Anthem – Information for Care Providers about COVID-19
March 2020 ~
Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company (Anthem) issued a notice informing patients and providers that the insurer is closely monitoring COVID-19 developments and reports from the Centers for Disease Control and Prevention (CDC) to help determine what action is necessary.
The insurer has developed a list of frequently asked questions regarding administrative processes and recent changes related to COVID-19. These areas include:
Member Cost Share Waiver
Effective March 5, 2020 and until further notice, Anthem or its delegated entities will waive member cost shares, inclusive of copays, coinsurance, and deductibles for screening and testing for COVID-19. Tests samples may be obtained in many settings including a doctor’s office, urgent care, ER or even drive-thru testing once available. While a test sample cannot be obtained through a telehealth visit, the telehealth provider can help a member get to a provider who can do so. The waivers apply to members who have individual, employer-sponsored, Medicare and Medicaid plans.
The insurer notes that the waiver of cost shares is limited to screening and testing for COVID-19. For care unrelated to COVID-19 screening and testing members will pay any out-of-pocket expenses their plan requires unless otherwise determined by state law or regulation. As of March 17, 2020, Anthem will waive, until further notice, any member cost share for telehealth or telephonic visits provided by an in-network provider, including visits for mental health, for our fully insured employer, individual, Medicare and Medicaid plans. Cost shares will be waived for members using Anthem’s telemedicine service, LiveHealth Online, as well as care received from other telehealth providers. Self-insured plan sponsors will have the choice to participate.
Prior Authorization Requirement Waiver
Prior authorization is not required from Anthem or its delegated entities for screening or testing related to COVID-19 testing.
Telehealth and Telephonic Services
Effective March 17, 2020, and until further notice, Anthem and its delegated entities will waive cost-sharing for members using Anthem’s telemedicine service, LiveHealth Online, as well as care received from other in-network providers delivering virtual care through internet video + audio services for our fully insured employer plans, Individual plans, Medicare plans and Medicaid plans. Self-insured plan sponsors may opt-out of this program. Anthem notes that member cost shares for telehealth services will not be waived for out of network providers, except for COVID-19 screening.
Effective March 19, 2020, Anthem and its delegated entities will cover telephone-only medical and behavioral health services from in-network providers and out-of-network providers when appropriate. Exceptions include chiropractic services, physical, occupational, and speech therapies. These services require face-to-face interaction and therefore are not appropriate for telephone-only consultations. Self-insured plan sponsors may opt-out of this program.
Members be will be allowed to obtain an extra 30-day supply of medication when medically appropriate and permitted by state and federal law. Anthem also encourages patients that, when member plans allow, they switch from 30-day home delivery to 90-day home delivery.
Source(s): Anthem Blue Cross Blue Shield;