Health Insurers’ Coronavirus Coverage

Thankfully, modern medicine has progressed in remarkable ways over the past century since the so-called Spanish Influenza that began in 1918 and killed between 17 to 50 million people (record keeping and data from then is limited), including upwards of 650,000 here in the United States. The World Health Organization estimates that 30% of our population was infected and that between 2-3% of those infected died. According to John Barry, author of 2004’s The Great Influenza: The Epic Story of the Greatest Plague in History, more people died from the 1918 influenza over a 24 week period than were sadly killed by HIV/AIDS over 24 years. By any measure, the impact of that ‘flu’ virus 100 years ago is simply staggering.

In recent weeks, that history and those numbers have become rather sobering. Frightening even. As I write this post, over 130,000 people worldwide have tested positive for the Coronavirus (COVID-19) and the death toll now exceeds 4,200 people. As the hours pass it has become clear that this virus is having a dramatic, dire impact on every aspect of our global society and that impact here in the United States is very likely to grow as testing becomes more prevalent. And speaking of testing and medical care, many clients have asked us whether their medical insurance will cover the virus (yes), its testing (yes) and what one insurer or another might do or offer with regards to access, co-payments, deductibles and so forth. That’s the core purpose of this post: to allow you to read what the most significant insurers in the country are doing to help provide you with the protection and peace of mind that you need.

And speaking of peace of mind, I want to briefly share that Morris & Reynolds has taken and will continue to take aggressive steps to ensure that when you need us we will be here for you, our clients. For over a decade our files and documents have been digital and cloud based. In recent weeks we’ve implemented rigorous procedures related to our workplace including social distancing, travel, client visitation, cleaning and remote/virtual work options. Heck, don’t be surprised if we visit with you remotely via Zoom video conferencing sometime soon. Things will be different for a while and for that we apologize, but we are doing all we can to continue ‘business as usual’ even in these unprecedented, unusual times.   

Some epidemiologists have suggested that it might take eight weeks to get an outbreak in a given community under ‘control’ but doctors have been clear to say that a cure is likely one to one and a half years away. Perhaps longer. Thankfully, modern medicine moves far quicker than was the case in 1918 and today our ability to communicate is instant and global. A cure will come, and hopefully soon, but until then the news over the last several weeks suggests that being prepared and informed is wise.

And with that in mind, my entire team here at Morris & Reynolds will strive to provide you with the most relevant and current information possible from the insurance world. Many folks are wondering whether and how their medical insurance will cover testing and how their coverage will work when it comes to access, co-payments and deductibles. We are pleased to provide you with the most recent information possible from many of America’s largest medical insurers, as well as one of our region’s largest medical providers including:

  1. Aetna
  2. AvMed
  3. Baptist Health
  4. Cigna
  5. Florida Blue
  6. Humana
  7. United Healthcare

Please click on the links (insurer’s name) above and you will be taken directly to the details of that company’s current position, services and advice. Please also feel free to contact any of the professional agents or underwriters here at Morris & Reynolds with your questions related to the Coronavirus or any other matter as we are most happy to help. 

Insurer Communications

1. Aetna issued the following letter to its members on March 6, 2020: 

CVS Health announces COVID-19 resources for Aetna members

Friday, March 6, 2020

Diagnostic testing and telemedicine visits available with no co-pay

WOONSOCKET, R.I. — CVS Health (NYSE: CVS) today announced several steps to support Aetna members in response to the COVID-19 outbreak.

“Supporting the health and well-being of our members and removing barriers to care are among our key areas of focus as we navigate the spread of COVID-19,” said Karen S. Lynch, President, Aetna and Executive Vice President, CVS Health. “That’s why we’re providing COVID-19 diagnostic testing and telemedicine visits with no out-of-pocket costs or cost sharing for Aetna members, along with a number of other programs and offerings that reinforce our commitment to delivering timely and seamless access to care.”

CVS Health has engaged with public health experts and organizations, including the Centers for Disease Control and Prevention (CDC), to spread awareness of emergency preparedness efforts. Through its frequently-updated COVID-19 resource center, the company is providing the latest information on precautions consumers should take to help prevent the spread of COVID-19 and who should seek medical attention.

Effective immediately, Aetna members will have access to the following resources:

Aetna will waive co-pays for all diagnostic testing related to COVID-19. This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location. Aetna will waive the member costs associated with diagnostic testing at any authorized location for all Commercial, Medicare and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of this program at their discretion.

For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason. Aetna members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices. Cost sharing will be waived for all video visits through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing) for all Commercial plan designs. Self-insured plan sponsors will be able to opt-out of this program at their discretion.

Through Aetna’s Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms. The package will also include personal and household cleaning supplies to help keep others in the home protected from potential exposure.

Through existing care management programs, Aetna will proactively reach out to members most at-risk for COVID-19. Care managers will walk members through what they can do to protect themselves, where to get information on the virus, and where to go to get tested.

Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna Commercial members as a fully-covered benefit. This offering will empower members with other conditions that need follow-up care to engage with providers without the concern of sitting in a physician’s office and risking potential exposure to COVID-19.

CVS Health is implementing the following programs to educate members about COVID-19 and help address any associated anxiety and stress:

  1. Opening Crisis Response Lines for all Aetna (Commercial, Medicare, Medicaid) and Caremark members who may be experiencing anxiety related to COVID-19.
  2. Expanding 24×7 access to the Aetna Nurse Medical Line for all Aetna and Caremark members.
  3. Providing Aetna plan sponsors with a Resources for Living toolkit with materials specifically developed for members experiencing anxiety related to COVID-19.

Anyone presenting symptoms compatible with COVID-19 should contact their health care provider immediately.

2. AvMed released the following bulletin on March 12, 2020: 

AvMed is closely monitoring the Coronavirus (COVID-19) situation and aware that there have been several confirmed cases in Florida. 

We are working directly with health experts to share information, mitigate health risks and keep our Members informed. The health of our Members and their families is top priority in our ongoing response to this evolving situation. 

 Being prepared is essential to ensuring our Members and their health is cared for. We’ve outlined AvMed’s Coverage and Benefits below:

 Coverage and Benefits:

  • AvMed will allow for the modification of medical management practices and make adjustments to policies as appropriate.
  • AvMed routinely covers diagnostic lab tests consistent with an individual’s health insurance coverage.
  • At this time, the CDC and its designated labs are not billing for testing for COVID-19 testing, so patients should not incur costs when tested by the CDC.
    • When the FDA gives approval for certified labs, such as Quest, to test for the virus SARS-CoV-2 that causes COVID-19, AvMed will cover the test under the no-cost sharing preventive health benefit.
    • Medical supplies such as masks, gloves, disinfectants are not currently covered by AvMed but may be purchased over-the-counter at most major pharmacies.  Some of these costs may be built into home care costs for certain medical conditions currently under treatment such as wound care. 
  • The CDC is recommending voluntary home quarantine for those who have traveled to/from countries where COVID-19 has spread or who have been exposed to individuals with the virus. 
  • At this time, there is no specific antiviral treatment or vaccine for COVID-19. Members should receive care from their doctor to help relieve symptoms as they would other viral respiratory infections. 
  • AvMed will continue to cover medically necessary healthcare costs to treat infectious diseases, including COVID-19, based on the terms of an individual’s insurance plan. 
  • AvMed covers vaccines recommended by CDC’s Advisory Committee on Immunization Practices (ACIP). 
  • Members who wish to stock up on essential medications may request a 90-day supply as part of their benefit any time of the year. CVS Health is waiving early refill limits on 30-day prescriptions for maintenance medications and waiving charges for home delivery of all prescription medications. 
  • AvMed will cover hospital quarantine stays for Members diagnosed with COVID-19 resulting from community spread of the virus consistent with the individual’s health insurance coverage. 
  • Most of AvMed’s Members already have telehealth coverage through our Virtual Visits service with MD Live, which provides access to care while reducing the opportunities for disease transmission. 
  • Treatment of COVID-19 is aligned with treatment of other viral respiratory infections and any medical management, cost-sharing and/or deductible obligations would be similarly aligned and in accordance with the terms of an individual’s insurance plan. 

 As the situation evolves, additional updates will be shared with you.

3. Baptist Health shared the following with the community and agent partners on March 10, 2020: 

As news on Coronavirus continues to evolve, the CDC is urging patients with symptoms or concerns to stay home and use telehealth as a first line of defense. Virtual care remains a highly effective method for evaluating and treating illness from the comfort of one’s home, while minimizing exposure to potentially contagious viruses. 

If you or a loved one are experiencing symptoms associated with COVID-19 (fever, cough, shortness of breath), Baptist Health South Florida has doctors available online, nationwide 24/7, who can help assess your condition and determine the best course of action.  

Simply download the Baptist Health Care On Demand App, sign up and see a doctor right away from your phone, tablet or computer. Video visits, available in both English and Spanish, are only $20 by using the code CARE19. Learn more at BaptistHealth.net/CareOnDemand.

4. Cigna shared on March 11, 2020 they will be announcing the following communications to their members: 

5. Florida Blue published the following notice to its members on March 10, 2020: 

Florida Blue is making several adjustments to make it easier for members to get tested and treated for COVID-19 and increasing access to other health care services.

To help members get needed care and treatment, Florida Blue is:

  • Waiving all costs related to medical testing for the virus for members who are part of our commercial insurance plans, including Affordable Care Act (ACA)/Individual and Medicare Advantage health plans.
  • Steps for members
    • Members should consult their health care provider if they are experiencing symptoms linked to the Coronavirus, such as mild to severe respiratory symptoms, like a cough and difficulty breathing, and a fever. If testing is needed, Florida Blue supports the work of providers, the Florida Department of Health and the Centers for Disease Control and Prevention to ensure COVID-19 testing is available. The tests are provided at no cost by state and federal health authorities and may soon be available at other laboratories.
  • Providing access to necessary medications. Florida Blue will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and/or encouraging members to use 90-day mail order benefit.
  • Florida Blue will also ensure formulary flexibility if there are shortages or access issues. In the event of shortages or access issues, members will not be liable for the additional charges that stem from obtaining a non-preferred medication. 
  • Offering counseling for members feeling stress related to Coronavirus. In partnership with New Directions Behavioral Health, members can talk to specially trained behavioral health counselors at no cost via a 24/7 toll-free help line at 833-848-1762.

NOTE: We are strongly encouraging members to take advantage of virtual care options in their plans for less serious medical issues. Seeking in-person care may lead to further spreading of the Coronavirus. Those with conditions, such as common colds or other mild illnesses, can visit floridablue.com to learn more about virtual care options.

In addition, there is an upcoming webinar next week that is open to anyone interested.

The Better You team invites you to join Dr. Kelli Wells to learn more about novel Coronavirus which causes COVID-19, a respiratory illness that can spread from person to person. We will discuss symptoms, how it spreads, everyday preventive measures and what to do if you are sick.

You will have the opportunity to ask Dr. Wells your questions live after the presentation.

Thursday, March 19th, 2020 from 11:30 am – 12:30 pm   

CLICK HERE TO REGISTER

6. Humana provided the following notice to its Group medical clients on March 10, 2020: 

An important communication to Humana Employer Group Clients

Care for your employees
Our highest priority remains the care of our members – your employees. Therefore, Humana will waive out-of-pocket costs, where allowed within state and federal law, associated with testing for COVID-19 for patients who meet CDC guidelines at approved laboratory locations. Self-insured plan sponsors will be able to opt-out of the program at their discretion.

Additionally, Humana is working closely with federal agencies to gain clarity on the impacts of these actions on High Deductible Health Plans and Health Savings Accounts. The CDC continues to offer free testing for Coronavirus.

We are also announcing the following resources for members:

Telemedicine costs waived for all urgent care needs for next 90 days – To help reduce the risk of infection and spread of disease, Humana is encouraging members to use Doctor on Demand (e.g., video chat) as a first line of defense for all urgent care needs. The company will waive costs for telemedicine visits for urgent care needs for the next 90 days. This is limited to in-network providers delivering synchronous virtual care (live video-conferencing). Self-insured plan sponsors will be able to opt-out of the program at their discretion.

Early prescription refills allowed for next 30 days – Humana is allowing early refills on prescription medicines so members can prepare for extended supply needs – an extra 30- or 90-day supply as appropriate.

Member support line available – Humana has trained a specialized group of call center associates to help support members with specific Coronavirus questions and concerns, including live assistance with telemedicine. Members can call Humana’s toll-free customer support line, which can be found on the back of their member I.D. card, to be connected to this dedicated team of professionals.

Ongoing collaboration with health organizations
Humana will continue to be in regular contact with the Centers for Disease Control and Prevention (CDC), federal agencies, state authorities and provider partners to monitor COVID developments. We will update you as needed to ensure you have visibility to any additional steps Humana takes regarding our COVID support approach.

Steadfast commitment to supporting you
Finally, the Humana team is committed to ensuring you have the support you need. Your Humana representative will continue to be available to assist you locally. We have also established a dedicated phone service line: 1-800-592-3005 and email account COVIDquestions@humana.com to answer any COVID-19 related questions.

7. United Healthcare recently announced the following position: 

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