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Songer Benefits, Inc. Blog

All You Ever Wanted to Know About Insurance

Extended: Temporary provisions waiving COVID-19 treatment cost-sharing

UnitedHealthcare is waiving cost-sharing for COVID-19 inpatient treatment at in-network facilities for Individual and Group Market fully insured plans, as well as UnitedHealthcare Individual Exchange plans.

Between Jan. 1, 2021, and Jan. 31, 2021, UnitedHealthcare has extended medically necessary network inpatient COVID-19 treatment at no cost share for fully insured groups and for All Savers and ASO groups that follow UnitedHealthcare COVID-19 coverage. This extension applies only to inpatient COVID-19 treatment with a COVID-19 diagnosis, and UnitedHealthcare Individual Exchange plans.

Implementation of the extension may apply to self-funded customers (ASO) that follow UnitedHealthcare fully insured unless they chose to opt-out. State variations and regulations may apply during this time.

Emergency room treatment will be covered at no cost share between Jan. 1, 2021, and Jan. 31, 2021, if the patient is admitted to the facility; otherwise, coverage will be according to plan benefits.

Telehealth reimbursement policy effective Jan. 1, 2021

As a reminder, a new commercial telehealth reimbursement policy went into effect on Jan. 1, 2021. Most benefit plans will include telehealth visits with in-network providers. Members will be responsible for any copay, coinsurance, or deductible according to their benefits plan. 

Testing and test-related visits

Cost-share waivers for testing and test-related visit (including telehealth), when ordered by a physician or appropriately licensed health care professional for purposes of the diagnosis or treatment of an individual member, align with the national public health emergency period, currently scheduled to end Apr. 20, 2021.

If the U.S. Department of Health and Human Services extends the national public health emergency period, we will communicate that change shortly after it is announced.