How are medical insurances responding to COVID-19?

Insurance of the Day: Blue Cross Blue Shield

BCBS announced that all of its 36 networks – both independent and locally operated – will be

  • waiving off prior authorizations for diagnostic tests and services covered for COVID-19
  • cover tests at no member cost-sharing
  • waive prescription refill limits on maintenance drugs
  • expand telehealth and nurse and provider hotline access
  • waive cost-sharing for telehealth services for a limited time
    • Check website for validity of waiver
  • BCBS Association has donated nearly $3 billion to date in support of members, health care workers, and local communities to aid the ongoing fight against the COVID-19.

This would apply to all fully insured members, individuals, and Medicare Advantage plan members, including plans working with Medicaid and CHIP agencies to ensure people have access to needed testing services.

Blue Cross Blue Shield of Massachusetts

  • Has processed up to 180,000 telehealth claims after expanding coverage for telephone and virtual visits and reimburse them
    • Will be reimbursing providers at the same rate as in-person visits
  • The telehealth claims figure for the month of March show a 3600% increase in claim submission over February – a 5100% increase in monthly average for 2019
  • Made payments of over $800 million to physicians and hospitals, including more than 50,000 new claims for COVID-19 testing, treatment, care – approximating $10 million
  • For providers participating in its Alternative Quality Contract (AQC), BCBS is accelerating payment being dispatched to providers.  This payment was to be made in late 2020 or early 2021.
  • Has developed a new, expedited, credentialing program for providers and practitioners.  This is aim to have providers enrolled and approved within 72 hours. 
    • Simple, one-page application
  • Launched a “We Are Mighty, Massachusetts” campaign – celebrating resiliency and unity against COVID-19
  • Deploying a fraction of its employees to work with field hospitals and essential elements in the states response to the pandemic

Blue Cross Blue Shield of Michigan

  • For fully insured and Medicare Advantage plan members BCBS will
    • waive off prior authorizations for diagnostic tests and services covered for COVID-19
    • cover tests at no member cost-sharing
    • waive prescription refill limits on maintenance drugs
    • expand telehealth and nurse and provider hotline access
  • will support self-insured customers who choose similar routes
  • will further expand access to prescription refills – to comply with the executive order of Gov. Whitmer. 
    • This expands the BCBSM and BCN efforts by requiring all insurance providers to waive off any limitations on early refills.
  • Will waive all copays, deductibles, coinsurances for COVID-19 testing and treatment. 
    • Applies to Commercial PPO, Medicare Advantage PPO and HMO plans
  • Is accelerating payments to Michigan-based physician organizations and practices – supporting their efforts for treating patients during the pandemic. 
    • BCBS is relaxing some of its administrative requirements allowing these organizations and health systems to spend more time treating patients and less time in other hassles.
    • Available to PGIP (Blue Cross’ Physician Group Incentive Program) – including over 20 thousand PCP and Specialists
  • Offering full salaries and benefits to employees with medical backgrounds willing to volunteer in the coronavirus field hospital in the TCF Center
  • Will waive cost-sharing for Medicare Advantage for certain specific services enabling seniors to consult doctors and therapists. 
  • Are launching new telehealth and behavioral health providers so members can prevent from an affected mental health.

Blue Cross Blue Shield of Wyoming

  • Will waive members coinsurance, copayments, and deductibles for COVID-19 medical treatments through June 30, 2020
  • Will also waive cost sharing payments for COVID-19 related testing and other services related – including but not limited to – office visits, urgent cares, or emergency department visits
  • Temporarily waiving member cost-shar for telemedicine visits by phone, video or by other means
  • Has also waived the early refill limit for prescription medications
    • Prior authorization for refill also waived off
  • Has donated $100,000 to local anti-hunger programs

Blue Cross Blue Shield of Alabama

  • Is expanding telehealth coverage allowing physicians, PAs, nurse practitioners and behavioral health practitioners to provide necessary services through telephone consultations
  • Is also waiving prior authorizations for testing and covered services that are consistent with CDC guidance for members diagnosed with COVID-19
  • Providing COVID-19 diagnostic testing at no cost to members who have a fully insured plan, an employer-based plan, are under the Federal Employee Program, or are insured under the Medicare Advantage plans.

Blue Cross and Blue Shield of Illinois

  • Is temporarily lifting cost sharing payments for medically necessary services through telehealth.
    • Applies to all fully insured members whose plan includes telehealth benefits
  • Has added 18 additional telehealth procedure codes that may be used when billing for medically necessary health care services, including codes for behavioral health therapy.
  • Has launched a microsite with information for providers, members on COVID-19
  • Has opened $1.5 million funding program for organizations focused on
    • Access to health care
    • Hunger
    • Shelter
  • Is supporting non-profit organizations that serve the most vulnerable through a $1 million donation to Governor Pritzker’s Illinois COVID-19 Response Fund and $500,000 to the Chicago Community COVID-19 Response Fund
  • Has purchased and donated 150,000 KN95 masks to meet the meet for PPEs.

Blue Cross Blue Shield of Kansas

  • Will expand coverage for telehealth services
    • Includes waiving cost-sharing for all telehealth services for members

Blue Cross Blue Shield of Kansas City

  • Will waive cost-sharing for COVID-19 testing
  • Will eliminate prior authorizations for COVID-19 services
  • Is waiving refill limits for 30-day maintenance medications, and also for urgent/sick virtual care visits
  • Is offering same or next day therapy appointments to help ease anxiety about coronavirus
  • Is waiving cost sharing and copayments for hospital admissions due to COVID-19 diagnosis.
    • Policy will remain active through June 30, 2020
    • Applies to Blue KC plans

Blue Cross Blue Shield of Louisiana

  • BlueCare allows members make a medical or behavioral telehealth visit available for $0
  • BCBS Louisiana data and analytics teams work closely with the local health department to collect, analyze and model diverse data for BC members and members of the state Medicaid plans.  This data will help projections about rates of hospitalizations, deaths, healthcare facility capacities, and proper allocation and division of crucial medical resources.
    • This information shall be shared with the state officials to help fight the pandemic.
  • Has made more than $3.1 million in grants to 70 non-profit organizations

Blue Cross Blue Shield of Minnesota

  • For all fully insured employers, individuals, and also Medicare members:
    • Will waive prior authorizations for diagnostic tests and services for COVID-19 patients
    • Test performed at no cost share to members
    • Waive prescription drug refill limits on maintenance drugs
    • Expand access to telehealth and provider hotlines
  • Self-insured employers will have the option to apply the same no-cost structure
  • Announced a new community-based initiative with Allina Health, enabling skilled volunteers to help with the shortage of PPE for health care workers – and sew CDC-approved reusable face masks
  • Is waiving all patient costs related to COVID-19 care and treatment for in-network patients – including hospitalizations.
    • This waiver applies to Minnesotans who have Blue Cross coverage on their own, seniors citizens enrolled in Medicare and all members in fully insured commercial plans.
    • Waiver will be effective through May 31, 2020
  • Has joined up with North Memorial Health to create covers for masks.  These covers will be made of surgical wrap material that can be worn over N95 masks.
  • Has granted more than $825,000 to community organizations through its COVID-19 rapid response funds.

Blue Cross Blue Shield of Mississippi

  • Covering medically necessary diagnostic tests under CDC guidance – related to COVID-19 at no cost share (deductible, copay, coinsurance) to all members.
  • Is waiving member cost sharing for necessary medical services for COVID-19 treatment – through May 31, 2020
  • Medically necessary covered telemedicine services are also being provided with no member cost sharing payments

Blue Cross Blue Shield of Nebraska

  • Will cover testing for COVID-19 with 0 cost-sharing
  • Is waiving early refill limits on 30 day prescription drugs
  • Will cover the cost of all telehealth visits with no cost-sharing for all members

Blue Cross Blue Shield of New Mexico

  • Will waive co-pays and deductibles for COVID-19 related testing
  • Will waive prior authorization
  • Launched a dedicated microsite with more information for both members and providers

Blue Cross Blue Shield of Oklahoma

  • Will waive co-pays and deductibles for all COVID-19 testing
  • Will waive prior authorization
  • Has partnered with DispatchHealth to deliver on-demand health care services at members’ homes
  • Will be temporarily lifting  all cost-sharing related to necessary behavioral and medical health services provided through telehealth.
  • Has launched a dedicated microsite with more information for both providers and members
  • Any patient receiving treatment outside Oklahoma prior to March 15 will continue receiving care closer to home if they wish so

Blue Cross Blue Shield of Texas

  • Will not apply co-pays or deductibles for testing to diagnose COVID-19
  • Will not require providers to seek preauthorization before testing for COVID-19
  • Will temporarily lift cost sharing for all medically necessary telemedicine visits related to
    • Medical issues
    • Behavioral issues
  • Will launch a dedicated microsite with information pertaining to COVID-19 for providers and members
  • Will offer an SEP (Special Enrollment Period) for its insured group customers. 
    • Employees whose groups are fully insured and did not opt in for coverage during the regular enrollment timeframe may still get coverage for their health care needs.
    • Please check the BCBSTX website for effective dates before accepting patients
  • Is waiving (cost-sharing, deductibles, copayments and co-insurances) for those receiving COVID-19 treatment. 
    • Includes treatment received at in-network facilities and for out-of-network emergencies
    • Policy expires on May 31,2020
  • Has donated $1 million to the Communities Foundation of Texas to help with relief efforts during the pandemic.  The donation should help provide
    • Personal Protective Equipment (PPE) for first responders
    • Services for senior citizens
    • Childcare for first responders and healthcare professionals
  • Has made a $1 million grant to the Texas Restaurant Associations Restaurant Relief Fund to ensure the restaurants are operational and provide meals to first responders across Texas

Please make sure you check with the relative insurances before accepting patients. ClaimsMedInc bears no responsibility for any financial loss incurred due to the information provided above.

1 Comment

  1. We’ve found that a ton of toxicology labs are making good money from private insurance payouts. We bill for a lot of them and see the numbers. Additionally, a ton of that is through BCBS. I guess the question becomes, how long will they cover it, who defines that?

    Nice write-up.

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