Note: This article has been updated to reflect that UnitedHealthcare and Anthem have since announced they would waive out-of-pocket costs.
Three insurers have moved to cover the cost of care related to Covid-19, as more people across the U.S. are sickened by the pandemic. Cigna, Humana and Aetna all moved within the last week to waive related out-of-pocket costs for members in their individual and group health plans.
Most people who have milder cases of Covid-19 will be told to self-quarantine at home. But for those who are severely ill, the cost of a hospital trip, or a multiple-day stay, can quickly add up. One uninsured patient reported a bill just short of $35,000 after it took multiple hospital trips to get a diagnosis. Another estimate pegged the cost of a six-day hospital stay at over $73,000.
All group and individual health plans must waive out-of-pocket costs for testing and associated visits, per the Families First Coronavirus Response Act. But outside of that, there’s still a lot of variation in what insurers require members to pay.
Even for insurers that will cover out-of-pocket costs for treatment, there’s still one critical flaw: they do not address so-called “surprise bills” that are often incurred when patients unknowingly receive treatment from an out-of-network provider.
Here’s how different commercial insurers have changed their plans in response to Covid-19:
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Cigna: On Monday, Cigna moved to waive co-payments and other out-of-pocket costs for Covid-19 treatment through May 31. The insurer will also cover more telehealth appointments, but is only waiving the cost of virtual appointments related to Covid-19. The changes apply to Cigna’s individual, group and Medicare Advantage plans. The insurer said it is also offering this coverage to self-insured plans, though they have the option to opt out.
Humana: Humana also recently announced it would waive cost-sharing related to Covid-19 treatment, including telehealth visits, hospital visits and ambulance services. Since tests have been hard to come by, the insurer specified that a positive Covid-19 test confirmation is not required to be covered. Humana is also waiving out-of-pocket costs for telehealth visits. The company has not specified when this extended coverage would end.
Aetna: Last week, the CVS Health subsidiary was the first to say it would waive cost-sharing and co-pays for in-network hospital admissions related to Covid-19. Aetna is also waiving the cost of all telemedicine visits until the beginning of June.
UnitedHealthcare- On Tuesday, UnitedHealthcare said it would waive out-of-pocket payments for Covid-19 treatment, which would include its commercial plans, Medicare Advantage and Medicaid Plans. It also said it would work with self-funded employers to waive costs. The company also announced it will waive out-of-pocket costs for in-network telehealth visits through June 18.
Anthem– Anthem on Wednesday moved to waive cost-sharing for treatment costs related to Covid-19 through May 31. The company said it is also “strongly encouraging” self-funded employers to participate.
Other insurers have expanded some aspects of their coverage, but plan members would still pay the associated costs with a hospital visit:
Blue Cross Blue Shield Association– The 36 independent companies as part of the Blue Cross Blue Shield Association will expand their telehealth coverage for the next three months. This includes waiving cost-sharing for in-network telehealth providers.
Kaiser Permanente– Aside from covering costs related to Covid-19 testing at its facilities, Kaiser Permanente has not yet announced any changes to cost-sharing.
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