One problem is that insurers have waived copays and other telehealth cost sharing for in-network doctors only. Another is that Blue Cross Blue Shield, Aetna, Cigna, UnitedHealthcare and other carriers promoting telehealth have little power to change telemedicine benefits for self-insured employers whose claims they process. Effective immediately, Cigna is waiving all cost-sharing for in-network medical or behavioral telehealth visits for customers in the U.S. Covered by Medicare Advantage and Individual and Family Plans.
Cigna is eliminating cost-sharing for all primary, specialty and behavioral care for in-office or telehealth visits for all COVID-19 and non-COVID-19 care.
This is for in-network medical or behavioral telehealth visits for customers in the U.S. covered by Medicare Advantage, individual or family plans, including individual plans sold on the marketplace.
Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits for customers during the pandemic. The insurer is providing additional days of nutrition through meal delivery for customers following their discharge from a hospital stay for any condition, including COVID-19.
Telehealth Cigna Coverage Policy
Cigna's Medicare Advantage customers will now have access to 28 meals for 14 days at no extra cost following their discharge from a hospital, which doubles the meals offered previously.
These home-delivered meals incorporate individual dietary restrictions, and are delivered frozen with preparation instructions.
For Cigna's Medicare Advantage customers, these cost-share measures, benefits extensions and policy changes will be in effect through the end of December 2020. For individual and family plans and exchange customers, these changes will apply until the end of applicable federal and state public health emergencies.
WHY THIS MATTERS
While telehealth is not suitable for every condition, it is important for people not to defer critical care needs at this time, Cigna said.
In May, the Centers for Medicare and Medicaid Services finalized requirements that increased access to telehealth for seniors in Medicare Advantage plans. The agency provided more flexibility for telehealth providers in specialty areas.
THE LARGER TREND
Cigna Telehealth Billing Requirements
Cigna previously eliminated cost share for COVID-19 testing and treatment.
Cigna Telehealth 2021
These measures are an expansion of Cigna's previously-announced efforts during COVID-19.
Cigna followed CMS's lead by reimbursing providers for COVID-related virtual visits as if they were in-person visits. It also eased primary care provider referrals for specialists in certain situations.
Customers who were eligible to pick a Medicare Advantage plan earlier this year, but could not because of the pandemic, are entitled to a special enrollment period.
Additionally, individuals who lost healthcare coverage from their employer, or had other significant life events, are entitled to a special enrollment period for individual health plans.
ON THE RECORD
'COVID-19 has affected all age groups – physically, financially and emotionally,' said Brian Evanko, president of Cigna's Government Business. 'We want everyone to focus on getting and staying well – including those being tested for and diagnosed with the virus and their loved ones – and not having to worry about how they will access or afford the care and services they need.'
'For many customers, virtual care is an effective way to address their health concerns and continue to access their medications without leaving the safety of their homes,' said Dr. Gina Conflitti, chief medical officer of Cigna's Medicare Advantage business. 'By waiving cost sharing for these behavioral health visits, in addition to medical services, we're making it easier and more affordable for customers to attend to both their mental health and physical well-being in a setting that works best for their individual needs.'
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com