Article

COVID-19: Health Plans and Insurers
Q & A: Temporary policy changes

Are health plans offering any relief during this time for prior authorizations, member cost sharing, or other policies?

Many health plans have announced they’re suspending prior authorization requirements and waiving cost sharing for certain services, as well as offering other temporary support. 

  • Blue Shield of California has announced that it will make available up to $200 million in direct support to health care providers and hospitals through financing guarantees, advance payments, and restructuring of contracts to help offset some of the heavy losses hospitals and doctors are enduring as they suspend normal operations before the expected surge of COVID-19 patients.
  • Anthem announced on March 27 that its health plans will
    • Suspend prior authorization requirements for patient transfers, as well as for use of medical equipment critical to COVID-19 treatment
    • Cover respiratory services for acute treatment of COVID-19 along with in-network and out-of-network coverage for COVID-19 laboratory testing
    • Temporarily adjust handling and monitoring of claims and audits

In April, Anthem also announced it will waive cost sharing for COVID-19 treatment received through May 31, and provide post-discharge support to Medicare members with complex care needs following hospitalization.

  • Centene Corp. has announced it will:

    • Waive prior authorization and member cost sharing for COVID-19 related screening, testing, and treatment for all Medicare, Medicaid, and Exchange members
    • Provide additional support to safety net providers, including assistance in securing small-business loans for behavioral health providers, obtaining personal protective equipment, and providing data and other support
  • UnitedHealthcare has announced it will:
    • Waive cost sharing through May 31 for COVID-19 testing, treatment, early prescription refills, and telehealth visits for Medicare Advantage, Medicaid, and commercial plan members.
    • Accelerate payments and other financial support to medical and behavioral health  providers to help address the short-term financial pressure caused by the COVID-19 emergency. The move applies to UnitedHealthcare’s fully insured commercial, Medicare Advantage, and Medicaid businesses.
  • Cigna has announced plans to waive cost sharing for COVID-19 testing, early prescription refills, and FDA-approved medications or vaccines when they become available, until May 31.
  • Humana has announced plans to waive cost sharing for COVID-19 testing, early prescription refills, and FDA-approved medications or vaccines when they become available.
  • SCAN Health Plan has announced it will:
    • Waive co-pays for primary and urgent care visits
    • Allocate more than $5 million to address the needs of seniors including:
      • Additional service to seniors in need of nutritious meals and other essential supplies
      • Additional financial support to nonprofit senior organizations

Updated 4/15

Commands