The Texas Association of Health Plans, its member companies, and our employees are heavily invested in the health of the Texas communities in which we live and serve, and we are fully committed to meeting this challenge. Texas health plans are working to help contain the virus, ensure people have coverage for and access to needed testing, and help patients who are infected receive the care and treatment they need. Here are some ways Texas health plans are taking action:
- Aetna-CVS announced several steps to support its members in response to the COVID-19 outbreak including waiving co-pays for all diagnostic testing related to COVID-19, offering zero co-pay telemedicine visits for any reason over the next 90 days, giving members diagnosed with COVID-19 a care package including over-the-counter medications to help relieve symptoms, and proactively reaching out to members most at-risk for COVID-19. Aetna also announced additional steps, including waiving charges for home delivery of CVS Pharmacy prescription medications and offering 90-day maintenance medication prescriptions for insured and Medicare members. Aetna is working with state governments to make the same option available to Medicaid members where allowable, and self-funded plan sponsors will also have the ability to offer this option. In addition, Aetna will waive early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark.
- Blue Cross and Blue Shield of Texas will not require preauthorization and will not apply members’ copays or deductibles for testing to diagnose COVID-19 when medically necessary and consistent with CDC guidelines.
- Centene (WellCare Health Plan of Texas) announced it is covering COVID-19 testing and screening services for Medicaid, Medicare and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening. Centene will not require prior authorization, prior certification, prior notification or step therapy protocols for these services.
- Cigna is waiving customer cost-sharing for office visits related to COVID-19 testing and telehealth screenings for COVID-19 through May 31, 2020. The plan is also providing free home delivery of up to 90-day supplies for prescription maintenance medications available through the Express Scripts Pharmacy, as well as 24/7 access to pharmacists. Cigna is also staffing a second 24-hour toll-free telephone help line to connect members experiencing feelings of stress, anxiety, sleeplessness, and in some cases, loss, directly with qualified clinicians who can provide support and guidance on coping and resiliency.
- Community Health Choice announced it is optimizing access and removing potential barriers to member screening and diagnostic testing for COVID-19 by providing access to testing without prior authorization and waiving copays and member cost-sharing on FDA-approved testing for COVID-19. The plan is also increasing access to outpatient services for COVID-19 by encouraging the use of telemedicine services, ensuring its members are aware of telemedicine benefits Community’s nurse advice line, and waiving copay and member cost-share for telemedicine services of any modality for any reason for 90 days, including for Marketplace and DSNP members (continue zero cost telemedicine services); for Marketplace, DSNP, and CHIP members (waive member copay/cost-share for telemedicine services provided by network providers); and for STAR members (access to and coverage of telemedicine services provided by network providers). Community is also increasing accessibility to maintenance medications and waiving early medication refill limits on maintenance medications.
- Humana is waiving the out-of-pocket costs associated with COVID-19 testing and costs for telemedicine visits for urgent care needs for the next 90 days for its Medicare Advantage, Medicaid and commercial employer-sponsored plans and is limited to in-network providers delivering synchronous virtual care. For the 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. Humana has also trained a specialized group of call center employees to help support members with specific coronavirus questions and concerns, including live assistance with telemedicine. Members should call the normal customer support line to be connecting with this service.
- Memorial Hermann Health Plan is waiving all co-pays and cost shares related to requested COVID-19 diagnostic screening and has created a dedicated clinical triage nurse line to help direct care. The plan is also lifting up refill-to-soon edits to chronic medications and allowing a 90-day supply temporarily.
- Molina announced it is waiving all member costs associated with testing for COVID-19.
- Oscar is waiving cost-sharing for diagnostic testing for COVID-19 when recommended by a doctor and is offering $0 telemedicine services on most plans. The plan has also launched a coronavirus risk assessment survey and testing center locator, both accessible by the general public.
- Scott & White Health Plan is waiving all member out-of-pocket copays and cost-sharing for telemedicine eVisits and tests for the diagnosis of COVID-19 and is committed to providing its members with access to all their prescription medication needs. This applies to fully insured Commercial Group and Individual policies, as well as Medicare plan members. Self-insured or administrative services only (ASO) employer groups will be permitted to opt out of this additional preventive coverage at their discretion. Members of self-insured groups should contact their Human Resources Department for information.
- Superior HealthPlan is covering COVID-19 testing and screening services for STAR, STAR+PLUS, STAR Health, STAR Kids (Medicaid), CHIP, STAR+PLUS Medicare-Medicaid Plan (MMP), Allwell from Superior HealthPlan (Medicare), and Ambetter from Superior HealthPlan (Marketplace) members and is waiving all associated member cost-share amounts for COVID-19 testing and screening. Superior will not require prior authorization, prior certification, prior notification, or step therapy protocols for these services. Additionally, telehealth visits with a doctor in Superior’s network are available at no cost or cost sharing for members.
- UnitedHealthcare has waived all member cost-sharing, including copays, coinsurance, and deductibles, for COVID-19 diagnostic testing provided at approved locations in accordance with CDC guidelines for all commercial insured, Medicaid, and Medicare members. The plan is also waiving copays, coinsurance, and deductibles for visits associated with COVID-19 testing at physicians’ offices, urgent care centers, and emergency departments for those members. UnitedHealthcare is also expanding Telehealth access for their members by allowing them to access their existing telehealth benefit offered through one of UnitedHealthcare’s designated partners for free and by waiving member cost-sharing for COVID-19 testing-related Telehealth visits for all eligible in-network medical providers connecting with members through synchronous virtual care (live video-conferencing). UnitedHealthcare is rapidly expanding access to its personalized digital care platform for those who need it most, including highest-risk members. This interactive platform helps members receive up-to-date information, schedule an in person or a telehealth visit with their provider, talk to a nurse, refill or schedule home delivery for prescriptions, and access emotional support 24 hours a day. The plan is also adding a symptom checker that can guide members to the appropriate services and deploying a new home-based care management platform for high-risk members. UnitedHealthcare has established a navigation support program—which provides members with a dedicated customer service professional to help coordinate access to medications, supplies, food, and appropriate care—for members under home isolation due to COVID-19 diagnosis or exposure. Members can access the program by calling the customer care number located on the back of their ID card and indicating that their provider has prescribed self-isolation. Eligible UnitedHealthcare and OptumRx members needing help obtaining an early prescription refill can call the customer care number located on the back of their medical ID card for assistance or contact OptumRx customer service (800) 788-4863. Optum’s Emotional-Support Help Line is available to support anyone who may be experiencing anxiety or stress following the recent developments around COVID-19. The free service can be reached at (866) 342-6892, 24 hours a day, seven days a week and is open to all.
We will continue working closely with health care providers, government agencies, community leaders, and our other partners to ensure all stakeholders are operating effectively to keep Texans as safe and healthy as possible.
For more information, please click here to see TAHP’s statement, which includes a link to our legislative testimony on coronavirus preparedness.