COVID-19 Cost Share Waivers FAQ

  • We know these are difficult times for many, and the worry about medical bills, especially as they relate to COVID-19, is great. To ease some of the burden for our members, effective today Premera Blue Cross will be waiving cost shares including copays, deductibles, and coinsurance for all COVID-19 related treatment (both inpatient and outpatient), in addition to our previous waiver for COVID-19 testing and related provider visit. This cost share waiver will continue through October 1, 2020. For Premera Medicare Advantage customers, regulators haven't communicated an end date for this flexibility. Premera will adjust our policy as regulator guidance becomes available. 

    We'll keep you updated as more information becomes available.

     

  • This benefit applies to members of insured group, individual, grandfathered, and non-grandfathered plans, associations, and Premera Medicare enrollees. Self-funded group plans have the option to participate. This includes qualified high deductible plan participants.

    The cost share waivers don't apply to shared admin, FEP, and self-funded plans who opt out.

    Premera is waiving member cost shares including copays, deductibles, and coinsurance for treatment of COVID-19 or health complications associated with COVID-19, including hospitalizations and medical transportation when needed, and FDA-approved medications administered inpatient for both in and out of network providers. 

    No. We’ll be reviewing all claims for COVID-19 testing and treatment from January 1, 2020 forward. For Premera’s Medicare enrollees, we’ll review claims dating back to February 4, 2020. If you feel you had a claim with a COVID-19 diagnosis where cost share waivers didn’t apply, call our customer service team at the number on the back of your ID card. We’ll need to know the patient’s name, date of service, and the provider and location of the service. 

    Our providers are using specific claim and diagnosis codes that have been provided by various regulatory agencies. We’ll use those codes to determine if a claim is related to COVID-19. 

    We plan to continue the cost shares including copays, deductibles, and coinsurance waivers for COVID-19 treatment through October 1, 2020. We’ll continue to review this date as needed.

    We’ve waived cost shares including copays, deductibles, and coinsurance for telehealth services, including our newest partners and brick and mortar in-network providers. 

    At this time, we’re waiving cost shares and deductibles for all COVID-19 related testing and treatment or health complications associated with COVID-19 (both inpatient and outpatient). All other treatments and services outside of COVID-19, will be subject to the usual benefits and cost shares.

    Self-funded groups have the option to opt out of this expansion if they choose. If we don’t receive an opt-out email, those employees will automatically be included, and claims will be processed accordingly. Those who wish to opt out will need to notify their account manager and send an email to optout2020@premera.com by noon PST on April 16, 2020.

    Self-funded groups, including OptiFlex, have until noon PST on April 16, 2020 to determine if they want to opt out of the cost share waiver for COVID-19 treatment. We’ll have information about self-funded group participation by April 16, 2020.