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Humana COVID-19 At-Home Testing Updates

January 17, 2022/in Carrier, COVID Tests (January 2022), Employee Benefits, Humana, Legislation/by Cornerstone

Beginning January 15, 2022, Humana will cover over-the-counter COVID-19 at-home test kits for members.

As announced by the U.S. Department of Health and Human Services group health plans will cover the cost of at-home, over-the-counter COVID-19 test kits beginning on January 15. This new policy will cover eight test kits per month, for all covered members, at no out-of-pocket cost.

Humana will offer commercial group members two options to get at-home, OTC COVID-19 test kits at no-cost:

  1. Pay the full amount for the test up-front and get reimbursed, and
  2. Have the pharmacy staff process the at-home OTC COVID-19 test kit as a claim and receive payment directly from Humana at no cost to them.

Please read the FAQ below for details and contact your Cornerstone representative with any questions.

Click me
https://www.crnstone.com/wp-content/uploads/2022/01/Humana-COVID-19-At-Home-Testing-Updates.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-17 21:09:302022-01-19 19:28:34Humana COVID-19 At-Home Testing Updates

UnitedHealthcare to Cover COVID-19 At-Home Tests, Small Business Market Segment Update

January 17, 2022/in Carrier, COVID Tests (January 2022), Employee Benefits, Legislation, UnitedHealthOne/by Cornerstone

On Jannuary 10, 2022, the Departments of Labor, Treasury and Health and Human Services released guidance to support the Administration’s directive that health insurers and group health plans cover, subject to certain criteria, the cost of FDA-authorized or approved over-the-counter (OTC) COVID-19 at home tests beginning on January 15, 2022.

On January 15, 2022, UnitedHealthcare began covering most commercial individual and group health plan members’ FDA-authorized or approved over-the-counter COVID-19 at home tests without a doctor’s prescription or clinical assessment. This COVID-19 at home test benefit includes up to eight tests per member per 30 days.

UnitedHealthcare fully insured and level-funded individual and group health plan members will have two ways that they can receive reimbursement for these COVID-19 at home test kits.

  1. Preferred Retailers — UnitedHealthcare has developed and deployed a solution of Preferred Retailers for coverage of over-the-counter COVID-19 at home test kits. A Preferred Retailer is a pharmacy that UnitedHealthcare has made arrangement with to provide an OTC COVID-19 at home tests at no cost to the member at time of purchase or later. The list of Preferred Retailers and their websites may be found in the Preferred Retailer list on uhc.com. UnitedHealthcare is working to add additional Preferred Retailers.
  2. Other retailers or online — If the member purchases a COVID-19 at home test at any in-store or online retailer other than at the in-store pharmacy counter, they may submit purchase receipt(s) for reimbursement at the UnitedHealthcare member portal for a maximum reimbursement of $12 per test. Many COVID-19 tests are sold as a two-pack so that means the test pack would be reimbursed at $24 ($12 for each test).

A member must be a UnitedHealthcare commercial individual or group health plan member and have UnitedHealthcare’s Pharmacy benefit to purchase over-the-counter COVID-19 at home tests at the Preferred Retailer at no cost using their UnitedHealthcare member ID card. As mentioned earlier, the member may also purchase and then submit a receipt for reimbursement at the retail location of their choice.

Other self-funded customers will receive a communication shortly that will outline the program and options for their business and members.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/01/UnitedHealthcare-to-Cover-COVID-19-At-Home-Tests-Small-Business-Market-Segment-Update.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-17 21:04:232022-01-21 14:14:26UnitedHealthcare to Cover COVID-19 At-Home Tests, Small Business Market Segment Update

Anthem Members Will be Reimbursed for Over-the-Counter COVID-19 Tests

January 17, 2022/in Anthem, Carrier, COVID Tests (January 2022), Employee Benefits, Legislation/by Cornerstone

A recent announcement from the federal government intends to increase access to COVID-19 testing. As of January 15, 2022, members can get reimbursed by their health plan without cost share for the costs of over-the-counter diagnostic COVID-19 tests until the end of the Coronavirus Public Health Emergency. Diagnostic tests are performed if members are experiencing COVID-19 symptoms or have been recently exposed.

When should an employee take a test?

The Centers for Disease Control and Prevention (CDC) provides guidelines for who should get a diagnostic test and when based on their current health vaccination status and history of infection.

Where can employees find a test?

  • Visit COVIDtests.gov for information on free tests that may be available through government programs.
  • Anthem has a limited number of at-home diagnostic test kits available for certain members to order online. Log in using the Sydney Health mobile app (see attached flyer for details) or at anthem.com. If the member is eligible to order an at-home test, they will see an option to place an order.
  • Employees can still use in-person diagnostic COVID-19 testing sites. These may include their doctor’s office, a pharmacy or health clinic, or an urgent care center. They can use our  COVID-19 Test Site Finder to find a testing location close to them.
  • Over-the-counter diagnostic tests can be purchased online, at a local pharmacy, or from a big-box store.

Can employees visit the emergency room for a test?

As hospitals and emergency departments are overwhelmed, employees should avoid going to the emergency room (ER) to be tested. They should only visit the ER or call 911 if they’re experiencing life-threatening symptoms.

How are the over-the-counter tests covered?

From January 15, 2022, until the end of the Coronavirus Public Health Emergency, each member on a group plan can get up to eight over-the-counter tests each month. If they purchase a test kit that includes two rapid tests, that will count as two of their eight covered tests.

How will employees be reimbursed?

Members will be reimbursed for over-the-counter COVID-19 diagnostic tests purchased on or after January 15, 2022.  The member may have to pay out of pocket at the time of purchase but should keep their receipt and submit a claim online.  The member will log in to anthem.com and following the steps in the attached document titled How Members File for At-Home COVID Test Reimbursement.

 

Click this link to find Anthem’s COVID-19 resource site with more information on the over-the-counter kits.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/01/Anthem-Members-Will-be-Reimbursed-for-Over-the-Counter-COVID-19-Tests.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-17 20:59:302022-01-27 15:58:36Anthem Members Will be Reimbursed for Over-the-Counter COVID-19 Tests

Insurance Companies and Group Health Plans Now Required to Cover Costs of At-Home COVID-19 Tests

January 11, 2022/in Compliance, Cornerstone Updates, COVID Tests (January 2022), Employee Benefits, Individual, Legislation, Marketplace/by Cornerstone

The following information was originally posted by CMS.gov.

As part of its ongoing efforts across many channels to expand Americans’ access to free testing, the Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of over-the-counter, at-home COVID-19 tests, so people with private health coverage can get them for free starting January 15th. The new coverage requirement means that most consumers with private health coverage can go online or to a pharmacy or store, buy a test, and either get it paid for up front by their health plan, or get reimbursed for the cost by submitting a claim to their plan. This requirement incentivizes insurers to cover these costs up front and ensures individuals do not need an order from their health care provider to access these tests for free.

Beginning January 15, 2022, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance. Insurance companies and health plans are required to cover 8 free over-the-counter at-home tests per covered individual per month. That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan per month. There is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.

“Under President Biden’s leadership, we are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost,” said HHS Secretary Xavier Becerra. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also purchasing half a billion at-home, rapid tests to send for free to Americans who need them. By requiring private health plans to cover people’s at-home tests, we are further expanding Americans’ ability to get tests for free when they need them.”

Over-the-counter test purchases will be covered in the commercial market without the need for a health care provider’s order or individualized clinical assessment, and without any cost-sharing requirements such as deductibles, co-payments or coinsurance, prior authorization, or other medical management requirements.

As part of the requirement, the Administration is incentivizing insurers and group health plans to set up programs that allow people to get the over-the-counter tests directly through preferred pharmacies, retailers or other entities with no out-of-pocket costs. Insurers and plans would cover the costs upfront, eliminating the need for consumers to submit a claim for reimbursement. When plans and insurers make tests available for upfront coverage through preferred pharmacies or retailers, they are still required to reimburse tests purchased by consumers outside of that network, at a rate of up to $12 per individual test (or the cost of the test, if less than $12). For example, if an individual has a plan that offers direct coverage through their preferred pharmacy but that individual instead purchases tests through an online retailer, the plan is still required to reimburse them up to $12 per individual test. Consumers can find out more information from their plan about how their plan or insurer will cover over-the-counter tests.

“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated. Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people,” said CMS Administrator Chiquita Brooks-LaSure.

State Medicaid and Children’s Health Insurance Program (CHIP) programs are currently required to cover FDA-authorized at-home COVID-19 tests without cost-sharing. In 2021, the Biden-Harris Administration issued guidance explaining that State Medicaid and Children’s Health Insurance Program (CHIP) programs must cover all types of FDA-authorized COVID-19 tests without cost sharing under CMS’s interpretation of the American Rescue Plan Act of 2019 (ARP). Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People enrolled in a Medicare Advantage plan should check with their plan to see if their plan offers coverage and payment for at-home over-the-counter COVID-19 tests.

This effort is in addition to a number of actions the Biden Administration is taking to expand access to testing for all Americans. The U.S. Department of Health and Human Services (HHS) is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. The program is intended to ensure COVID-19 tests are made available to populations and settings in need of testing. HHS also has established more than 10,000 free community-based pharmacy testing sites around the country. To respond to the Omicron surge, HHS and FEMA are creating surge testing sites in states across the nation.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/01/Insurance-Companies-and-Group-Health-Plans-Now-Required-to-Cover-Costs-of-At-Home-COVID-19-Tests.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-11 16:17:382022-01-21 14:38:29Insurance Companies and Group Health Plans Now Required to Cover Costs of At-Home COVID-19 Tests

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