Insurance Policies Get a COVID-19 Shake-up

Meeting the challenges of the COVID-19 pandemic isn’t just about having enough protective masks, hospital beds and ventilators.  It’s also about establishing insurance policies that protect access. 

Insurance coverage and plan design have a major impact on patients’ ability to receive optimal care during the COVID-19 pandemic.  Several insurance companies have taken steps to make treatment more accessible.

Cigna, for example, is waiving all out-of-pocket costs for COVID-19-related visits to in-network providers at a doctor’s office, urgent care clinic, emergency room or telehealth visit.  Aetna, Humana and others are waiving patients’ cost sharing too. This means patients covered by these insurers won’t have to worry about meeting their deductible before they can get COVID-19 care.

But it’s not just out-of-pocket costs that are being waived.  Many insurers have suspended utilization management policies like prior authorization for COVID-19 treatment too.  

Some states aren’t waiting for insurers to initiate change on their own, though.  Louisiana Insurance Commissioner Jim Donelon announced a total ban on the use of step therapy for treating coronavirus or any other condition.  Step therapy, also called “fail first,” requires patients to try and fail on an insurer-preferred medication before using the one their doctor ordered.  The emergency rule issued in Louisiana also permits early prescription refills for most medications, among other patient-oriented provisions.

According to predictions, coronavirus infections have yet to peak in most parts of the country.  There’s still time for more insurers and states to adjust course so that patients who have COVID-19 – and those who do not – can access necessary health care. 

Categorized in: