Dive Brief:
- Two more major private payers said Monday they will waive cost-sharing for COVID-19 treatment, joining Aetna, which made the same policy change Wednesday.
- Humana's waiver applies to Medicare Advantage plans and fully-insured commercial members and will cover all medical costs related to treatment of COVID-19 as well as any medication or vaccines that are approved by the FDA for treating the disease, once they become available. The policy will cover in-network and out-of-network providers and has no set end date at the moment.
- Cigna is waiving customer cost-sharing for the treatment through May 31 for MA and commercial members while self-insured plans have the option to opt-out. Providers will be reimbursed at Medicare or Cigna's in-network rates.
Dive Insight:
As the number of coronavirus cases has increased rapidly in the United States, with no signs of slowing, insurers have taken several steps to respond to the unprecedented outbreak. Pushed by states and the large payer lobby America's Health Insurance Plans, major insurers first said they would waive co-payments for COVID-19 diagnostics to encourage more Americans to get tested, although testing is still not widely available in most areas.
President Donald Trump during a Sunday evening press briefing first announced the new Humana and Cigna policies, thanking the payers for the change. "They don't waive co-pays easily, but we asked them to do it ... to help ease the financial burden on American families during this pandemic," he said.
Private payers and CMS have also said telemedicine visits will be covered with no cost-sharing so that more patients can get care with less risk of exposing themselves to the virus. Most have also said prescription refill limits are relaxed.
Cigna said Monday it is also deploying staff clinicians to its partner telehealth provider MDLive to "help increase capacity by delivering much-needed care to patients." The payer has also worked with AI platform Buoy Health on a web-based triage tool to assess COVID-19 risk.
While the focus now is on treating COVID-19 patients who need intensive care and finding enough doctors and supplies as the U.S. healthcare system is stretched to the brink, the pandemic will have other effects down the line.
When payers assess premium rates for 2021, they could institute increases of as much as 40% to recoup costs and protect solvency, according to one analysis from actuaries in California. And a projection from Willis Towers Watson found U.S. employers can expect their health benefit costs to rise as much as 7% as a result of COVID-19 testing and treatment.
Various estimates have surfaced for what treatment of the disease costs. The California actuaries said an average bill for COVID-19 treatment will be about $72,000. The Kaiser Family Foundation suggested an average of about $20,000 for a hospital stay while FAIR Health came in at between $42,000 and $74,000 a patient.