With waived coinsurance and deductibles for COVID-19 treatment, savings can add up Cigna and Humana both waived COVID-19-related cost-sharing for their Medicare Advantage (Medicare Part C) plans. Medicare Advantage plans cover the same inpatient and outpatient services and items that are covered by Original Medicare (Medicare Part A and Part B). Urgent care copay rates (Care for minor illnesses and injuries) There's no limit to how many times you can use urgent care. To be eligible for urgent care benefits, including through our network of approved community providers, you must. Be enrolled in the VA health care system, and Have received care from us within the past 24 months (2 years). Compliance Risk for Physician Practices in Waiving Patient Copays and Deductibles The waiver of coinsurance and deductibles owed by patients treated by physicians and other health care providers has come under increased scrutiny recently.
Waiving copays and deductibles removes the disincentive for utilization, thereby potentially increasing payor costs. Accordingly, federal and state laws as well as payor contracts generally prohibit waiving cost-sharing absent genuine financial hardship. Several commercial health insurers will waive member cost-sharing — which includes copays, deductibles and coinsurance — for COVID-19 testing and treatment into the next year.
Cigna is eliminating cost-sharing for all primary, specialty and behavioral care for in-office or telehealth visits for all COVID-19 and non-COVID-19 care.
This is for in-network medical or behavioral telehealth visits for customers in the U.S. covered by Medicare Advantage, individual or family plans, including individual plans sold on the marketplace.
Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits for customers during the pandemic. The insurer is providing additional days of nutrition through meal delivery for customers following their discharge from a hospital stay for any condition, including COVID-19.
Cigna's Medicare Advantage customers will now have access to 28 meals for 14 days at no extra cost following their discharge from a hospital, which doubles the meals offered previously.
These home-delivered meals incorporate individual dietary restrictions, and are delivered frozen with preparation instructions.
For Cigna's Medicare Advantage customers, these cost-share measures, benefits extensions and policy changes will be in effect through the end of December 2020. For individual and family plans and exchange customers, these changes will apply until the end of applicable federal and state public health emergencies.
WHY THIS MATTERS
While telehealth is not suitable for every condition, it is important for people not to defer critical care needs at this time, Cigna said.
In May, the Centers for Medicare and Medicaid Services finalized requirements that increased access to telehealth for seniors in Medicare Advantage plans. The agency provided more flexibility for telehealth providers in specialty areas.
THE LARGER TREND
Waiving Copays And Deductibles
Cigna previously eliminated cost share for COVID-19 testing and treatment.
These measures are an expansion of Cigna's previously-announced efforts during COVID-19.
Cigna followed CMS's lead by reimbursing providers for COVID-related virtual visits as if they were in-person visits. It also eased primary care provider referrals for specialists in certain situations.
Customers who were eligible to pick a Medicare Advantage plan earlier this year, but could not because of the pandemic, are entitled to a special enrollment period.
Additionally, individuals who lost healthcare coverage from their employer, or had other significant life events, are entitled to a special enrollment period for individual health plans.
ON THE RECORD
'COVID-19 has affected all age groups – physically, financially and emotionally,' said Brian Evanko, president of Cigna's Government Business. 'We want everyone to focus on getting and staying well – including those being tested for and diagnosed with the virus and their loved ones – and not having to worry about how they will access or afford the care and services they need.'
Cigna previously eliminated cost share for COVID-19 testing and treatment.
These measures are an expansion of Cigna's previously-announced efforts during COVID-19.
Cigna followed CMS's lead by reimbursing providers for COVID-related virtual visits as if they were in-person visits. It also eased primary care provider referrals for specialists in certain situations.
Customers who were eligible to pick a Medicare Advantage plan earlier this year, but could not because of the pandemic, are entitled to a special enrollment period.
Additionally, individuals who lost healthcare coverage from their employer, or had other significant life events, are entitled to a special enrollment period for individual health plans.
ON THE RECORD
'COVID-19 has affected all age groups – physically, financially and emotionally,' said Brian Evanko, president of Cigna's Government Business. 'We want everyone to focus on getting and staying well – including those being tested for and diagnosed with the virus and their loved ones – and not having to worry about how they will access or afford the care and services they need.'
Chrome default search engine. 'For many customers, virtual care is an effective way to address their health concerns and continue to access their medications without leaving the safety of their homes,' said Dr. Gina Conflitti, chief medical officer of Cigna's Medicare Advantage business. 'By waiving cost sharing for these behavioral health visits, in addition to medical services, we're making it easier and more affordable for customers to attend to both their mental health and physical well-being in a setting that works best for their individual needs.'
Waiving Copays And Deductibles Fraud
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
