Aetna Waiving Copays For Telehealth

 



Aetna announcement effective March 6 on zero co-pay telemedicine visits for any reason for 90 days, please see below excerpt. Also attached is Aetna’s updated telemedicine policy that was new 1/1/1/20 that had coverage details and CPTs and has been updated to reflect this March 6th update. 2nd attachment is the Aetna Covid Press release. This announcement also is posted and available to providers on NaviNet and Availity with links to policy and press release as well.

Beginning March 6, 2020, Aetna will offer zero co-pay telemedicine visits for any reason for 90 days. We will waive the cost share for all video visits through the Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live video-conferencing) for all Commercial plan designs*. Self-insured plan sponsors can opt-out of this program at their discretion.

Aetna is waiving member cost-sharing for inpatient admissions to treat COVID-19 for commercially insured and Medicare Advantage members through Jan. Arkansas Blue Cross and Blue Shield.

Members, Aetna is here to keep you informed during the coronavirus (COVID-19) pandemic. Visit our COVID-19 FAQ page for answers to the most frequently asked questions regarding the coronavirus and to get the latest information. Aetna is here for you during the coronavirus (COVID-19) pandemic, no matter what. Learn about extra benefits and well-being resources just for you, find testing locations, get answers to the most frequently asked questions regarding COVID-19 and tips to stay safe, and much more. Cost-share waivers for all telehealth visits (primary, speciality and behavioral services) with in-network providers, regardless of COVID-19 diagnosis: Dec. 31 UnitedHealthcare. Aetna will cover appropriate evaluation and management codes with a wellness diagnosis for those aspects of the visit done via telehealth. Preventative visit codes should be reserved for such time when routine in-office visits resume and the remaining parts of the well visit can be completed.

*We will also cover G2010, G2012, 99441, 99442, and 99443 during the 90-day period.

For more information, see our press release below or at these links:

Additionally , more from Aetna:

March 17, 2020

Dear Valued Partner:

We share the same goal: to help people get and stay healthy. We are your partners in health care, and act to serve you and the millions of patients who rely on us for their health care needs.

In response to the rapidly evolving COVID-19 outbreak, CVS Health and Aetna are here to support you with timely answers and information. Through CVS Health and Aetna's combined resources and your partnership, we can best support your Aetna patients' health and well-being, ensure their access to medication and remove barriers to care.

We're here to help you, help your patients and recently announced these resources and enhancements when applicable:

If you request testing related to COVID-19, we'll waive your Aetna patient's cost sharing.

Aetna Commercial patients pay $0 for covered telemedicine visits until June 4, 2020.

Until further notice, Aetna is also expanding coverage of telemedicine visits to its Aetna Medicare members, so they can receive the care they need from you without leaving their homes. With this change and new flexibilities announced by the Centers for Medicare and Medicaid Services to help combat the virus, Aetna Medicare members can now see their providers virtually via telephone or video.

Aetna is offering its Medicare Advantage brief virtual check-in and remote evaluation benefits to all Aetna Commercial members and waiving the co-pay.

Care packages will be sent to Aetna patients diagnosed with COVID-19. Through Aetna's Healing Better program, Aetna Commercial and Medicare Advantage members will receive CVS items to help relieve symptoms as well as personal and household cleaning supplies to help keep others in the home protected from potential exposure. Call the number on your Aetna patient's ID card to register a recently diagnosed patient.

Patients won't have to pay a fee for home delivery of prescription medications from CVS Pharmacy®.

Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna members as a fully-covered benefit.

We're waiving early refill limits on 30-day prescription maintenance medications for all Commercial members with pharmacy benefits administered through CVS Caremark.

Aetna Medicare members may request early refills on 90-day prescription maintenance medications at retail or mail pharmacies if needed. For drugs on a specialty tier, we're waiving early refill limits for a 30-day supply.

Through existing care management programs, Aetna will proactively reach out to your patients who are most at-risk for COVID-19.

Please refer to the What You Need to Know About the Coronavirus (COVID-19) - Aetna Providers FAQs on Aetna.com for additional important information. There, you'll find information about codes related to COVID-19 and selected labs approved to do COVID-19 testing. This page will continually be updated with information as it becomes available to help you care for your patients.

Let's work together to provide your patients with a clear path to care. Thank you for your continued partnership.

Please see the updated attachments for additional and up to date information from Aetna.

Many insurance companies are currently waiving copays and deductibles for telehealth; while some are waiving these fees for all telehealth services, others are limited to COVID-19 related treatment only, and many require that the provider use the insurer’s preferred telemedicine platform.

Below is a list of health insurance companies, indicating which companies are waiving copays, coinsurances, and deductibles, and if so, when they will return to regular coverage. Most health insurance companies have not released updates since they first made changes in March, but we're keeping a close eye on the situation and will share updates as we have them!

For the latest information, we encourage you to visit the linked sources, which will take you to the health insurance company's relevant press release.

Please note that specifics vary across plans, especially employer-issued plans.

Cost-Sharing Waivers By Health Insurance During COVID-19

Aetna

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: For all Aetna plans offering Teladoc® coverage, cost sharing will be waived for all Teladoc® virtual visits. For all Commercial plans, cost sharing will also be waived for real-time virtual visits offered by in-network providers.
  • Applicable plans: Applies to all Aetna plans; self-insured plan sponsors can opt out.
  • Description: Until at least June 4th, 2020, Aetna will waive member cost sharing for any covered telemedicine visits — regardless of diagnosis. For all Aetna plans offering Teladoc® coverage, cost sharing will be waived for all Teladoc® virtual visits. Cost sharing will also be waived for real-time virtual visits offered by in-network providers (live video-conferencing and telephone-only telemedicine services) for all Commercial plan designs. Members may use telemedicine services for any reason, not just COVID-19 diagnosis. Self-insured plan sponsors will be able to opt-out of this program at their discretion.
  • Notes: If clients have self-insured plans, it is important to check that the plan has not opted out of the program.
  • Sources: Source one, Source two

Allways Health Partners

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists.
  • Applicable plans: Not explicitly indicated.
  • Description: 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... There will be no cost to you for telemedicine (including telephone) visits for standard/routine outpatient behavioral health.
  • Sources:Source

Anthem

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: Applies to all Anthem affiliated plans; self-insured plan sponsors can opt out.
  • Description: For 90 days effective March 17, 2020, Anthem’s affiliated health plans will waive member cost shares for telehealth visits, including visits for mental health or substance use disorders, for our fully-insured employer plans, individual plans, Medicare plans and Medicaid plans, where permissible. Cost sharing will be waived for members using Anthem’s authorized telemedicine service, LiveHealth Online, as well as care received from other providers delivering virtual care through internet video + audio services. Self-insured plan sponsors may opt out of this program.
  • Sources:Source

Blue Cross Blue Shield Association

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: All 'fully-insured' members
  • Description: 'All 36 independently-operated BCBS companies and the Blue Cross and Blue Shield Federal Employee Program® (FEP®) are expanding coverage for telehealth services for the next 90 days. The expanded coverage includes waiving cost-sharing for telehealth services for fully-insured members and applies to in network telehealth providers who are providing appropriate medical services. We are also advocating for physician and health system adoption of social distancing-encouraged capabilities such as video, chat and/or e-visits. This builds on the commitment we previously announced to ensure swift and smooth access to care during the COVID-19 outbreak.'
  • Sources:Source

Blue Cross Blue Shield of Massachusetts

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: All members
  • Description: 'Blue Cross has waived member cost share (co-pays, co-insurance and deductibles) for all medically necessary medical and behavioral health covered services, via phone or video (telehealth) with in-network providers if such services are offered.'
  • Sources: Source

Blue Cross and Blue Shield of Illinois

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: All BCBSIL members with telemedicine/telehealth benefits in their plan (excluding Part D plans for Medicare members)
  • Description: 'Currently, if you are insured by BCBSIL, including Medicare (excluding Part D plans) and Medicare Supplement members, you can: Access provider visits for covered services through telemedicine or telehealth as outlined in your benefit plan. You won’t pay copays, deductibles, or coinsurance on in-network covered telemedicine or telehealth services.'
  • Sources: Source

Blue Cross and Blue Shield of Rhode Island

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: All members
  • Description: Expanded coverage for clinically appropriate telehealth services that are provided by any in-network provider through permitted means, including telephone and audiovisual technologies. Permitted audiovisual capabilities include nonpublic video conferencing such as Skype, Google Hangouts and FaceTime. Waived all member cost sharing (copays and deductibles) for telehealth whether provided by an in-network provider or through the Doctors Online telehealth platform.
  • Sources: Source

Blue Shield of California

  • Cost sharing waived for teletherapy? Yes, but only for Teladoc Services
  • Applicable providers: Only waiving costs for Teladoc Health virtual care service.
  • Applicable plans: Applies to Blue Shield’s Individual and Family Plans, Medicare Supplemental plans, Medicare Advantage plans, as well as employer- and union insured plans.
  • Description: 'Blue Shield previously announced it is waiving prior approval and copayments for Teladoc Health virtual care service through May 31, 2020 for most of its members. Not all plans have access to these services.'
  • Sources:Source

Cigna

  • Cost sharing waived for teletherapy? No (only for categories of 'screening, diagnosis, or testing' for COVID-19)
  • Applicable providers: N/A
  • Applicable plans: N/A
  • Description: 'Effective today, Cigna is waiving customer cost-sharing for all COVID-19 treatment through May 31, 2020. The treatments that Cigna will cover for COVID-19 are those covered under Medicare or other applicable state regulations. The company will reimburse health care providers at Cigna's in-network rates or Medicare rates, as applicable. Will Cigna cover Coronavirus virtual care visits? Yes. If your visit is related to screening, diagnosis, or testing for the Coronavirus, your out-of-pocket costs will be waived.'
  • Sources: Source

ConnectiCare

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network
  • Applicable plans: All members
  • Description: 'Today, ConnectiCare, one of the region’s leading health plans, announced that members can temporarily use telehealth for covered medical and mental health services at no cost. To make it easier for our members to get the care they need, ConnectiCare is eliminating the financial burden associated with office visits by covering telehealth appointments for any reason.' The company is allowing no-cost member real time visits with medical and mental health professionals by phone, computer, and mobile app.'
  • Sources:Source

EmblemHealth

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network
  • Applicable plans: All except potentially not ASO plans
  • Description: 'EmblemHealth members across all our product lines will have no cost sharing (including copayments, coinsurance, or deductibles) for in-network telehealth visits. These visits have no cost-sharing for COVID-19 and non-COVID-19 related services. Members with a benefit plan that includes the Teladoc™ program will also have no cost-sharing for Teladoc visits. The telehealth cost-sharing waiver may not apply to ASO plans.'
  • Sources:Source

First Choice Health

  • Cost sharing waived for teletherapy? No (only for virtual primary care service, not teletherapy)
  • Applicable providers: N/A
  • Applicable plans: N/A
  • Description: 'To help ensure people will have access to a doctor during the current COVID-19 crisis, First Choice Health (FCH), a leading provider-owned healthcare administrator in the Northwest, has announced that it is covering the cost of telehealth services for its self-funded employer customers via on-demand primary care service 98point6.'
  • Sources:Source

Harvard Pilgrim Health Care

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network
  • Applicable plans: Members on individual and group fully insured plans
  • Description: All telemedicine services: Covered in full (no copays, deductibles or coinsurance)
  • Sources: Source

Healthfirst

  • Cost sharing waived for teletherapy? No (only COVID-19 related testing and evaluation)
  • Applicable providers: N/A
  • Applicable plans: N/A
  • Description: 'Healthfirst is waiving co-pays for all diagnostic testing and evaluations related to coronavirus.'
  • Sources: Source

HealthPartners

  • Cost sharing waived for teletherapy? No (only COVID-19 related testing and diagnosis)
  • Applicable providers: N/A
  • Applicable plans: N/A
  • Description: 'If you’re a HealthPartners member, you have coverage with no member cost sharing for COVID-19 testing and diagnosis. This includes the cost of the care visit associated with testing.'
  • Sources: Source
Cost

Kaiser Permanente

  • Cost sharing waived for teletherapy? No (only COVID-19 related screening and testing fully covered)
  • Applicable providers: N/A
  • Applicable plans: N/A
  • Description: 'We’re proactively extending the use of telehealth appointments via video and phone where appropriate. As a Kaiser Permanente member, you won’t have to pay for costs related to COVID-19 screening or testing if referred by a Kaiser Permanente doctor. If you’re diagnosed with COVID-19, additional services, including hospital admission (if applicable), will be covered according to your plan details.'
  • Sources: Source
For

Magellan Health

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: All members
  • Description: 'As the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) guidance came out on Tuesday, Magellan was revising its operations to 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. Providers are able to use a number of HHS OCR-approved platforms to conduct their telehealth video sessions. Magellan is also allowing telephone-only sessions when a member has no access to a video platform. These alternative approaches will be covered to ensure members get the care they need, when they need it. Our experienced behavioral health network providers are available to serve the needs of our clients’ members through a variety of avenues. We are proud of our network providers and look forward to working with them to support those who may need mental health services as a result of the COVID-19 outbreak.'
  • Sources: Source

Neighborhood Health Plan of Rhode Island

  • Cost sharing waived for teletherapy? Yes, but only for Optum-based virtual visits
  • Applicable providers: Optum virtual visits only for behavioral health
  • Applicable plans: All members
  • Description: 'Neighborhood’s behavioral health partner Optum, offers virtual visits so you can receive confidential care without leaving your home. For more information on accessing virtual visits, go to live and work well to locate providers and schedule an appointment with them online. Neighborhood has expanded telemedicine coverage for all members to include clinically appropriate and medically necessary services to support you not having to go into your doctor’s office, urgent cares or emergency rooms during the time of the Governor’s executive order. If your plan usually has co pays, deductibles or other cost-sharing, you will not need to pay for the services outlined below. Primary care physicians All Medical Specialists – defined as any MD, DO, NP and PA Optometrists Doctors of Podiatric Medicine (DPM’s) Lactation Consultants Physical, Occupational, and Speech Therapists Diabetes Educators Nutritionists Midwifes Urgent Care Centers Emergency Departments Retail Based Clinics'
  • Sources: Source

Oscar

  • Cost sharing waived for teletherapy? No; standard cost sharing rules apply for teletherapy
  • Applicable providers: Offering Oscar's Doctor on Call for 'most members' free of charge
  • Applicable plans: Varies depending on details of individual plans
  • Description: 'In addition to offering Oscar's Doctor on Call services to most members for $0, Oscar will cover all COVID-19 care delivered via telemedicine at $0 for our members through May 10. We will re-evaluate this date as needed. Oscar will also cover telemedicine care, consistent with our plan terms, for our members when they see an in-network provider through May 10. Standard cost-sharing rules will apply in all states except New York and New Jersey. In these states, members will pay $0 for any medically-necessary telemedicine visit with an in-network provider.'
  • Sources: Source

Premera Blue Cross

  • Cost sharing waived for teletherapy? No; only through certain platforms
  • Applicable providers: Specific services only (Talkspace for therapy)
  • Applicable plans: Varies depending on 'participating groups'
  • Description: 'To ease the burden for our members, we will waive copays, deductibles, and coinsurance for COVID-19 related treatment (both inpatient and outpatient). This waiver will continue through October 1, 2020 for participating groups. We've expanded options for you: Call your in-network primary care doctor's office. 24-Hour NurseLine is available at no charge. Just call the number on the back of your member ID card to reach medical professionals. Doctor On Demand is a video chat with a doctor. 98point6 is a text-based primary care app. Talkspace offers virtual access to licensed therapists.'
  • Sources: Source

UnitedHealthcare

  • Cost sharing waived for teletherapy? Yes
  • Applicable providers: All in-network therapists
  • Applicable plans: Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans
  • Description: 'Starting March 31, 2020 until June 18, 2020, UnitedHealthcare will now also waive cost-sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, Individual and Group Market fully insured health plans. Again, we will work with self-funded customers who want us to implement a similar approach. The company previously announced we would waive cost-sharing for telehealth visits related to COVID-19 testing, in addition to waiving cost-sharing for 24/7 Virtual Visits with preferred telehealth partners.'
  • Sources: Source

Medicare coverage

For the duration of the Public Health Emergency (PHE) declared by the Secretary of Health and Human Services, CMS will be making these changes. The main note is that there will no longer be a limit on the originating site -- the place where a client or patient is receiving care. Clients can now temporarily receive telehealth visits in their home, regardless of whether they are located in a rural area.

Aetna Telehealth Provider

Waived Cost End Dates

Aetna Copay Information

Insurance companies are planning to waive fees until the dates listed below. They will be re-evaluating and updating these dates as the situation progresses.

  • Aetna: June 4, 2020 (source)
  • Anthem: June 15, 2020 (source)
  • Cigna: May 31, 2020 (source)
  • Blue Cross Blue Shield: June 15, 2020 (source) ('All 36 independently-operated BCBS companies and the Blue Cross and Blue Shield Federal Employee Program® (FEP®) are expanding coverage for telehealth services for the next 90 days. The expanded coverage includes waiving cost-sharing for telehealth services for fully-insured members and applies to in network telehealth providers who are providing appropriate medical services.' 90 days from the publication date of this press release of March 19th, 2020, takes us to about June 15th, 2020 (calculation), which is how we arrived at this end date.)
  • Empire Blue Cross Blue Shield: June 15, 2020 (or “as long as the COVID-19 emergency is in effect.”) (source)
  • UnitedHealthcare: June 18, 2020 (source)

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Aetna Waiving Copays For Telehealth Services