Cigna, Humana waive cost-sharing for COVID-19 treatment

(Bloomberg) – Two of America’s largest health insurers, Cigna Corp. and Humana Inc., said they will waive out-of-pocket costs for patients who need treatment for COVID-19.

Leaders of both companies called it the right thing to do to help alleviate financial stress for their members and to remove barriers that could keep people from getting needed medical care.

Related: Coronavirus coverage stumps most health insurance enrollees

“We’re stepping in as aggressively as we can to support care access and peace of mind,” Cigna Chief Executive Officer David Cordani said in a joint interview with Humana CEO Bruce Broussard.

The immediacy of the coronavirus crisis has overshadowed America’s longstanding conflicts over the price of medical care and how costs should be distributed. But those problems are simmering in the background as the pandemic meets a population where access to health care was already precarious for tens of millions of people.

About 45 percent of working-age Americans don’t have adequate health coverage, according to a survey by the Commonwealth Fund, a health research nonprofit. That includes those who have no insurance and those with high out-of-pocket costs relative to their income. Last week, an uninsured 17-year-old in Lancaster, California, died of suspected Covid-19 after being turned away from an urgent care center and sent to a hospital instead, according to a video the city’s mayor posted on YouTube.

Health insurers moved earlier this month to lift cost-sharing for Covid-19 diagnostic testing, a practice that was later mandated by Congress for the duration of the public health emergency. Insurers and government health regulators have taken other steps to encourage telemedicine, lift prior-authorization requirements and allow hospitals to quickly discharge patients to post-acute settings.

Surprise billing

Cordani and Broussard said they don’t want disputes over payment or concern about doctors being out-of-network to dissuade anyone from seeking care. Cigna said it would pay providers its in-network rates or Medicare rates, and both executives said patients would be shielded from balance or surprise billing by doctors or hospitals.

“We’re going to keep it between the provider and the company,” Broussard said.

Both Cigna and Humana said it was too early to tell whether expenses like deductibles, co-payments, and co-insurance — portions of the medical bills that patients are responsible for — were keeping their members from getting treatment for Covid-19.

“In general, what we see is that when there are significant financial barriers people do delay care,” Broussard said.

Half of all adults with employer-based health insurance said they or a family member have delayed or skipped care in the past year because of cost, according to a 2019 survey from the Kaiser Family Foundation and the LA Times.

The decision to waive cost-sharing for Covid-19 treatment will apply across all of the two companies’ fully insured products, executives said. Self-insured employer plans — where the employer holds the financial risk and the insurer administers benefits — will be encouraged to follow but can opt out of the practice.

Medical services

The companies are emphasizing that they are not merely insurers pooling financial risk but actively delivering needed medical services to their members. Company nurses and other clinicians are reaching out to patients, particularly those most vulnerable to the virus and the economic hardship of shutting down much of the economy. Broussard said Humana helped direct more than 10,000 meals to senior citizen members in need last week.

Cigna insured about 17 million members in medical plans, mostly for employers, at the end of last year, and another 76 million in pharmacy coverage. Humana, whose business is focused on private Medicare Advantage plans, covered about 17 million across medical and drug plans.

Cigna said the policy will take effect immediately and last through May 31. Humana said the policy has no current end date, and the company will re-evaluate as the situation changes.

Both executives said it was too early to say how the pandemic might affect health insurance premiums for next year. Both declined to say in detail how it might impact their broader businesses.

Read more: 

• Coronavirus sparks renewed calls for Medicaid expansion
• Insurers offer free coronavirus testing, but you might pay for it next year
• Coronavirus: A checklist for employers

Copyright 2020 Bloomberg. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.