Private Payers News

BCBSM, Humana Waive Medicare Advantage Costs as States Reopen

Payers focus on covering primary care visits, mental and behavioral healthcare, and enabling Medicare Advantage members to adapt to the post-pandemic world.

primary care, medicare advantage, behavioral healthcare, mental healthcare, telehealth, employer-sponsored health plan, coronavirus

Source: Getty Images

By Kelsey Waddill

- Blue Cross Blue Shield of Michigan (BCBSM) and Humana have stepped up their commitments to Medicare Advantage members as states begin to reopen businesses and lift stay-at-home orders.

For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.

Medicare Advantage members are particularly prone to severe coronavirus symptoms. For that reason, CMS had initially targeted Medicare Advantage plans in its response efforts.

As the states begin to reopen, health plans continue to find ways to bring down costs for their Medicare Advantage population.

“Without question, seniors have proven to be particularly vulnerable during the COVID19 pandemic, from both a physical health and emotional support perspective,” said Daniel Loepp, BCBSM president and chief executive officer. 

“Even if they have not been personally affected by coronavirus, nearly all older adults are affected by the disruptions that have occurred in getting to the doctor’s office for checkups and regular care.  Blue Cross wants to encourage our Medicare Advantage members to continue to seek care and consultations with their doctors and therapists during this time, and waiving cost-sharing is one thing we can do to encourage our seniors to continue to consult with their health and mental health professionals.”

BCBSM responded in collaboration with the Blue Care Network of Michigan.

The companies recently waived cost-sharing for all Medicare Advantage members for some consultation services. Both virtual care and in-person care may be free of cost-sharing—encompassing deductibles, coinsurance, and copays.

Valid services include in-person primary care services, behavioral health visits to the doctor’s office, and medical and behavioral healthcare via telehealth, which has become a primary resource in the efforts against coronavirus.

BCBSM is working individually with its employer customers to determine coverage for Medicare Advantage plan members on employer-sponsored health plans.

The waivers started May 1 and continue through December 31, 2020.

Humana also recently announced a move to waive certain healthcare costs for Medicare Advantage members during the coronavirus.

“These actions are the latest in a series of efforts we’re taking to support Humana members and help them best manage their chronic conditions and other health issues and ensure that we’re living up to our commitment to meet their needs,” said Bruce Broussard, president and chief executive officer of Humana. “By supporting members’ safety and lowering financial barriers, we can also help facilitate the reopening of the healthcare system and help bolster the economy.”

The payer’s approach was two-pronged: it covered behavioral healthcare and primary care visits and it provided safety kits for members delivered directly to their homes. The main goal is to alleviate cost burden for Medicare Advantage members as the coronavirus restrictions lift.

Humana waived out-of-pocket costs for primary care office visits, whether or not the visit is related to coronavirus. This includes outpatient and non-facility based behavioral healthcare treatment as well as all in-network telehealth visits through the end of 2020.

“By eliminating these costs, Humana is supporting members to re-engage with their physician for pressing primary care and behavioral health needs whether in-person or virtually, depending on their personal situation,” the press release explained.

The safety kits are intended to support seniors as they begin to emerge from their homes and care institutions when the restrictions lift. The kits include masks and health instructions to safely navigate the post-pandemic world.

Reopening states has been a controversial move, as some experts warn that a second wave is likely in America’s near future.

America’s Health Insurance Plans (AHIP) has endorsed several strategies for plans to embrace as their states reopen, including continued telehealth reliance and mental and behavioral healthcare resources.