COVID-19 (Coronavirus) in Ohio is responsible for numerous deaths and hospitalizations in the Buckeye State. Healthcare companies are committed to help prevent the spread, and offer benefits that help diagnose and treat symptoms. Ohio Marketplace health insurance plans provide the needed benefits for statewide residents. Large-scale production of face shields has begun, and high-risk patients will be treated with convalescent plasma.
Ohio Governor Mike DeWine signed House Bill 197, which offers emergency treatment and economic assistance during the pandemic. The bill waives testing requirements for school children for 2020, extends the income tax filing deadline to July 15th, provides funding for small businesses, extends professional licenses, allows local governments to conduct business remotely, and extends absentee voting until April 28th. Educational resources recently made available include guidance on dispute resolutions for essential and non-essential businesses, stay-at-home information, COVID-19 checklists, news releases, press conference slides, childcare and education guidelines, and coping with anxiety.
Many insurers conducting business in Ohio (Marketplace, Senior Medicare, and private) have waived copays and deductibles, and reduced out-of-pocket expenses. Here are some of the actions taken by carriers:
Aetna (a CVS company) is waiving diagnostic test copays related to the virus for commercial, Medicaid and Medicare plans. Telemed visit copays have been waived, (regardless of diagnosis) and several programs are available to help customers with anxiety and stress. Member cost-sharing for inpatient admissions at network facilities will be waived. Members may use telemedicine services for any aliment. The “Healing Better Program,” a care package will be sent to members that have tested positive. The package will contain over-the-counter medications, and personal and household cleaning supplies. The nurse medical line will be expanded, and crisis response lines will be available for members experiencing anxiety related to COVID-19.
Anthem BCBS will fully cover the costs of testing at 100%. Prior authorization has also been waived for diagnostic tests. Telehealth visits are available and encouraged. The virus assessment tool can also be downloaded at no cost. Copays, deductibles, and coinsurance will be waived for COVID-19 diagnostic tests (affiliated plans). The treatment can take place in an ER, physician’s office, or Urgent Care facility. Early prescription refill limits for 30-day prescriptions are being relaxed. Mental healthcare cost-sharing expenses will also be waived for individual, Group, Medicare, and Medicaid plans. The Anthem Ohio health insurance foundation is donating funds to Boys And Girls Clubs to assist distributing food to needy families and children. LiveHealth Online is increasing physician availability, while maintaining acceptable wait times.
CareSource and FoodBank Inc are working together to provide supplemental food boxes for lower-income Seniors. A two-week supply of food will be delivered, providing three meals per day. More than 50,000 free meals will be provided.
Centene (Ambetter) will pay for testing and screening expenses for Marketplace, Medicaid, and Medicare policyholders. Step therapy protocols, prior authorization, prior certification, and prior notification have been waived for COVID-19 services. The cost of treatments will be paid by Centene, and providers no longer need to collect copays. A medical reserve leave policy is also being created for support staff that request to join a medical reserve force. Employees can maintain pay based on the number of hours they were scheduled to work,and also maintain their normal work benefits. Paid time off will continue to accumulate and holiday pay will not be lost. Ten additional days of paid emergency sick leave have also been added.
Cigna will waive out-of-pocket costs for testing at in-network facilities, including doctor’s offices, Urgent Care clinics, emergency rooms, and online telehealth visits. Impacted plans are individual, employer-union group, Medicaid, and Senior Medicare policies. Persons with chronic health or transportation issues will be assisted through May 31. The Express Scripts Pharmacy provides 90 days of free home delivery of maintenance medications. A 24-hour toll-free phone number has been created to assist customers with questions. Cost-sharing and copayments have been waived through December 31 for most plans. Cigna and Express Scripts are working with Buoy Health to offer an early screening tool.
Humana is waiving COVID-19 testing out-of-pocket costs, and telemedicine costs for Urgent Care visits for the next 90 days. Early refills will be offered on regular prescriptions.Expenses for treatment-covered services are also being waived. This includes inpatient hospital admissions. FDA-approved vaccines and medications will be included. Also provided is administrative and financial relief for healthcare providers.
Medical Mutual is waiving cost-sharing expenses when ordered by a healthcare professional. This applies to fully-insured plans through May 31. Treatment includes ambulance transfers (ground) and hospitalization expenses for persons with a positive COVID-19 diagnosis. In-network and out-of-network providers will be included. Self-funded groups will be notified of mandates that relate to their covered persons. FDA-approved vaccines and medications will be covered when they become available. This is retroactive to January 27th. Telehealth visits no longer need visual interaction. Telephonic visits will be covered.
Molina Healthcare will waive all costs associated with COVID-19 testing. Office visits, ER visits, and Urgent Care visits do not require prior authorization. A Coronavirus Chatbook has been created to provide insureds tools to learn about their risk profile, and make live help available. $150,000 has been donated for buying COVID-19 test kits, personal protective equipment, and other needed items for healthcare professionals. TeleDoc is available for MyCareOhio, and free home delivery of prescription drugs is available from CVS.
Oscar is waiving cost-sharing for COVID-19 diagnostic testing. In-network and out-of-network facilities can be used if recommended by a healthcare provider. The “Doctor On Call” service is provided with no out-of-pocket costs. A new COVID-19 testing center was also launched, with additional centers continuously being added. A resource center is provided to all members. Early refills on most prescription drugs are being waived at network pharmacies. Free CVS home-delivery has also been added.
SummaCare is waiving deductibles and copays for provider-ordered testing. This applies to Medicare Advantage, commercial, and private individual plans. Self-insured plans are under different guidelines. A free online screening process is provided to persons under age 65 that think they have symptoms. Telehealth and Teledoc services are covered with a licensed physician. SummaCare is partnering with MedImpact for emergency preparedness for Medicare, Marketplace, MEWA, fully-insured, and self-funded members.
UnitedHealthcare is waiving the costs of COVID-19 testing at approved locations. This includes the cost of copays, coinsurance, and deductibles for visits. Since UHC does not offer under-65 Marketplace plans, these benefits apply to commercial, Medicaid, and Medicare Advantage policyholders. Some commercial customers had a special Open Enrollment period that ended on April 6. Prior authorizations for post-acute care have been suspended. Telehealth policies are expanding to provide better access for customers. Telehealth can be accessed through a designated partner (no charge) and, for the next 90 days, through in-network providers by video-conferencing. Claim payments are being accelerated to behavioral and medical care providers. Also, $125 million in small business loans to OptumHealth clinical partners. Golden Rule, a UHC subsidiary that underwrites short-term plans, is also waiving member cost-sharing for COVID-19 testing and treatment. An emotional support line is available for persons with stress and anxiety.