·  Legal News, Analysis, & Commentary

Health & Medicine

Insurance Companies Opt to Waive COVID-19 Costs

— April 7, 2020

Insurance companies are opting to waive cost-sharing obligations amid pandemic.

Health insurance companies Aetna, Cigna and Humana are following CVS Health’s lead in deciding to waive member cost-sharing and copays on all medical costs related to the treatment of coronavirus, including future FDA-approved medications and vaccines, as well as ambulatory transportation and hospitalization.  The decision includes all group plans as well as Medicaid and Medicare patients, and comes shortly after the passage of the $2 trillion federal Coronavirus Aid, Relief, and Economic Security (CARES) Act.  The CARES Act requires the healthcare industry to provide “first-dollar coverage for testing, emergency room care and for future vaccines.”

“Our customers with COVID-19 should focus on fighting this virus and preventing its spread,” said David Cordani, Cigna president and CEO, adding, “While our customers focus on regaining their health, we have their backs.”

“We’re taking this significant action to help ease the burden on seniors and others who are struggling right now.  No American should be concerned about the cost of care when being treated for coronavirus,” said Bruce Broussard, president and CEO of Humana.

Insurance Companies Opt to Waive COVID-19 Costs
Photo by Olga Kononenko on Unsplash

Aetna, Humana and Cigna announced coverage of members’ cost-sharing responsibilities for both in-network and out-of-network COVID-19 services and said they would negotiate with federal authorities to make sure that patients do not receive out-of-network bills.  Prior authorizations have also been waived by most insurers.

For healthcare providers, the CARES Act allocated $1.32 billion in grants for COVID-19 testing, $29 million per year for the next five years for telehealth, and it also extends federal support for rural healthcare with grants of $79.5 million per year for the next five years.  Volunteer healthcare workers are to have added protections against lability for treatment of COVID-19, so providers can focus on treating patients and containing the virus.

The decision of insurers to waive cost-sharing to provide relief during such a pivotal time comes before anyone can truly estimate the total cost of the crisis.  CVS Health said in a regulatory filing, “At this time we cannot reasonably estimate the adverse impact COVID-19.  The adverse impact could be material.”  Many consumers are worried about added premium costs in 2021 to compensate for the loss.  However, so long as it can be eradicated by the end of this year, this shouldn’t be an issue.

“When issuers develop rates for 2021, it must be based on 2021 expected costs.  Issuers are not allowed to include past losses in prospective premium rates if those costs are not expected to persist,” Dave Dillon, a Dallas-based member of the Society of Actuaries, said. “Therefore, for the majority of health insurance issuers, premiums would not be expected to increase as a result of COVID-19-related costs if the pandemic is limited to 2020.”  What’s more, he added, “Many issuers are receiving significantly lower call volumes, which is considered a key predictor for future claims.  Therefore, it appears that 2020 COVID-19-related losses may be offset by reduced spending in other areas in the short term.”

Much to the chagrin of policy holders and Democrats, President Trump recently made the decision not to open the healthcare marketplace for Obamacare plans.  “It should be unimaginable that in the middle of a pandemic the President of the United States would reject a clear opportunity to help people get health care coverage they desperately need,” Senator Patty Murray, the ranking Democrat on the Senate Health Committee. “But that’s exactly what President Trump is doing.  It’s inexcusable.”


Cigna and Humana waive coronavirus treatment costs

CARES Act: H. R. 748

The coronavirus’s unpredictable impact on next year’s health insurance rates, explained

Donald Trump Won’t Open The Obamacare Markets During The Coronavirus Outbreak

Join the conversation!