed to the virus. This includes health care workers serving at non-IU Health facilities.
Indiana University Health provides free screening for COVID-19 via its virtual visits app where Indiana residents of any age are able to review symptoms with a health care provider. The team will recommend and facilitate appropriate pathways for care and will provide direct access and communication with local hospitals as medically appropriate.
Inland Empire Health Plan has awarded Rolling Start Inc., a non-profit organization serving people with disabilities, with a $5,000 sponsorship to support its new Digital Access Pilot Program. In addition to the sponsorship, IEHP will encourage interested employees to volunteer for the program, launching September 1.
Aiming to reduce the digital divide and social isolation experienced by seniors and persons with disabilities in the face of COVID-19, Rolling Start Inc.’s Digital Access Pilot Program will provide eligible individuals who have restricted or no internet access with paid access for up to three months, a Chromebook and instructional courses.
Program participants will be required to complete all instructional courses within a designated time to keep their devices. IEHP team members will use this training as a tool to teach program participants how to navigate social media websites, access telehealth benefits, and how to use the tool to improve communication with their medical providers.
Inland Empire Health Plan has housed 164 homeless members who have chronic health conditions and are high utilizers of health services. The innovative program also assigns members to case managers who provide benefit education and preventative health support.
Inland Empire Health Plan has provided more than 2.4 million units of personal protective equipment (PPE) to Inland Empire government agencies, medical societies, associations, and hospitals during the COVID-19 pandemic.
To date, the plan has provided over 1.9 million disposable masks, 145,000 N95/KN95 respiratory masks, 80,000 surgical gowns, 130,000 isolation gowns, 43,000 boxes of gloves, 150,000 containers of sanitizing wipes and 48,000 wipe refills.
Inland Empire Health Plan is amending its contracts to include a capitation feature that will pay a facility the hospital’s expected net patient revenue for IEHP Medi-Cal members or their monthly claims’ average for calendar year 2019, whichever is greater. IEHP is expecting to provide more than $90 million in support to providers during their pandemic response efforts.
Inland Empire Health Plan has joined with local organizations to create several innovative initiatives, including: COVID-19 testing and lifted pharmacy restrictions for members; personal protective equipment and adjusted financial support for health workers; and resource support to the greater community.
IEHP has secured and distributed much-needed PPE to local hospitals and providers. They have also increased financial support for skilled nursing facilities to provide care for COVID-19 patients, when clinically appropriate. Dedicated IEHP webpages for COVID-19 information for providers, members, and community were developed and are updated daily with testing information, changes in county restrictions, and safety information.
Inland Empire Health Plan’s provider payment initiative compares the average claim payments in 2019 to what a physician specialist received during the COVID-19 crisis in 2020. The difference, up to 90%, is paid to the physician so they can keep their practice and employees intact. All provider claims are also being processed in under 30 days to make sure critical cash flow is available to physicians, hospitals, clinics, and other providers.
Inland Empire has also provided $100,000 grants to Federal Qualified Health Centers who have begun testing for COVID-19 in their clinics.
Inland Empire is also providing 17 skilled nursing facilities in the area with increased rates to provide care to COVID-19 patients to lower the number of patients transferred to hospital emergency rooms.
Uninsured Inland Empire residents now have access to medical advice 24/7 through the Inland Empire COVID-19 Medline, due to a collaboration between Inland Empire Health Plan, 211 Riverside and San Bernardino County, Riverside and San Bernardino County Public Health, and Carenet Health.
This free resource is accessible to uninsured residents in Riverside and San Bernardino counties who call 211’s social service line with COVID-19 related health questions. In addition to community resources, 211 can route callers to a health professional, staffed by Carenet Health.
Inland Empire Health Plan has sourced and donated more than 221,000 units of personal protective equipment supplies to local government agencies, medical societies, associations and hospitals in Riverside and San Bernardino counties during the COVID-19 pandemic.
Inland Empire Health Plan’s (IEHP) response to COVID-19 includes collaborative efforts with counties, county hospitals, public health, local medical associations, providers, and partners to coordinate efforts to serve the plan’s members, providers and community.
To ensure members continuity to access routine and COVID-19 related care, IEHP has partnered with county public health, county health systems, and one of the nation’s largest Federally Qualified Health Centers, SAC Health System, to administer tests to members locally. The health plan has also expanded telehealth services to include both new and established patients for an array of services.
To support health care workers and providers in care delivery, IEHP has increased rates for Skilled Nursing Facilities so they may provide care for COVID-19 patients (when clinically appropriate) to lower the number of patients transferred to hospital emergency rooms. In addition, IEHP has also organized the procurement and distribution of personal protective equipment for hospitals and providers.
To address food and resource insecurity for the greater community, IEHP has provided sponsorships, donations of goods and volunteers to local food banks. To ensure the continuity of services from additional community-based-organizations, technology sponsorships have also been awarded to transition their critical services to digital platforms.
Inter Valley Health Plan is treating COVID-19 diagnostic tests as covered benefits, and is waiving all cost sharing for members for screening and testing of COVID-19. It has also provided more flexibility for Part D refill restrictions to allow members to receive their needed medications.
InnovaCare Health is fully compensating primary care physicians for April and May. Through its subsidiary, MSO of Puerto Rico, InnovaCare will also compensate specialists, dentists, hospitals and hospitalists to ease the financial stress from reduced patient volumes. Hospitals are receiving payments based upon average monthly billings while hospitalists are receiving full payment based on their contractual agreements.
InnovaCare expects to disburse more than $100 million in advanced payments to providers by the end of May.
InnovaCare has also implemented expedited claims processing, ensuring claims are processed within five days or sooner, allowing providers to be reimbursed as quickly as possible for the care they’re providing.
At the onset of this pandemic, InnovaCare’s plans were first in their markets to announce they would cover patients’ healthcare usage related to COVID-19, ultimately waiving copays and deductibles during this time.
Through subsidiary Orlando Family Physicians, InnovaCare has expanded its telehealth offerings to help patients access the care they need and maintain important relationships with their physicians.
The expanded capabilities have allowed OFP to handle an increased number of visits during the COVID-19 pandemic and also to be one of Central Florida’s only provider groups to continue accepting new patients.
Kaiser Permanente is committing $63 million to support California’s contact-tracing work in order to reduce the number of Californians who contract COVID-19.
This support, in the form of charitable grant funding to the Public Health Institute, will create agile community health teams hired from within communities that have been disproportionately affected by COVID-19 to support the critical work of local public health departments. The support teams will be embedded in clinical settings to rapidly respond to COVID-19 hot spots and support ongoing contact-tracing efforts while ensuring high levels of privacy and security. This funding will also connect Californians in self-imposed isolation and quarantine with supportive services to assist with food, housing, child care, and other needs.
The work is being undertaken in collaboration with Gov. Gavin Newsom’s administration, with the aim of reducing the number of Californians who contract COVID-19. The effort will add up to 500 people in clinical settings to support the state’s contact-tracing effort, which will help facilitate safe reopening for businesses and schools.
Kaiser Permanente and its employees will donate $500,000 to the Colorado COVID Relief Fund, $300,000 of which will be restricted to organizations applying to do contact tracing, specifically organizations focused on cultural competency within Colorado communities. The remaining $200,000 will come through Kaiser Permanente’s employee donation matching campaign, ending on September 30, 2020.
Kaiser Permanente is joining with nonprofit Civica Rx in its mission of assuring that health providers nationally have access to stable and affordable supplies of essential generic medications throughout the COVID-19 crisis and beyond.
Kaiser Permanente joins Civica as a governing member with a seat on the board of directors and as an integrated health system with 12.4 million members will provide an important voice in designing Civica’s future strategy. The addition of Kaiser Permanente comes at a time when Civica is already delivering 20 essential generic medications, 10 of which are currently being used to treat COVID-19 patients. Civica is also working to significantly boost generic drug production within the United States.
Kaiser Permanente will extend its waiver for most member out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19 through December 31, 2020. This waiver, put into effect on April 1 and originally set to expire on May 31, is intended to alleviate the cost burden and stress of paying for care, allowing members to focus on recovery.
Kaiser Permanente’s elimination of member out-of-pocket costs applies to all fully insured benefit plans, in all markets, unless prohibited or modified by law or regulation. It will apply for all dates of service from April 1 through December 31, 2020, unless superseded by government action or extended by Kaiser Permanente.
Kaiser Permanente has released a playbook, “Planning for the Next Normal at Work,” to guide employers and businesses through health considerations they will need to address as they safeguard workplaces during the COVID-19 pandemic and prepare to bring employees back to traditional work environments.
Examples of recommended safety modifications to the workplace include:
- Re-configuring office space to allow at least 2 arms’ length of space between workstations and providing hand sanitizer in multiple locations.
- Limiting meetings and gatherings to 10 people or fewer.
- Creating processes for potential employee diagnoses, including evaluating leave-of-absence policies.
- Reinforcing a psychologically healthy workplace where employees feel safe, respected, and empowered.
Kaiser Permanente members can now download Calm Premium on their smartphone, computer, or tablet through their kp.org account.
Kaiser Permanente members will have unlimited access to Calm content, including an ever-growing library of guided meditations, sleep stories for deeper and better sleep, and video lessons on mindful movement and gentle stretching.
The availability of the Calm app is part of Kaiser Permanente’s continued commitment to provide its members with new ways to support emotional wellness anytime and anywhere, particularly during times of increased stress and anxiety.
Kaiser Permanente and Dignity Health will partner with California and Los Angeles County to open the Los Angeles Surge Hospital, a temporary facility in Los Angeles that will expand access to additional beds and expand ICU capacity for patients who contract COVID-19. The facility will be located on the campus of the former St. Vincent Medical Center in central Los Angeles.
The Los Angeles Surge Hospital is expected to open April 13.
Futuro Health, a California-based nonprofit established by Kaiser Permanente and the Service Employees International Union-United Healthcare Workers West (SEIU-UHW) to address the nation’s allied health worker shortage, has expanded its education offerings to prepare front-line health care workers for an expected surge in COVID-19 cases, committing $1 million to launch a new pandemic-readiness program.
Kaiser Permanente will waive all member out-of-pocket costs for inpatient and outpatient services related to the treatment of COVID-19.
Kaiser Permanente’s elimination of member out-of-pocket costs will apply to all fully insured benefit plans, in all lines of business, in all markets, unless prohibited or modified by law or regulation. It will apply for all dates of service from April 1 through May 31, 2020, unless superseded by government action or extended by Kaiser Permanente.
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. Kaiser Permanente has more information about how its medical centers continue to prepare to contain and treat the disease. Kaiser Permanente is not requiring members to pay any costs related to COVID-19 screening or testing when referred by a Kaiser Permanente doctor.
L.A. Care Health Plan, the California Endowment, Blue Shield of California Promise Health Plan, and the Los Angeles County Department of Public Health are hosting a second COVID-19 Disparities Leadership Summit. The summit will bring together dozens of health care and community leaders to strategize on how to address the devastating disproportionate impact on Black and Latino communities.
The summit leaders will learn more about what fellow community partners are doing to assist residents, and explore ways to combat persistent disparities.
L.A. Care has announced 29 awardees in its seventh round of Elevating the Safety Net Provider Recruitment Program grants. The 29 grants will bring more physicians into the safety net, helping to relieve the strain that has worsened during the COVID-19 crisis.
The grants are worth nearly $4.3 million, bringing the total award amount from all six rounds to nearly $19 million.
Newly recruited physicians to the safety net are eligible for the Provider Loan Repayment Program, another part of Elevating the Safety Net. Under the program, physicians receive loan repayments of up to $5,000 per month for up to 36 months, as long as they continue to work within the safety net. Sixty-seven physicians have been approved for loan repayment grants.
L.A. Care is committing $750,000 to help fight evictions that have been exacerbated by the COVID-19 crisis.
Six legal aid agencies that have long been fighting to protect low-income and under resourced individuals and families who are often from communities of color, will receive the funding. While California Governor Newsom has extended authorization allowing local governments to delay evictions through the end of September, UCLA researchers found that 365,000 renter households in Los Angeles County are in imminent danger of eviction once eviction orders are lifted.
L.A. Care has awarded the United Way of Greater Los Angeles two grants worth $975,000 to support workers on the frontline during the COVID-19 crisis as well as those experiencing homelessness.
One grant commits $475,000 to provide personal protective equipment (PPE) for up to 5,000 frontline workers in the COVID-19 crisis. United Way will also use the funding to procure and distribute food, tents, sleeping bags, or other shelter in place equipment to as many as 10,000 individuals who are living on the streets during this crisis. They will also provide essential supplies such as masks, health kits, and hygiene kits.
L.A. Care has awarded nearly $1.5 million to 10 grantees through the Robert E. Tranquada, MD Safety Net Initiative XI. Health care centers and community clinics across Los Angeles County will receive between $100,000 and $150,000 to conduct projects that will primarily help communities of color, which have been harder hit by COVID-19.
The various projects involve combatting diabetes, hypertension, periodontal disease, and more, while tailoring their clinical services to meet COVID-19 demands. Total funding for the Tranquada Initiative is $1,425,000. In some cases, the funding will support hiring of nurses and support personnel who are members of the community they will serve. Other funding covers equipment, software, and renovations that will help the centers meets their goals.
L.A. Care has committed grant funding of up to $550,000 to Project Angel Food. Project Angel Food provides medically tailored meals and nutritional counselling to 2,000 low-income individuals in Los Angeles County affected by life threatening illnesses each week. L.A. Care is helping Project Angel Food reduce their waiting list.
Food insecurity has long been a major deterrent to good health outcomes for low-income individuals, and the COVID-19 pandemic has exacerbated the problem. The 151 people on the Project Angel Food waiting list were part of a rush that applied for help in the wake of the COVID-19 outbreak. For a year, these clients will receive medically tailored meals based upon their personal health conditions.
L.A. Care is moving to accelerate claims payments and provide other financial support to many providers in its provider network to help address the financial pressure caused by the COVID-19 pandemic.
L.A. Care will be accelerating more than $7 million in grant payments to 138 clinics and community-based organizations. The health plan is also committing more than $6 million in targeted grant support for its most vulnerable members and communities, including some who are experiencing homelessness.
L.A. Care is providing up to $35 million in accelerated claims payments to hospitals, and more than $21 million in advanced incentive payments for individual primary care physicians and FQHC clinics.
L.A. Care is waiving all costs associated with screening, testing and medically necessary treatment for COVID-19.
Lighthouse Health Plan is waiving all co-payments for COVID-19 related services.
Magellan Health has launched a free crisis texting service for anyone who needs help during the COVID-19 crisis. Individuals can connect with a certified, licensed mental health clinician who will provide confidential mental health services. This service supports Magellan’s crisis telephone hotline, offering another way to access mental health services.
Magellan’s confidential mental health crisis text line is offered free-of-charge to the community to assist individuals as they try to cope with feelings of fear, sadness, anger and hopelessness. Individuals may also seek information and guidance to other available resources, such as community-based support.
Magellan Health has opened a free national 24-hour crisis line for all first responders and healthcare workers who are serving on the front lines battling the coronavirus pandemic. These critical workers who call the hotline will speak directly to a certified licensed mental health clinician. The hotline is being operated by Magellan Healthcare, the behavioral and specialty healthcare segment of the company.
Magellan Health has expanded telehealth services to help support clients during the COVID-19 pandemic. Magellan will permit all credentialed and contracted behavioral health providers to conduct telehealth video sessions for all routine services and certain psychological testing, applied behavior analysis (ABA), intensive outpatient programs (IOP) and partial hospitalization program (PHP) services.
Magellan Health is providing free access to one of its digital cognitive behavioral therapy, RESTORE®, for members who are experiencing sleep difficulty and insomnia related to the COVID-19 pandemic.
Magnolia Health is providing additional mental health resources to Mississippi residents impacted by the COVID-19 pandemic. Through a series of local partnerships, Magnolia will enable providers to better support communities that are experiencing elevated levels of stress and mental strain caused by an increase in grief, loss, economic pressure, unemployment, and social isolation.
As part of this effort Magnolia, in partnership with its parent company Centene Corporation, is investing to support the following programs:
- Provider Training and Support – Training for clinicians and support for front-line providers dealing with the COVID-19 crisis and the increase in mental health-related challenges in their practices.
- Expanding Access to Mental Health First Aid– An investment to help the National Council for Behavioral Health transition part of their training program to a virtual program, which will make MHFA training more accessible for people in Mississippi and nationwide.
Allwell from Magnolia Health has waived pre-authorizations, co-pays, and other costs related to COVID-19 testing, screening and medically necessary treatment. Allwell from Magnolia has also waived prescription refill limits, and members are able to refill prescriptions prior to their refill date during the crisis.
Effective July 1, 2020, expanded benefits will include:
- $0 Member Liability Extension:Allwell from Magnolia is waiving in-network member costs for all primary care visits for the rest of 2020. Allwell from Magnolia is also waiving member costs for outpatient, non-facility-based behavioral health visits and extending telehealth cost share waivers for all telehealth visits—primary care, specialty, and behavioral health—for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility, or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states.
- Extended Meal Benefits –Members eligible for meal benefits due to a chronic condition or recent discharge may receive an additional 14 meals delivered to their home at no cost.
- Increased Annual Wellness Visit Incentives – Members may be eligible for an increased incentive for completing their annual wellness visits, a benefit offered at no cost to the member.
- Additional Over-The-Counter (OTC) Benefits – Plans with an OTC benefit may now receive additional allowance dollars in monthly or quarterly increments, adding up to as much as $150 for the remainder of 2020, depending on plan.
- Access to WellCare’s Community Connections Help Line – The Community Connections Help Line – a toll-free line provided by partners at WellCare and available to anyone in need – is staffed by peer coaches and support specialists who can refer individuals and caregivers in need to a database of more than half a million social services in local communities across the country. By calling the line at 1-866-775-2192, members can also receive help coordinating of the expanded meal program benefits, OTC allowances, and annual wellness visit incentives via the line.
Beginning July 1, 2020, providers should also waive the member liability for the eligible primary and behavioral health care claims at the point of service, and forego the collection of the member cost share.
Magnolia Health has partnered with the Mississippi Department of Child Protective Services to provide healthcare workers with the items they need. Magnolia Health, a MississippiCAN Medicaid health plan, has provided 500 masks to Child Protective Services workers.
Martin’s Point Health Care has received the first Maine shipment of newly developed rapid COVID-19 tests. The new test offers results in minutes, rather than the days required by current tests.
Medica Health Plan has extended the waiver for copays, co-insurance and deductibles for in-network COVID-19 inpatient hospital care for fully insured group members. These changes will extend through September 30, 2020.
Medica Health Plan has waived in-person, in-network primary, specialty and behavioral care office visit copays for all Medica Advantage members for appointments completed between June 1, 2020 through September 30, 2020. Medica will continue to suspend prior authorization for admission to a post-acute care setting, also through September 30, 2020.
Medica Health Plan is distributing more than 200,000 disposable protective masks to members who are at the greatest risk for experiencing complications related to COVID-19. Medica is also donating an additional 150,000 masks and other personal protection equipment to community organizations and its skilled nursing partners.
Medica Health Plan is donating $200,000 to nine Nebraska non-profit organizations and community health centers that play important roles in addressing the needs of the most vulnerable people in communities statewide, especially during the coronavirus pandemic. Funding is being made available through the Medica Foundation.
The organizations include the United Way of the Midlands, the Nebraska Farm Bureau, and the Charles Drew Health Center.
Medica Health Plan is waiving copays, co-insurance, and deductibles for COVID-19 in-patient hospital care. The waiver will extend through May 31. Prior authorization will not be required for admissions to long-term care facilities, acute in-patient rehabilitation, or skilled nursing and home health care facilities. This change will extend through May 31.
Medica has donated $1 million to Minnesota non-profits to address the health needs of the most vulnerable people in the state during the COVID-19 pandemic. Medica’s funding is targeted to support key focus areas including child and family support, clinics and shelters, food security, mental health / telehealth services and general disaster relief.
Medica Health Plan will waive co-pays, co-insurance and deductibles related to COVID-19 testing for all fully insured group, individual and Medicare members. Self-insured employers will have an opportunity to also waive fees related to the testing of COVID-19. To help limit the spread of COVID-19, Medica provides coverage for virtual care or telehealth services.
Medical Associates Health Plan
Medical Associates Health Plan is waiving in-plan providers cost share for testing and treatment.
MAHP will be in compliance with state and federal requirements for coverage of the testing, to include pop-up facilities.
Telemedicine will be covered at no-cost share for in-plan providers who offer the service.
Medical Mutual of Ohio has extended the cost sharing waivers for all COVID-19-related treatment through December 31, 2020. Treatment includes hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis. In addition, Medical Mutual will permanently cover FDA-approved medications and vaccines when they become available.
Medical Mutual is waiving member cost sharing associated with COVID-19 testing and treatment. This applies to services provided by both in-network and out-of-network providers.
For testing, this covers the cost of the test, as well as the cost of the provider visit, which could include a telehealth (telemedicine), urgent care or emergency room visit, to determine whether the COVID-19 testing is required, and the visit to administer the test. This is effective through the end of the national public health emergency declared by the U.S. Department of Health and Human Services.
Medical Mutual has extended the period during which cost sharing for all treatment related to COVID-19 will be waived to now go through July 24, 2020. Treatment includes hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis. In addition, Medical Mutual will permanently cover FDA-approved medications and vaccines when they become available.
MeridianHealth will waive all out-of-pocket costs for COVID-19 testing treatments through the end of 2020, including copays, deductibles, and coinsurance.
MeridianHealth is partnering with Aunt Martha’s Health and Wellness to offer COVID-19 PCR tests and antibody testing at no cost in the Chicago Heights and Kankakee communities.
MeridianHealth has donated more than 130,000 units of PPE to help protect Michigan’s first responders and essential workers on the front lines of the coronavirus (COVID-19) pandemic.
MeridianHealth, a subsidiary of Centene, has identified four organizations serving as either Federally Qualified Health Centers and/or Community Mental Health Centers to receive $500,000 in total funding to continue their work during the COVID-19 crisis, including providing shelter or secure housing for those who have been exposed to COVID-19 and must be quarantined or those who have tested positive, but do not need hospitalization. In addition to this funding, Meridian has recently provided 100,000 protective masks to the Westside Homeless COVID-19 Response Workgroup.
MetroPlus Health Plan and Healthx have launched improved online engagement platforms for the health plan’s 545,000 members and more than 23,000 participating providers. The COVID-19 crisis has created an urgent need for increased remote engagement. The websites include strategic enhancements to the MetroPlus Health Plan’s previous websites, including secure messaging and self-service tools like “gaps in care” alerts for members and clinical decision support powered by InterQual. The partnership between MetroPlus Health Plan and Healthx is designed to improve engagement and collaboration between members, providers, and MetroPlusHealth.
MetroPlus Health Plan has also started a new food and safety member care package initiative that will soon reach 10,000 of its members determined to be especially in need. The care packages, containing non-perishable foods and items like hand sanitizer and face masks, are particularly needed now as, due to the COVID-19 pandemic, there is an urgent need for lower income New Yorkers to safely access food and personal protective equipment.
MHS Health Wisconsin, a subsidiary of Centene, has donated $45,000 to food banks in Milwaukee, Eastern Wisconsin and Western Wisconsin.
Additionally, a partnership with Feeding America, Centene and MHS Health will coordinate a donation of 1 million meals a month for the next 12 months to feed those in Wisconsin and across the country.
MHS Wisconsin is also coordinating with Centene to purchase 500 gift cards for use on essential items. MHS Wisconsin will deliver the cards to FQHCs and a local pharmacy for distribution to individuals in need. The gift cards will have a value of $35 and can be used to purchase essential health care and educational items, including diapers, over-the-counter medicines, cleaning supplies, and books.
MHS Health has made several additional donations, including:
- $5,000 to Discovery World to support the museum’s online free, hands-on educational opportunities.
- $500 to Healthy Eats for Hospital Heroes. This organization prepares and delivers healthy meals to health care providers who are treating coronavirus patients at Froedtert Hospital in Milwaukee.
- 100 canvas bags filled with children’s supplies donated to Milwaukee Health Services Community Health Center (FQHC) for patients at their COVID-19 testing tents.
- In partnership with Log Cabin Sewing Company, MHS Health will mail 300 masks to high-risk members.
Minnesota Council of Health Plans
Minnesota Council of Health Plans announced that Minnesota’s nonprofit health plans are voluntarily extending cost-sharing waivers for in-patient COVID-19 treatment through the end of 2020.
The Minnesota Council of Health Plans announced that Minnesota’s nonprofit health plans are enhancing support for enrollees impacted by the COVID-19 pandemic by extending cost-sharing waivers for in-patient treatment.
To the extent permitted by law, health plans are extending waivers for cost sharing for in-network COVID-19 hospitalization on fully insured, individual and group health plans until Sept. 30, 2020.
- Plans that have committed to this extension include:
- Blue Cross and Blue Shield/Blue Plus of Minnesota
- HealthPartners
- Hennepin Health
- Medica
- PreferredOne
- UCare
Moda Health has extended cost-sharing waivers through December 31, 2020 for the in-network treatment of COVID-19, both inpatient and outpatient. The waiver applies to Oregon members covered on Individual or Family plans or fully-insured employer group members.
Moda Health has extended cost sharing waivers for in-network treatment of COVID-19 for Oregon members on individual and family plans and employer group plans through Aug. 31, 2020.
Moda Health is waiving cost sharing for Oregon and Alaska Individual and Family plans and fully-insured employer groups plans for in-network medical treatment of COVID-19, both inpatient and outpatient, and FDA-approved medications administered inpatient for the treatment of COVID-19, until May 31.
Alaska Moda is waiving cost sharing payments for all commercial medical members for respiratory diagnostic testing needs, including respiratory syncytial virus, influenza, and COVID-19 lab tests. This includes office visits, urgent care visits, telehealth visits, or emergency room visits when the purpose or outcome of the visit is to be tested for respiratory illness. The waiver applies to in-network and out-of-network providers, facilities, and laboratories. Oregon Moda is waiving cost sharing payments for commercial health members for COVID-19 testing needs, including:
- a telehealth visit to be evaluated for COVID-19 testing;
- a provider office visit, urgent care center visit, or emergency room visit to be tested for COVID-19;
- COVID-19 lab test for all testing facilities; and
- other testing received during a COVID-19 testing visit, when administered to determine if there is a need for COVID-19 testing.
Oregon Moda is waiving all cost sharing payments for Medicare Advantage members, including:
- a telehealth visit to be evaluated for COVID-19 testing;
- a provider office visit, urgent care center visit, or emergency room visit to be tested for COVID-19;
- COVID-19 lab tests for all testing facilities;
- and other testing received during a COVID-19 testing visit, when administered to determine if there is a need for COVID-19 testing.
Molina Healthcare has launched the MolinaCares Accord, which will channel investments into solving the many gaps that exist in the access to, and delivery of, health care, particularly for disadvantaged populations. While the COVID-19 crisis isn’t directly responsible for the gaps, it has highlighted them.
The Accord will use Molina’s clinical and community resources and an initial $150 million funding commitment to address the many social issues that afflict the delivery of health care today, including racial disparities, rural access to care, and health care for the elderly, infirmed, and frail.
The Accord will use Molina’s clinical and community resources and an initial $150 million funding commitment to address the many social issues that afflict the delivery of health care today, including racial disparities, rural access to care, and health care for the elderly, infirmed, and frail.
Molina Healthcare will waive all out-of-pocket costs associated with COVID-19 testing and treatment for its Medicare, Medicaid, and Marketplace members nationwide through Dec. 31, 2020.
Molina Healthcare of Washington has committed over $1 million in donations and relief efforts to local communities and organizations in the state as part of its comprehensive COVID-19 Community Response Plan. This initiative focuses on reducing disparities in access to care through the following: the provision of personal protective equipment (PPE) donations; telehealth support to various health care providers; and reducing food insecurity through charitable contributions to food banks and meals delivered directly to members’ homes.
To increase access to telehealth services, Molina is providing more than 20 behavioral health provider organizations with technological support and resources, such as computers and cell phones. Molina is also offering cell phones and data plans to its Medicaid members who do not otherwise have the capabilities to contact their provider via virtual visits. This effort focuses primarily on smaller behavioral health organizations in rural and remote areas of the state.
Molina Healthcare of Ohio has committed over $1.5 million to support innovative programs across Ohio. The Molina Community Innovation Fund will provide grants and sponsorships to various partners launching innovative programs designed to increase access to care, provide unique approaches to reinforce health and wellness, and support integrated care services. The funding also supports organizations helping to fill community needs around social determinants of health, which can have a lasting effect on the health outcomes of women, children, and vulnerable seniors. Through Molina’s efforts with partner organizations, Ohioans will be provided with additional access to resources that support their physical and behavioral health, especially amid the COVID crisis.
Molina Healthcare of Texas has contributed $20,000 to the North Texas Food Bank to help replenish necessary food supplies for area residents experiencing high levels of unemployment or reduced income due to the current pandemic.
Molina Healthcare of Illinois has donated $40,500 to an array of community-based organizations across the state. The grants and supply donations will help the nonprofits provide hygiene essentials, food, financial support, and other resources to help vulnerable communities during the COVID-19 pandemic.
Molina Healthcare of Utah is donating $15,500 to relief efforts in the wake of COVID-19. Molina will provide funds to food banks and other community-based organizations across the state that are working to provide for the communities most in need.
Molina Healthcare of New York is donating over $38,000 to community-based organizations that are providing support and essentials during the COVID-19 crisis.
Molina Healthcare of Mississippi is committing nearly $50,000 for the purchase of personal protective equipment to help protect health care professionals and those in need during the coronavirus pandemic. Molina is aiding its provider partners most impacted by low and in some cases, depleted, PPE supply by donating more than 17,000 3-ply masks, 4,000 N95 masks, and 7,000 nitrile medical gloves. This contribution will support small clinics, federally qualified health centers, rural health clinics, and larger health systems.
Molina Healthcare of Ohio has partnered with the Make-A-Day Foundation and former Ohio State University Football Coach Urban Meyer to provide 20,000 nutritious meals to Ohioans experiencing homelessness or financial distress during the COVID-19 pandemic.
Molina Healthcare has accelerated $150 million in payments to providers. Additionally, Molina has extended all previously approved prior authorizations until September 1, 2020. Molina has also enabled providers to be paid the same amount for servicing members via telehealth as they would have for in-person service, and has expedited credentialing to ensure providers are able to see members for any health care reason.
Molina has also provided personal protective equipment in many markets and continues efforts to seek and provide PPE where it is most needed.
Molina Healthcare of Ohio is committing $150,000 for the purchase of personal protective equipment, COVID-19 test kits, as well as other needed essentials to help protect providers, health care professionals, and those in need during the coronavirus pandemic.
Molina Healthcare is waiving all COVID-19-related out-of-pocket expenses for its Medicare, Medicaid, and Marketplace members nationwide, following up on its previous announcement last month about waiving all member costs associated with testing for the coronavirus, which causes COVID-19.
Molina Healthcare of New Mexico is donating a relief package that includes medical supplies for families, Indian Health Services, and 638 facilities across the Navajo Nation that are experiencing hardships as a result of the coronavirus pandemic.
The relief package includes 5,000 rapid test kits, 240 N95 masks, 200 first aid kits, cleaning supplies, and $25,000 for food supplies.
Molina Healthcare has launched a Coronavirus Chatbot, an enhanced digital tool for members seeking information about COVID-19 risk factors and their own personal risk profile. This new self-appraisal feature is available for members looking for current insight, risk factors, live help, and appropriate action to take if symptoms are present.
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.
MVP Health Care, CDPHP, and Quick Response have partnered to provide the cities of Albany, Schenectady, and Troy with essential sanitation equipment to protect local first responders from COVID-19. Each city will receive two Defense Soap Cordless Electrostatic Hand or Backpack Sprayers for use by the police and fire departments. Each sprayer provides up to 23,000 square feet of disinfectant in a single tank.
MVP Health Care and Media Logic have launched a new website, trytelemedicinefirst.com, that serves as a directory of available telemedicine services, and can be searched by health insurance company name or by zip code – the latter of which will provide information on hospitals and providers that offer telemedicine services.
MVP Health Care is making COVID-19 screening and testing free for all MVP members. Patients are not responsible for any co-payments, other cost-share, or fees associated with:
- an emergency room visit or visit to an in-network health care provider for the purpose of getting tested for COVID-19;
- drive-thru specimen collection sites; and
- telemedicine services, like MVP’s myERnow virtual emergency room and myVisitNowonline doctor visits.
Neighborhood Health Plan of Rhode Island
Neighborhood Health Plan of Rhode Island is waiving requirements for health care providers to seek prior authorizations for all behavioral health and all inpatient medical services regardless of whether they are COVID-19 related or not.
Neighborhood is also waiving prior authorizations and all members’ out-of-pocket fees for treatment related to COVID-19, including copays, deductibles and co-insurance.
Neighborhood Health Plan of Rhode Island will not require pre-authorization for COVID-19 testing and they will cover the cost if a doctor believes a patient needs testing and the patient meets testing guidelines from the CDC. There will be no cost sharing for those patients.
Northeast Delta Dental will provide relief totaling $18.8 million in returned and reduced premiums to individual and group customers by: extending rate holds for fully insured individual and group customers renewing July through December, 2020; crediting all fully insured individual and group customers with a one-month dental premium in July based on June’s billed amount; and crediting all self-insured group customers for the July administrative fee. It will help the producers and consultants who market its dental insurance by providing relief payments totaling $700,000 for the premium/administrative credit period based on commissions paid for the previous month.
‘Ohana Health Plan has donated 26,000 units of personal protection equipment to the Hawaii Hospital Education and Research Foundation to help protect providers across Hawaii during the novel coronavirus (COVID-19) pandemic.
Oscar has waived the cost of COVID-19 treatment delivered by in-network providers through September 30, 2020. If members are treated at an out-of-network facility, Oscar will also waive the cost through September 30, 2020, as long as members have received prior-authorization.
Oscar is also waiving the cost of all COVID-19 care delivered through telemedicine for our members.
Oscar Health will offer zero dollar Virtual Primary Care in 10 markets in 2021: Miami, FL, Fort Lauderdale, FL, Palm Beach, FL, Houston, TX, Dallas, TX, Austin, TX, Los Angeles, CA, Orange County, CA, Denver, CO, and New York, NY, pending regulatory approval.
The COVID-19 pandemic is transforming how Americans access health care and accelerating demand for virtual services.
The new service will include unlimited virtual visits with a dedicated team of Oscar primary care providers. Oscar Primary Care also will bring some care directly to members in their homes, by offering $0 vitals monitoring kits and in-home lab draws when ordered by an Oscar Primary Care provider.
Oscar will waive cost-sharing for the treatment of COVID-19 for its Individual and Small Group members through July 31, 2020. If you’re treated at an out-of-network facility, Oscar also will waive the cost through July 31, 2020, as long as the patient has received prior-authorization.
Oscar and Uno Health are partnering to help Oscar Medicare Advantage members unlock financial assistance, providing critical relief during the COVID-19 pandemic. Uno has helped Oscar Medicare Advantage members achieve an average financial assistance of more than $5,000 per member.
30-50% of Medicare members are eligible for financial assistance through government programs, but have not enrolled in them – often because they don’t know they exist or how to navigate complex signup processes.
Oscar and Uno are helping more Medicare Advantage members tap into this government support.
Oscar has also launched the first testing center locator for COVID-19 in the United States. It is free and accessible to the general public, and it is being updated daily to reflect both in-network and out-of-network facilities in the 29 markets that Oscar operates in. The tool builds on its at-home risk assessment survey.
Oscar will waive cost-sharing for the treatment of COVID-19 for its Individual and Small Group members through July 31, 2020. If you’re treated at an out-of-network facility, we’ll also waive the cost through July 31, 2020, as long as you’ve gotten prior-authorization.
Oscar is waiving cost-sharing for diagnostic testing for COVID-19, including the cost of the test and administration of the test, at both in-network and out-of-network facilities when recommended by a health care provider.
Oscar is offering telemedicine services at no cost to most members through its Doctor on Call service.
Optima Health has extended the waiver on member cost-sharing through September 30, 2020 for any necessary in-network or emergent out-of-network treatment of COVID-19. Optima has also extended cost-sharing waivers through September 30, 2020 for all telehealth visits with in-network providers.
Optima Health is extending member cost sharing waivers for all telehealth visits with in-network providers through Aug. 31, 2020.
Optima is also extending member cost sharing waivers for any necessary in-network or emergent out-of-network treatment for COVID-19 through Aug. 31, 2020.
Optima Health is extending coverage for treatment of COVID-19 to June 30.
Effective now through June 30, Optima Health is providing the following benefits at no cost to members (i.e. no member co-pays or cost-share) for in-network providers and labs for its fully insured Commercial, Medicare Advantage, and Medicaid plans, as well as participating self-funded groups:
- All telehealth visits, including telephone only, with any in-network care provider
- Any necessary in-network or emergent out-of-network treatment of COVID-19
In accordance with the CARES Act, out-of-pocket member costs will be covered for medical care and testing provided to our members who see a health care provider, in-person or via-telehealth technology, when they suspect they are suffering from COVID-19 through the duration of the pandemic.
In order to help remove barriers to care and provide safe options for its members, Optima Health is covering the following through July 31, 2020:
- All telehealth visits, including telephone only, with any in-network care provider
- Any necessary in-network or emergent out-of-network treatment of COVID-19
Pre-authorization requirements for out-of-network services will be waived as appropriate for Medicaid members. For all other members, if they choose an out-of-network provider, the existing out-of-network benefits and costs will remain in place.
PacificSource is waiving all out-of-pocket costs for coronavirus (COVID-19) testing, diagnosis and treatment for its fully insured commercial, Medicare Advantage, and health savings accounts members. This waiver will apply to those members who have received or will receive care between Jan. 31 through June 30, 2020, regardless of place of care. The organization’s self-funded businesses will have the option to adopt these provisions.
PacificSource is waiving out-of-pocket costs for COVID-19 testing and diagnosis-related office visits, urgent care visits, telemedicine visits, ER visits, testing and radiology if billed with one of the COVID DX codes. PacificSource providers are instructed to not collect copay/coinsurance or deductibles for visiting and testing.
PacificSource is also increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications, consistent with a member’s benefit plan.
Paramount Insurance is waiving deductibles, coinsurance and copays if the member’s doctor referred for diagnostic testing for the coronavirus disease effective until May 31, 2020 at in-network facilities.
Passport Health Plan is providing Medicaid members with virtual recovery support services for substance use disorders during the COVID-19 pandemic.
Passport Health Plan will not charge any copays for COVID-19 screening and testing. This includes: Any related hospital emergency visit, urgent care visit, provider office visit, lab testing, telehealth, and immunizations (shots). Passport also will not require any prior authorizations.
Peach State Health Plan is collaborating with Quest Diagnostics to increase access to real-time reverse transcription polymerase chain reaction (rRT-PCR) COVID-19 testing in critical areas of need Georgia. Through this collaboration, Peach State Health Plan will facilitate the distribution of approximately 1,000 Quest COVID-19 test kits each week to Federally Qualified Health Centers, including The Family Health Centers of Georgia, and Curtis V. Cooper Primary Health Care. The FQHCs will conduct testing as part of a broader initiative to test persons who are symptomatic and asymptomatic in underserved communities.
Physicians Health Plan of Northern Indiana
PHP will cover the COVID-19 test and the visit where the test takes place at 100%, with no deductible, copay, or coinsurance. If a patient is diagnosed with COVID-19, PHP benefit plans coverage applies to treatment.
This applies to all plan types, including self-funded plans. Employers may not opt-out.
Physicians Health Plan of Northern Indiana is covering the cost of the COVID-19 screening test for members at no out-of-pocket expense. PHP will waive co-pays, co-insurance, deductibles, and prior authorization, when the test is medically necessary, for members of its fully insured health plans.
PreferredOne is extending cost-sharing waivers for in-network COVID-19 hospitalization for fully-insured employer and individual plan members through September 30, 2020. Previously, the waivers were set to last through May 31, 2020.
PreferredOne is waiving cost-sharing for in-network COVID-19 hospitalization for fully-insured employer and individual plan members effective March 1st through May 31st, 2020.
PreferredOne will cover medically necessary COVID-19 laboratory testing without cost sharing for fully insured employer group and individual plan members. The tests will be available without prior authorization. PreferredOne is working with self-insured clients on their approaches.
Premera Blue Cross is launching its first-ever virtual primary care plan. Called Premera NOW, the new product leverages digital solutions to help customers access care easily and affordably without leaving the comfort of their home. Washington-state employers can purchase the product now for availability October 1, 2020.
Designed with 98point6, the Premera NOW health plan will offer access to a 98point6 virtual provider at any time across the country at a $0 copay.
Premera Blue Cross announced that more than 200,000 of its commercial and individual customers across Washington and Alaska will receive up to $65 million in premium relief funds and premium rebates over the coming months.
Premera is committing up to $25 million to provide premium relief for small and large group commercial customers, many of whom have been particularly hard hit by the economic crisis in the wake of the COVID-19 pandemic. These employers can expect to see premium relief applied to their August billing cycle.
In addition, Premera is working to accelerate nearly $40 million in rebates required under the Affordable Care Act to Washington and Alaska customers who purchased their insurance in the individual market due to a requirement under the Affordable Care Act.
Premera Blue Cross has expanded its zero cost share options for virtual mental health care and substance use disorder treatment in response to the unprecedented demand for virtual care during the COVID-19 pandemic.
Premera has signed provider agreements with Doctor On Demand, Boulder Care and Workit Health to deliver video-based mental health care and substance use disorder treatment to nearly all 2.3 million Premera Blue Cross, Premera Blue Cross and Blue Shield of Alaska, and LifeWise Health Plan of Washington customers through at least June 30.
Premera Blue Cross is providing up to $100 million in financial support in the form of advance payments of claims to medical, dental and behavioral health providers facing significant financial pressures due to the COVID-19 pandemic.
Thousands of primary care providers, specialists, behavioral health providers and dentists in Washington state and Alaska could be eligible for the program. These funds will be recouped by Premera as a percentage of claims over the course of nine months beginning Jan. 1, 2021.
Premera Blue Cross is waiving consumer cost shares and deductibles for treatment related to COVID-19 services for all fully insured, Medicare and individual market customers through Oct. 1, 2020.
Premera Blue Cross has expanded telehealth services to its members in response to the unprecedented demand for virtual care ignited by the COVID-19 pandemic. The company has signed agreements with 98point6 and Doctor On Demand to deliver text- and video-based virtual care to nearly all 2.3 million Premera and LifeWise Health Plan of Washington members for at least 90 days.
Priority Health has joined the Detroit Regional Chamber’s efforts to promote mask wearing across the state to protect public health during COVID-19 by taking the #MaskUpMichigan pledge. Priority Health led a social media campaign in conjunction with a $5,000 donation to the National Alliance on Mental Illness of Michigan to support the increased demand in behavioral health needs due to COVID-19.
The social media challenge encouraged Priority Health staff, members and participants all over Michigan to share photos of themselves wearing a mask and a statement on why it is a priority for them to protect public health. For every person who posted with the hashtags, #MaskUpMichigan and #PriorityHealthforGood, the company pledged to donate to the National Alliance on Mental Illness of Michigan which provides statewide support for people living with serious mental illness and their families.
Priority Health has extended its waiver of out-of-pocket costs for COVID-19 treatment from in-network providers through Dec. 31, 2020, as well as any member cost share payments for any COVID-19 test ordered by a medical provider that is medically necessary.
Priority Health and Papa are enlisting college students to provide essential services and companionship to the most vulnerable during the COVID-19 crisis.
Papa connects college students to Medicare members with specific chronic conditions who need assistance with transportation, house chores, technology lessons, companionship, and other senior services. As COVID-19 has isolated seniors in a way the nation has never experienced before, Papa Pals provide a variety of services to help members including:
- Helping sign up for and use technology services including telehealth.
- Virtual hangouts to socialize.
- Pick-up and delivery of pharmacy refills and food.
- Identifying and preventing COVID-19 email and phone scams.
- Transporting members to necessary medical appointments.
- Cleaning and sterilizing frequently touched surfaces inducing mailboxes and doorknobs.
Priority Health will provide financial support to members and employers facing challenges amid the ongoing COVID-19 crisis. Due to lowered utilization of health services, as well as efforts to keep administrative costs low, the company plans to offer premium credits and waive cost sharing for its most heavily impacted populations. Priority Health plans to return any revenue above the company’s low, ten percent administrative rate back to employers and members.
Priority Health has partnered with digital health specialist Livongo to offer free access to its members to myStrength, a mental wellness tool with activities to manage stress and bolster mental health.
Priority Health has created an affordable new option to help those who have lost their employer-based health benefits due to COVID-19. By combining a short-term plan, to bridge any coverage gap, with a special enrollment in an individual ACA plan, consumers can safely move from their employer-sponsored coverage to a new plan without the risk of going uninsured during the ongoing outbreak.
Priority Health is also offering a deductible credit to all new individual members transitioning from an employer group plan.
Priority Health is waiving all copays, deductibles and coinsurance for the treatment of COVID-19 through June 30. This means that all of the company’s nearly one million members across Commercial, Individual, Medicaid and Medicare plans can get the testing and treatment they need for COVID-19 with no out-of-pocket health insurance costs. Covered treatment may be inpatient or outpatient from an in-network provider. Self-funded employer groups are also included unless they choose to opt-out.
Priority Health has added an Employer Decision Guide that outlines options for helping employees maintain health coverage, along with a new COVID-19 screening bot that helps the user determine their risk level and offers resources based on their individual result.
Priority Health has also expanded access to home medication deliveries. Members can take advantage of free home delivery options offered by national retailers Meijer, Walgreens and CVS, as well as their own local pharmacies that offer this service.
Priority Health is expanding its existing $0 copay telehealth to include all lines of business through April 30. All of the company’s nearly 1 million members across commercial, individual, Medicaid and Medicare plans will now have virtual access to medical professionals for non-emergency care, at no additional cost.
Prominence Health Plan is providing members telehealth services through Teladoc with zero-dollar copays.
Providence Health Plan has extended the cost sharing waiver for COVID-19 treatment through December 31, 2020. This applies to in-network inpatient, outpatient, facility, and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan.
Providence Health Plan has extended the waiver for all cost sharing payments for COVID-19 treatment through Aug. 31, 2020.
Providence Health Plans has extended the waiver for all member cost sharing for COVID-19 treatment until June 30. This applies to in-network inpatient, outpatient, facility and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan.
Providence Health Plans is waiving cost sharing for commercial insured members for COVID-19 treatments for in-network inpatient, outpatient, facility, and professional visits.
Providence is taking the initiative to help ensure healthcare workers have the necessary personal protective equipment (PPE), and to provide vulnerable populations with soap and disinfectant to help
Providence expanded its health plan premium payment grace period for commercial groups so members can continue to receive care and medications during this time of uncertainty. Providence is also allowing commercial groups to maintain coverage for their furloughed employees at the group premium rate.
Providence has waived all cost sharing for testing services related to COVID-19, such as copays, coinsurance, and deductibles.
Providence significantly expanded telehealth provider policies to reduce barriers to care and to encourage the use of telehealth services by members and provider partners. Providence has also added virtual capacity so that more providers can be seen quickly.
Providence’s clinical pharmacists are monitoring the supply chain to anticipate and address any potential drug shortages, and are promoting 90-day supply of maintenance medications, early refills when appropriate, and mail delivery to support staying at home as well as extending prior authorization approval dates up to 90 days to enhance access to medication when appropriate.
Providence quickly developed and implemented a coronavirus assessment tool to help communities assess their symptoms in real time.
Providence’s labs began testing for coronavirus early on, becoming the first hospital system in the state to offer in-house lab analysis and increasing the community’s testing capacity.
Providence Health Plan is waiving cost sharing for COVID-19 treatment for service dates beginning April 1 through May 31, 2020. This applies to in-network inpatient, outpatient, facility and professional visits. This change is applicable for all members on an individual and family plan, small group fully insured plan and large group fully insured plan.
Providence Health Plan is proactively taking action to ensure continuity of coverage – so members can continue to receive care and medications during this time of uncertainty.
- If an employer group has furloughed or laid off employees, Providence will continue to cover those employees contingent on payment of premium by the employer. This means that normal minimum hour requirements will be waived. COBRA may be an option for some of those employees, but this “premium continuation” approach may provide additional stability in the event employers are willing to participate in hopes that they may be able to resume business in the near term.
- People who purchase individual plans through the federal marketplace and who receive an advance premium tax credit will continue to receive a 90-day grace period, established by federal law that we will continue to follow without adjustment.
- Providence will grant a 30-day extension for the following people that are unable to pay some or all of their premium:
- People who purchase individual plans through the federal marketplace and who do notreceive an advance premium tax credit
- People who purchase individual plans direct (not through the federal marketplace)
- Fully-insured employer group plans (small and large)
Providence Health Plan is waiving all cost sharing for testing services related to COVID-19, such as copays, coinsurance, and deductibles.
Piedmont Community Health Plan
Piedmont Community Health Plan’s waiver of out-pocket members costs for telehealth services has been extended through Dec. 31, 2020.
Piedmont’s waiver of out-of-pocket costs for COVID-19 testing has also been extended through Dec. 31, 2020.
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.
QualChoice Health Insurance in partnership with its parent company Centene Corporation, will be purchasing Walmart gift cards for distribution to Arkansans in need to use on essential items. QualChoice will deliver the cards to local providers and other community resources for distribution to individuals in need. The Walmart gift cards will have a value of $35 and can be used to purchase essential healthcare and educational items, including diapers, over-the-counter medicines, cleaning supplies and books.
QualChoice is also providing additional resources to communities across Arkansas. Through partnerships with local organizations such as the Arkansas Food Bank, Healthy Connections, Hoover Treatment Center, Lucie’s Place and others, QualChoice is working to provide food and essential resources to those who need it most.
QualChoice Health Insurance will cover COVID-19 testing without any copay, cost sharing, or pre-authorization.
There is also no cost sharing for telehealth services, and no prior authorization is required through June 30.
Quartz Health Solutions has waived out-of-pocket costs for testing related to COVID-19. Office visits and services associated with testing for COVID-19 will be covered with no out-of-pocket costs.
Quartz is offering telehealth, video visits, virtual visits, and e-visits with Quartz providers with no out-of-pocket costs. These benefit enhancements are being offered through December 31, 2020 and apply to Quartz’s Commercial lines of business and members enrolled in a HDHP or HSA plan. Note: Self-insured plan sponsors may opt-in to these enhancements at their discretion.
Quartz has waived cost-sharing for inpatient hospitalizations at all in-network facilities for treatment related to COVID-19. This benefit enhancement is being offered through October 22, 2020 and applies to Quartz’s Commercial lines of business. These services are also covered for both in and out-of-network providers for Quartz Medicare Advantage members as directed by CMS through the Public Health emergency.
Quartz is allowing earlier access to prescription drugs. For non-maintenance prescriptions, members can refill prescriptions 22 days before they should be needed based on the date of their last claim. For maintenance prescriptions eligible for a 90-day supply, members can refill prescriptions 30 days before they should be needed based on the date of their last claim. These benefit enhancements are being offered until further notice and apply to Quartz’s Commercial lines of business. Quartz’s Medicare Advantage members also have access to early refills, without limits, through the duration of the public health emergency.
Please visit Quartz’s dedicated COVID-19 page for updates to benefits, FAQ documents, and more.
Quartz has waived out-of-pocket costs for testing related to COVID-19. Office visits and services associated with testing for COVID-19 will be covered with no out-of-pocket costs.
Quartz is offering telehealth, video visits, virtual visits, and e-visits with Quartz providers with no out-of-pocket costs. These benefit enhancements are being offered through July 31, 2020 and apply to Quartz’s Commercial lines of business and members enrolled in a HDHP or HSA plan. Note: Self-insured plan sponsors may opt-in to these enhancements at their discretion.
Quartz has waived cost-sharing for inpatient hospitalizations at all in-network facilities for treatment related to COVID-19. This benefit enhancement is being offered through July 31, 2020 and applies to Quartz’s Commercial lines of business. These services are also covered for both in and out-of-network providers for Quartz Medicare Advantage members as directed by CMS through the Public Health emergency.
Quartz is allowing earlier access to prescription drugs. For non-maintenance prescriptions, members can refill prescriptions 22 days before they should be needed based on the date of their last claim. For maintenance prescriptions eligible for a 90-day supply, members can refill prescriptions 30 days before they should be needed based on the date of their last claim. These benefit enhancements are being offered until further notice and apply to Quartz’s Commercial lines of business. Quartz’s Medicare Advantage members also have access to early refills, without limits, through the duration of the public health emergency.
Regence BlueShield of Idaho is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills.
Regence BlueShield of Idaho’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January.
Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states.
Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020.
In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members.
Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year.
MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools.
Regence BlueShield of Idaho will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020.
Regence BlueShield of Idaho will cover the cost of coronavirus testing without any out-of-pocket costs for fully insured members. Regence is working with federal officials to ensure coordination of benefits for Medicare members and those with health savings accounts (HSA). Regence is also easing access through virtual care, as well as access to regularly prescribed medications.
Regence BlueCross BlueShield of Oregon
Regence BlueCross BlueShield of Oregon is providing $2 million in financial relief through a one-time premium credit to its members enrolled in a Medicare Advantage (MA) PPO plan. The credit amount will either be applied to eligible members’ October premium bill or sent as a printed check in September. This follows a one-time credit totaling $35 million that Regence health plans issued in August 2020 to select fully insured group and individual customers across Washington, Oregon, Idaho and Utah.
Regence BlueCross BlueShield of Oregon is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills.
Regence BlueCross BlueShield of Oregon’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January.
Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states.
Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020.
In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members.
Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year.
MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools.
Regence BlueCross BlueShield of Oregon will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020.
Regence BlueCross BlueShield of Oregon is covering COVID-19 testing at no cost, easing access to virtual care, easing access to regular prescription drugs, and proactively reaching out to high-risk members.
Regence BlueCross BlueShield of Utah
Regence BlueCross BlueShield of Utah is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills.
Regence BlueCross BlueShield of Utah’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January.
Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states.
Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020.
In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members.
Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year.
MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools.
Regence BlueCross BlueShield of Utah will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020.
Regence BlueCross BlueShield of Utah will cover the cost of coronavirus testing without any out-of-pocket costs for fully insured members. Regence is working with federal officials to ensure coordination of benefits for Medicare members and those with health savings accounts (HSA). Regence is also easing access through virtual care, as well as access to regularly prescribed medications.
Regence BlueShield of Washington
Regence BlueShield of Washington is providing $2.4 million in financial relief through a one-time premium credit to its Washington members enrolled in a Medicare Advantage (MA) PPO plan. The credit amount will either be applied to eligible members’ October premium bill or sent as a printed check in September. This follows a one-time credit totaling $35 million that Regence health plans issued in August 2020 to select fully insured group and individual customers across Washington, Oregon, Idaho and Utah.
Regence BlueShield of Washington is providing up to $35 million in financial relief to commercial health plan customers in its four-state footprint through a premium credit. Select fully insured group and individual Regence health plan customers across Idaho, Oregon, Utah and Washington will receive a credit for a portion of their health care premium on upcoming bills.
Regence BlueShield of Washington’s telehealth claims are up 4900 percent during the COVID-19 crisis. In January, Regence saw an average of 1,000 telehealth visits a week. In May, that average was more than 50,000 visits a week. Primary and specialty care are making up half of all telehealth utilization for Regence members, up from about 20% in January.
Members across Regence’s four-state region who received behavioral health care before the COVID-19 crisis successfully switched to virtual care options to ensure their continued care from the earliest days of physical distancing. This included 87% of members in Washington, 85% in Oregon, 85% in Idaho, and 82% in Utah, averaging to 85% across the four states.
Regence has also extended coverage for coronavirus (COVID-19) treatment without any out-of-pocket costs for fully insured members through December 31, 2020.
In addition, Regence will continue paying providers for virtual care services at the same rate as in-person visits through September 2020 to help ease member access and support providers experiencing financial challenges. Diagnostic testing also remains covered at no cost to members.
Regence is offering health plan members free access to COVID-19 and mental wellness resources powered by myStrength, a digital behavioral health app, through the end of the year.
MyStrength from Livongo for Behavioral Health provides interactive, activity-based modules designed to manage heightened stress and feelings of social isolation stemming from the current COVID-19 crisis. Through year-end, Regence’s fully-insured and self-funded members will have complementary access to myStrength’s COVID-19 and Mental Wellness resources, which include stress-management strategies, tips for parenting during challenging times, ideas to manage feelings of social isolation, and other emotional support tools.
Regence BlueShield of Washington will cover treatment for coronavirus (COVID-19) without any out-of-pocket costs for fully insured members through June 30, 2020.
Regence BlueShield of Washington is covering COVID-19 testing at no cost, easing access to virtual care, easing access to regular prescription drugs, and proactively reaching out to high-risk members.
Sanford Health Plan is waiving all cost-sharing payments for COVID-19 treatment through Sept. 30, 2020. Sanford is also waiving all co-pays for telehealth care through Sept. 30, 2020.
Sanford Health Plan has deployed a test for COVID-19 that can deliver results within 90 minutes. These rapid tests will be used for the highest priority patients, including those who are hospitalized, health care workers and elderly adults living in long-term care facilities, and are available in Sioux Falls, South Dakota, and Fargo, North Dakota.
Sanford Health Plan will cover 100% of the cost of specimen collection and testing for COVID-19. Testing is covered when indicated as medically necessary by a qualified practitioner. Sanford will also cover office visits and ER visits at 100% when related to COVID-19 testing. Sanford Health Plan is also extending prior authorizations an extra 90 days for all existing maintenance prescriptions with prior authorizations that will expire in 90 days or fewer.
SCAN Health Plan
SCAN Health Plan has launched the first phase of artificial intelligence (AI) based predictive models designed to improve health outcomes and inform benefit and service design. This implementation will improve SCAN’s ability to identify high-needs members and provide tailored interventions to help avoid or reduce hospitalizations.
SCAN Health Plan has launched Rally®, an interactive member engagement platform from digital health company Rally Health, Inc. Working in collaboration with Rally, SCAN is offering its members a digital solution that enables them to engage in online social communities, set and meet wellness goals, and get information about the health topics of interest to them.
The introduction of an online interactive experience for health, wellness, and social connectivity comes as seniors’ lives have been impacted significantly by the COVID-19 pandemic. Sheltering in place has forced many to become more familiar with tech platforms for everything from doctor’s appointments to ordering groceries to staying in touch with loved ones.
SCAN Health Plan is waiving copayments for primary care doctor visits, or members of their staff like a physician assistant or nurse practitioner, through Dec. 31, 2020. This includes in-person visits, as well as those done over the telephone or virtually through a computer or smart phone.
SCAN is also waiving copayments for outpatient visits with behavioral health professionals through Dec. 31, 2020.
SCAN Health Plan is committing $5.1 million to address a variety of needs for vulnerable seniors and others at risk due to the effects of the COVID-19 pandemic.
The emergency funding will address:
- Delivery of additional services to seniors in need of nutritious meals and other essential supplies;
- Additional financial support to non-profit, senior-focused organizations and provider groups in addition to the nearly $350,000 in COVID-19-related funding SCAN has already provided to such groups; and
- Assistance for SCAN employees most impacted by current circumstances.
SCAN Health Plan is supporting California Governor Gavin Newsom’s “Stay Home. Save Lives. Check In.” campaign, which is aimed at combatting social isolation and food insecurity among those 65 and older.
SCAN has launched an employee “all hands” effort, proactively calling members to make sure they have what they need to stay healthy at home, focusing first on those who are:
- High-risk, such as those on oxygen or who are homebound
- Socially isolated, because they live alone or don’t have a support system
SCAN is also providing emergency funding for nonprofits serving seniors, including, to date, an additional $330,000 to 14 organizations—most of which are delivering meals and other necessary supplies.
SCAN Health Plan has provided $200,000 in emergency funding for nonprofits to help them respond to demand for their services due to the COVID-19 pandemic. SCAN has also adapted many of their community services from in-person to telephonic, including clinical programs for seniors and caregivers and many volunteer efforts.
Security Health Plan is issuing premium rebates to its fully insured employer clients and waiving cost sharing for its individual consumer clients. These efforts are in response to the historic reductions in people seeking medical care in April and May due to the COVID crisis.
Security Health Plan will refund 10% of the April premium and 5% of the May premium to fully insured employer customers.
Security Health Plan will also waive cost sharing for Medicare Advantage and Affordable Care Act Individual and Family Plan primary and specialty office visits beginning August 1 and continuing through the end of 2020.
SelectHealth is covering in-network testing and treatment for COVID-19. There is no member cost-sharing; no copays, coinsurance or deductibles. Medications administered as part of a hospital stay for COVID-19 are also covered 100%.
SelectHealth offers Connect Care, the telemedicine benefit administered through Intermountain Healthcare, at a $0 copay before deductible, for HDHP plans when care is related to COVID-19 evaluation and treatment.
Here is a list of preferred COVID-19 testing facilities in Utah and Idaho.
Sendero Health Plans has waived all costs to its members for treatment of COVID-19 with in-network providers. Sendero has also waived copayments for in-network doctor visits and lab costs to screen for the disease.
Sentara Healthcare is partnering with local health departments, Urban League and NAACP chapters, community organizations and faith groups to provide free coronavirus testing in minority communities Sentara serves across Virginia and in northeast North Carolina. These may include African-American and Hispanic neighborhoods, LGBTQ persons, homeless persons and others without ready access to testing.
Sentara Healthcare has started providing drive-thru screening and testing at three locations for those who are concerned they may have coronavirus (COVID-19).
Sharp Health Plan has extended its waiver for out-of-pocket costs for all COVID-19 diagnostic treatment through September 30, 2020.
Sharp Health Plan has also waived out-of-pocket costs for all COVID-19 treatment received Apr. 1 through May 31, 2020 for members diagnosed with COVID-19.
Sharp Health Plan will waive the cost-share for all medically necessary screening and testing for COVID-19. This includes hospital (including emergency department), urgent care, provider office visits, and telehealth appointments for the purpose of screening and/or testing for coronavirus.
SummaCare is waiving any co-pays and deductibles related to provider-ordered testing of COVID-19 for Medicare Advantage, Individual and Commercial members regardless of where the test is ordered and performed. Self-insured plans will determine how their coverage will apply.
Superior HealthPlan will cover the cost of medically necessary COVID-19 tests, screenings, associated physician’s visit(s) and/or treatment for most members. If applicable, copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing, medical screening services and/or treatment.
Superior will not require prior authorization, prior certification, prior notification and/or step therapy protocols for medically necessary COVID-19 diagnostic testing, medical screening services, and/or treatment when medically necessary services are ordered and/or referred by a licensed health care provider. Any medically necessary treatment related to COVID-19 would be considered a covered benefit.
Superior HealthPlan is providing additional mental health resources to Texas residents impacted by the COVID-19 crisis. Through a series of partnerships, Superior will enable providers to better support communities that are experiencing elevated levels of stress caused by an increase in grief, loss, economic pressure, unemployment or social isolation.
As part of this effort, Superior is taking the following steps:
- Collaborating, in partnership with its parent company Centene Corporation, the Allegheny Health Network, and the CARES Institute at Rowan University to fund virtual Trauma-Focused Cognitive Behavioral Therapy training cohorts. This is an evidence-based treatment for providers for the impact of traumatic experience on child and adolescent mental health.
- Donating to the National Council for Behavioral Health’s COVID-19 Relief Fund, specifically for the provision of Mental Health First Aid, ensuring a long-term impact beyond the current pandemic. MHFA teaches people to identify, understand and respond to someone who might be experiencing a mental health crisis, such as suicidal thinking or misusing substances. Superior’s support will provide greater access to MHFA virtual trainings, helping more individuals support someone experiencing mental health and substance use challenges at this critical time.
Superior Healthplan is contributing a total of $100,000 to 9 organizations that support the disability community affected by the COVID-19 crisis. This includes funding to 6 organizations that will establish a Hygiene Closet to improve the health and well-being of the individuals they serve. These closets will be stocked with a variety of items, including personal protective equipment, toiletries, laundry baskets and detergents, and other items that can support people who have disabilities.
Sutter Health Plus will waive the cost-share for telehealth visits for covered services from April through the end of December 2020.
Sutter Health Plus will waive the cost-share for covered services related to COVID-19 treatment from February through the end of September 2020. This includes, but is not limited to, PCP office visits, urgent care visits, emergency department visits, inpatient hospital stays, telehealth visits, and lab tests. Members are responsible for the appropriate cost-shares for outpatient prescription drugs.
Sutter Health Plus will waive the cost share for covered services related to screening and testing for COVID-19.
TakeCare is providing coverage for the COVID-19 test and associated visit under the preventive care benefit, at no cost to members, when using in-network providers provided these tests and visits are not covered by the Public Health System. TakeCare is also allowing for early medication refills for an additional 30 days for members who meet criteria.
The Blue Cross and Blue Shield Federal Employee Program
The Blue Cross and Blue Shield Federal Employee Program will waive any copays or deductibles for medically necessary diagnostic tests or treatment if a member is diagnosed with COVID-19. It will waive prior authorization requirements for tests and treatment. It will eliminate cost sharing for prescriptions for up to a 14-day supply, and waive copays for telehealth services related to COVID-19.
The Health Plan will cover the cost of copays, co-insurance and deductibles for COVID-19 testing for Commercial, Medicare and Medicaid members when recommended by a medical professional.
The Health Plan is also waiving cost sharing where applicable for telemedicine visits for the next 90 days.
Trillium Health Plan will cover the cost of COVID-19 tests and the associated physician’s visit when medically necessary diagnostic testing or medical screening services are ordered and/or referred by a licensed health care provider. If applicable, your plan’s copayment, coinsurance and/or deductible cost-sharing will be waived for medically necessary COVID-19 diagnostic testing and/or medical screening services.
Trusted Health Plan will cover all medically necessary services required to facilitate testing and treatment of COVID-19 for its eligible enrollees, in accordance with federal and state guidance. No prior authorization is required for COVID-19 testing.
Tufts Health Plan Foundation board has approved an additional $900,000 to support recovery and rebuilding efforts addressing the effects of the coronavirus pandemic in Massachusetts, Rhode Island, New Hampshire and Connecticut. The Foundation’s commitment to COVID-19 response now reaches nearly $2 million.
Tufts Health Plan Foundation announced $170,000 in grants to 10 nonprofit organizations, part of the $1 million it committed to support community efforts addressing coronavirus in Massachusetts, Rhode Island, New Hampshire and Connecticut. In total, 49 organizations on the front lines of the pandemic have received funding.
This funding goes to organizations working to improve access to food and respond to inequities in housing and services. It bolsters collaborative regional responses, particularly in communities reporting the highest rates of COVID-19 infection.
Tufts Health Plan has launched an Employee Relief Fund to support employees who have been affected by the coronavirus pandemic and are experiencing financial hardship, including the loss of a job by someone in their household. Eligible employees can apply for $1,000 grants to cover essential living expenses, such as rent or mortgage, utilities and certain medical costs.
Tufts Health Plan Foundation has made grants to five diverse community organizations to help them address the COVID-19 crisis. The organization range from helping the homeless to supporting veterans and LGBTQ+ youths. Each organization will receive $10,000.
Tufts Health Plan Foundation is providing funding to 18 additional nonprofit organizations as part of the $1 million it has committed to support community efforts on behalf of older people affected by the coronavirus. This second wave of funding, totaling $345,000, focuses on housing and equity efforts in Massachusetts, Rhode Island, New Hampshire and Connecticut.
The organizations include housing providers, those working with people experiencing homelessness and immigrant communities, and several serving as hubs for collaborative regional responses.
Tufts Health Plan is waiving treatment costs for its members suffering from the coronavirus, including copays, deductibles and coinsurance. This coverage applies at in-network providers, urgent care centers, emergency rooms and other facilities, and at out-of-network providers in the event a member cannot easily find an in-network provider to provide timely services.
Tufts has also eliminated out-of-pocket costs for telehealth visits and removed prior authorization requirements for providers as it relates to treatment and care of coronavirus.
Tufts Health Plan Foundation is donating $1 million to efforts driven by community and nonprofit organizations supporting older people affected by the coronavirus outbreak in Massachusetts, Rhode Island, New Hampshire and Connecticut.
UCare is waiving copays, coinsurance and deductibles when members receive in-network, inpatient hospital services to treat COVID-19 through September 2020.
UCare is reducing member premium payments by 20% in July and August of 2020.
UCare is also:
- Removing copays for Medicare primary care and mental health clinic services – including telehealth – during the COVID-19 public health emergency
- Continuing to waive copays, coinsurance and deductibles for COVID-19 tests and associated clinic, urgent care and emergency room visits
- Continuing to waive copays, coinsurance, deductibles for COVID-19 inpatient hospitalizations through September 2020
- Supplying health care providers, group homes, nursing homes, assisted living facilities, social service organizations and vulnerable members with telehealth home kits, masks, healthy snack boxes and iPads
- Offering $25,000 grants to small provider groups and community clinics to build infrastructure during COVID-19
The UCare Foundation is providing $500,000 in short-and long-term assistance to benefit Minnesotans impacted by COVID-19. The funds support needs related to social isolation, telehealth, food insecurity and personal protective equipment. The UCare Foundation is a community-directed initiative focused on supporting innovative services, education, community outreach, and research that improve health.
UCare is covering coinsurance, copays, and deductibles for members who receive in-network hospital services to treat COVID-19 through May 31, 2020. UCare will continue to track the situation and determine whether to extend this coverage beyond May 31.
UCare will waive all copays, coinsurance or deductibles for doctor-ordered COVID-19 testing in all of its plans. UCare is also covering copays, coinsurance or deductibles for medically necessary clinic and urgent care services received at the visit when a COVID-19 test is administered at an in-network clinic, and at out-of-network clinics if in-network alternatives are not available.
UniCare will cover COVID-19 treatment with no copays or cost-sharing through December 31, 2020, as long as members receive treatment from doctors, hospitals, and other health-care professionals in their plan’s network.
UniCare is also covering telehealth visits with doctors and health-care professionals at no cost to members through Sept. 13, 2020.
UniCare Health Plan of West Virginia
UniCare Health Plan of West Virginia and its Foundation announced $134,000 in grants to community-based organizations to support health care workers and first responders, access to food and shelter for the homeless, and other vital community needs and resources.
The grants are being provided to several community-based organizations in West Virginia, and are part of UniCare Health Plan of West Virginia and its Foundation’s commitment to the whole health of individuals and families.
These efforts are part of UniCare’s coordinated response to COVID-19 for members, local community organizations, health care workers, and frontline responders. UniCare Health Plan has also provided ongoing member support for those that may have an increased need during this crisis, including those high-risk members impacted by immunosuppression, chronic conditions, or social isolation. These virtual check-ins assess if members need assistance addressing areas such as medical attention, telehealth access, medications, food insecurity, or isolation.
UnitedHealthcare will continue to waive all cost-sharing for COVID-19 testing-related visits, testing, and treatment, as well as telehealth coverage for COVID-19 related services, through October 22, 2020.
UnitedHealth Group and Microsoft Corp. have joined forces to launch ProtectWell™, an innovative return-to-workplace protocol that enables employers to bring employees back to work in a safer environment. ProtectWell™ helps employees determine they are safe to go to work, co-workers know their colleagues have been screened, and employers feel confident that their workplace is ready to do business. ProtectWell™ incorporates Centers for Disease Control and Prevention (CDC) guidelines and the latest clinical research to limit the spread of COVID-19 by screening employees for symptoms and establishing guidelines to support the health and safety of the workforce and workplace.
ProtectWell™ combines UnitedHealth Group’s clinical and data analytics capabilities with Microsoft’s technology leadership to help in the next phases of COVID-19 recovery efforts.
UnitedHealthcare is providing $1.5 billion in additional support for its customers. Actions taken to deliver the support include:
- Applying credits to premium billings received by June for people served by UnitedHealthcare commercial fully insured benefits. The credits will range from 5% to 20%.
- All specialist and primary care physician cost sharing will be waived at least through the end of September for people served by UnitedHealthcare under Medicare Advantage plans.
- Providing both new and renewal premium price stability and support for people served by UnitedHealthcare AARP Medicare Supplement policies.
- Accelerating funds to state partners and critical care providers to serve more people and expanding its Housing+Health and homeless support programs, providing shelf stable food and baby formula for people served by UnitedHealthcare Medicaid plans.
UnitedHealthcare Group is donating $5 million to support a federally sponsored program seeking to accelerate and expand the availability of investigational convalescent plasma treatments for COVID-19 patients nationwide. The initiative, led by Mayo Clinic, coordinates efforts to collect blood plasma from donors who have recovered from COVID-19 and distribute the plasma to hospitalized patients with severe or life-threatening COVID-19 infections.
UnitedHealth Group has been asked to assist the U.S. Department of Health and Human Services in distributing, as directed by the Department, an initial $30 billion in emergency funding to health care providers seeking assistance under the CARES Act.
UnitedHealth Group, through UnitedHealthcare and Optum, is taking steps immediately to accelerate nearly $2 billion in payments and other financial support to health care providers in the U.S. to help address the short-term financial pressure caused by the COVID-19 emergency.
UnitedHealth Group’s move to accelerate claim payments to medical and behavioral care providers applies to UnitedHealthcare’s fully insured commercial, Medicare Advantage and Medicaid businesses. Other financial support currently includes the provision for up to $125 million in small business loans to clinical operators with whom OptumHealth is partnered.
UnitedHealthcare is waiving member cost sharing for the treatment of COVID-19 through May 31, 2020 for its fully insured commercial, Medicare Advantage, and Medicaid plans.
Starting March 31, 2020 until June 18, 2020, UnitedHealth will also waive cost sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, and fully insured individual and group market health plans.
UnitedHealthcare is also opening a special enrollment period for some of its existing commercial customers beginning March 23 through April 6 due to the COVID-19 pandemic. UnitedHealthcare is also suspending prior authorization requirements to a post-acute care setting through May 31, and suspending them when a member transfers to a new provider through May 31.
UnitedHealthcare is waiving costs for COVID-19 testing provided at approved locations in accordance with the CDC guidelines, as well as waiving copays, coinsurance and deductibles for visits associated with COVID-19 testing, whether the care is received in a physician’s office, an urgent care center or an emergency department. This coverage applies to Medicare Advantage and Medicaid members as well as commercial members. United is also expanding provider telehealth access and waiving member cost sharing for COVID-19 testing-related visits.
University Health Alliance is covering 100% of the cost for all services related to the diagnosis of COVID-19. For inpatient hospitalizations, UHA is paying 100% of the UHA eligible charge. Member co-pays, coinsurance and deductibles will be waived.
University Health Alliance is also covering all telehealth access at 100% of eligible charges with no copay for any telehealth service for the duration of the COVID-19 state of emergency—regardless of the primary purpose of the visit.
UPMC Health Plan is providing parents with increased flexibility to meet the physical and emotional health care needs of their children as the new school year begins.
UPMC Health Plan encourages parents to resume routine well-visits for their children’s’ annual physicals and checkups, and is working with the pediatricians in its network to ensure that they are prepared to provide well-visits during the COVID-19 crisis in three ways: i) in-person visits, ii) virtual well-visits, and iii) split visits, with the first visit being a virtual well-visit and the second visit being an in-person visit, primarily for flu shots and immunizations. By providing this flexibility, UPMC Health Plan is ensuring that children are receiving continued care with their existing providers.
UPMC Health Plan encourages members to reach out to their providers to discuss the availability of virtual well-visits at each site. For individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, UPMC for Kids, UPMC for You, and individual ACA Marketplace plans, virtual pediatric well-visits are being offered through December 31, 2020. Well-visits are always no cost for individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, UPMC for Kids, UPMC for You, and individual ACA Marketplace plans.
UPMC Health Plan is waiving all deductibles, coinsurance, and copays for in-network, inpatient COVID-19 treatment for members through September 30.
UPMC Health Plan has launched a new initiative—Pathways to Work—that aims to increase access to employment through training, education, and dedicated support from UPMC staff. This program is administered through the UPMC Center for Social Impact, and it aggregates UPMC Health Plan’s existing workforce development and employment efforts, creates and scales new partnerships and programs, and connects individuals to employment opportunities at UPMC and other Pennsylvania employers.
The program has taken on a new urgency because of the COVID-19 pandemic. According to the Pennsylvania Department of Labor and Industry, more than 2 million Pennsylvanians have filed initial jobless claims since the pandemic began in March. To meet the increased need for employment services, human resource professionals are available to support UPMC Health Plan members who have lost their jobs and are seeking new career opportunities. Members can contact a talent acquisition specialist who can connect them with resources and opportunities through UPMC Health Plan customer service, or they can email pathwaystowork@upmc.edu and receive a response within two days.
UPMC Health Plan is extending $0 cost-sharing for all covered telehealth services through September 30, 2020.
With UPMC Health Plan’s commitment to remove financial barriers that could discourage members from seeking telehealth services, including through UPMC AnywhereCare, members will not face deductibles, copayments, or cost-sharing of any kind for in-network virtual visits with a health care provider, including primary care physicians, specialists, and both physical and occupational therapy. This extension until September 30, 2020, applies to individuals enrolled in UPMC Health Plan’s fully-insured commercial group coverage, individual ACA Marketplace plans, and UPMC for Life Medicare Advantage plans, as well as self-insured employer group plans that opt into this coverage.
UPMC is waiving all deductibles, co-insurance and co-pays for all in-network, inpatient COVID-19 treatment for its members enrolled in fully-insured group, ACA and Medicare Advantage plans, as well as in self-insured employer group plans that opt in to this coverage. This policy change is effective immediately and will stay in effect through June 15, 2020.
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.
UPMC Health Plan is waiving all member cost sharing payments for all in-network virtual health care visits with UPMC telehealth providers. The waiver lasts until June 15, 2020.
UPMC is also waiving early refill limits on medications filled at retail and specialty pharmacies until June 15, 2020.
UPMC is also working with a bank to help small businesses find available loans from state or federal programs.
Upper Peninsula Health Plan is waiving all costs associated with any diagnostic laboratory tests for COVID-19, when used in accordance with Centers for Disease Control and Prevention (CDC) testing recommendations.
Upper Peninsula is also waiving prior authorizations for diagnostic tests and for covered services related to COVID-19 that are medically necessary and in accordance with CDC guidelines.
Copays for telehealth services are also being waived for the next 90 days.
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.
Viva Health announced that if a member requires hospitalization for the treatment of COVID-19, inpatient hospital treatment will be covered at 100% on all Viva Health fully insured plans through September 30, 2020.
Viva Health will cover FDA-approved lab testing from a participating/in-network reference lab (Labcorp or Quest), as well as the Alabama Department of Public Health. No deductible, copayment, or coinsurance will apply to the lab test, and prior authorization is not required. Members can have telehealth visits from any location with any in-network physician, nurse practitioner, or physician assistant who offers this service. Members will not have a copayment for telehealth visits with their local provider for the next 30 days.
If a member requires hospitalization for the treatment of COVID-19, inpatient hospital treatment will be covered at 100% on all Viva Health fully insured plans through September 30.
WEA Trust will waive cost sharing, including co-pays, coinsurance and deductibles, for the COVID-19 test. In addition, it will not require pre-authorization for medical services related to the testing for COVID-19.
WellCare
WellCare has partnered with Shipt, a same-day delivery service, to help Medicare Advantage members safely and conveniently access groceries and everyday essentials throughout 2020, providing them with a critical service during the COVID-19 crisis.
WellCare is providing low-income and special needs plan members in select WellCare, WellCare TexanPlus and ‘Ohana Medicare Advantage plans with free, monthly Shipt memberships for the remainder of 2020.
With this benefit, members can have groceries and essentials delivered from a number of retailers directly to their homes through their Shipt account, which not only helps them easily obtain the essentials they need, but also helps reduce possible exposure to the virus by eliminating their need to go to the grocery store. The benefit, which is subject to availability, is being offered to more than 200,000 members across 23 states.
WellCare of North Carolina, a subsidiary of Centene Corporation, is partnering with community-based organizations and other programs across the state to provide access to food and other essential supplies.
WellCare of North Carolina has donated $40,000 directly to local food pantries and community partners across the state. The donation will help increase access to food support initiatives that serve vulnerable populations in high-need areas due to the COVID-19 pandemic.
WellCare also purchased nearly $35,000 worth of Walmart gift cards to support vulnerable populations in the community who are in need of food, supplies and support during the COVID-19 pandemic. Each gift card holds a value of $35 and can be used to purchase essential items like diapers, over-the-counter medicines, and cleaning supplies.
WellCare of South Carolina will award grants up to $1,500 to local community partners through its Community Connections Resource Grant (CCRG) process to help support those affected by the novel coronavirus (COVID-19). The goal of the grant process is to identify local, community-based organizations that are creating innovative solutions to address social service barriers affecting vulnerable populations due to the COVID-19 pandemic.
To qualify, an organization must address the following social service areas:
- Food access
- Financial assistance
- Transportation
- Medication assistance
- Homelessness/housing
WellCare of Georgia will award grants up to $1,500 to local community partners through its Community Connections Resource Grant process to help support those affected by the novel coronavirus (COVID-19). The goal of the grant process is to identify local, community-based organizations that are creating innovative solutions to address social service barriers affecting vulnerable populations due to the COVID-19 pandemic.
WellCare, which was acquired by Centene on Jan. 23, is covering Medicaid, Medicare and Marketplace members’ coronavirus testing, screening and treatment.
Wellmark Blue Cross and Blue Shield
Wellmark Blue Cross and Blue Shield will continue to waive cost-sharing for members undergoing inpatient treatment related to a COVID-19 diagnosis through Dec. 31, 2020. Extension of the waiver, which was scheduled to expire Aug. 31, 2020, provides Wellmark members with ongoing relief from copays, coinsurance, and deductibles for inpatient treatment of COVID-19 from an in-network health care provider.
Wellmark will also continue to cover appropriate testing and related services — with no cost-share — to establish the diagnosis of COVID-19 as required by the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act through the public health emergency, as declared by the federal government.
Wellmark Blue Cross and Blue Shield has seen virtual visits for behavioral health increase by more than 3,000% since March, when the company began encouraging members to use telehealth to help mitigate the spread of COVID-19. Most of the virtual visit claims received have been for existing patients seeking to continue their behavioral health services.
Wellmark Blue Cross and Blue Shield is extending the same reimbursement fee to Iowa providers for virtual visits as is paid for in-person visits until Feb.1, 2021. This applies to all appropriate medical and behavioral health virtual visits with any Wellmark in-network provider in Iowa.
Wellmark Blue Cross and Blue Shield will extend its previously announced COVID-19 benefits through Aug. 31, 2020. The benefits include member cost-share waivers for COVID-19 testing and treatment, virtual visits, and support for business customers. The extension also includes payment parity for providers of virtual health care visits. Without the extension, Wellmark’s COVID-19 coverage benefits would have expired on June 16, 2020.
Wellmark Blue Cross and Blue Shield will waive members’ cost-share related to the treatment of COVID-19 (copay, coinsurance and deductible) when seeking care from an in-network provider, effective Feb. 4 through at least June 16, 2020.
Wellmark Blue Cross and Blue Shield is offering virtual health care visits for all appropriate medical and behavioral health visits at no cost to members until June 16. Those who do not currently have a provider can use an in-network provider through Doctor on Demand. Telephonic visits are also permitted when audio/visual capabilities are not accessible. Wellmark is covering diagnostic testing for COVID-19 at no cost-share to members. It permits early refills of prescription medications. Wellmark’s BeWell 24/7 service is available to members to help them connect on various health concerns.
Western Health Advantage is waiving all treatment costs associated with COVID-19 care in an effort to alleviate any unnecessary stress or out-of-pocket costs to impacted members. This includes copayments and deductibles, if applicable, for office visits and hospitalization, for services related to the treatment of COVID-19. This relief will apply for any treatments from February 2020 until the end of September 2020.
Western Health Advantage will waive all cost-sharing for medically necessary screening and testing for COVID-19, including hospital/emergency room, urgent care, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.
West Virginia Association of Health Plans
The West Virginia Association of Health Plans announced that managed care organizations that manage West Virginia’s Medicaid program will temporarily remove all prior authorization/service authorization requirements for all covered medical services for out-of-network and in-network providers.
An additional measure will extend the time period for patients to remain in residential substance abuse disorder treatment facilities.
WPS Health Insurance is waiving copays for telehealth services for any condition provided by Teladoc providers and other preferred providers. The waiver will go through Dec. 31, 2020, but does not apply if a customer has an HSA-qualified HDHP.
WPS will waive any cost-sharing for laboratory tests related to COVID-19. WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers.
