Centene Emphasizes MA Wellness Care, Waives Healthcare Costs
Payer efforts to support Medicare Advantage members getting back on their feet emphasize primary care, behavioral healthcare, telehealth, and social determinants of health.
Source: Centene Logo
- Centene Medicare Advantage members will have free access to primary care, behavioral healthcare, and telehealth care through December 31, 2020, the company announced. This comes as a part of payer efforts to support wellness care and alleviate beneficiary healthcare costs.
"We believe the last thing people should be worried about during this pandemic is their healthcare," said Michael Polen, senior vice president and chief executive officer of the payer’s Medicare solutions. "We want our senior members and other vulnerable populations to know they're covered.”
The payer had already waived pre-authorizations, copays, other coronavirus-related testing and treatment costs, and prescription refill limits for the year.
Now, however, Medicare Advantage members will pay nothing for their in-network primary care visit. Outpatient and non-facility behavioral healthcare visits are also free. Coverage for in-network telehealth visits will now include primary care, specialty care, and behavioral healthcare.
The payer will also award an incentive to any Medicare Advantage members who complete their free annual wellness visit. This incentive may prove essential as a recent PwC consumer survey showed that Medicare Advantage members were 26 percent likely to skip their annual exams.
Medicare Advantage plans that have an over-the-counter benefit may see as much as $150 additional allowance through December 31, 2020. However, this benefit may vary based on the plan—for example, the allowance may be added every month or each quarter.
The payer also has a Community Connections Help Line that connects members and caregivers with community resources to address social determinants of health. The help line has connected around 3,000 calls since early March. Callers were most interested in assistance with five social determinants of health:
- Food security
- Medication support
- Utilities support
- Housing stability
- Transportation
Six in ten callers feared that they might run out of food before they had enough money to get groceries. Four in ten callers were concerned about paying their medical bills.
“It's difficult to prioritize your health and healthcare when you don't have access to healthy food or the ability to pay your bills," said Polen. "We want to do everything we can to eliminate those social determinants of health – social and economic factors that can have a major impact on overall health and wellbeing – especially during this challenging time.”
In light of these food insecurities, Centene offered additional food-related benefits for Medicare Advantage members.
Members who require chronic disease management or who have recently been hospitalized and discharged may have fourteen more free meal deliveries.
Seniors need protection financially as well as medically. Over six million seniors who are on Medicare but lack supplemental coverage would shoulder out-of-pocket healthcare costs for their coronavirus treatment if they contract the disease, a PAN Foundation report discovered. Thirty-seven percent of them make less than $20,000 annually.
Even members with coverage face grave financial concerns during the pandemic, as the Centene call center data underscores.
As America cautiously steps out of full quarantine and into the first phases of recovery, payers continue to focus on providing extra support for senior citizens, one of the populations that is most vulnerable to the coronavirus.
Blue Cross Blue Shield Michigan (BCBSM) and Humana have also increased their commitments to Medicare Advantage members. BCBSM waived cost-sharing for virtual and in-person care and covered the full cost of some consultation services.
Humana covered Medicare Advantage behavioral healthcare and primary care visits and also sent safety kits with masks and health instructions to seniors.
“As many states begin to lift shelter-in-place orders and reopen the healthcare system, we want to help our members stay safe while removing any unneeded financial burdens to accessing care,” explained Polen.
