FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

Source:  Juliette Cubanski and Meredith Freed  Published: Mar 30, 2020/https://www.kff.org/

More than 60 million people ages 65 and older and younger adults with long-term disabilities are covered by Medicare. Due to their older age and higher likelihood of having serious medical conditions than younger adults, virtually all Medicare beneficiaries are at greater risk of becoming seriously ill if they are infected with the new coronavirus that causes COVID-19. COVID-19 is an infectious respiratory disease, which currently has no vaccine or cure. Diagnosis of COVID-19 is confirmed through testing, and treatment varies based on the severity of illness.

These FAQs review current policies for Medicare coverage and costs associated with testing and treatment for COVID-19, including changes adopted in three recent bills: the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020, enacted on March 6, 2020 (Public Law 116-123); the Families First Coronavirus Response Act, enacted on March 18, 2020 (Public Law 116-127); and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted on March 27, 2020 (Public Law 116-136).

Does Medicare cover testing for COVID-19?

Yes, testing for COVID-19 is covered under Medicare Part B when it is ordered by a doctor or another health care provider that accepts Medicare, and if the test was ordered after February 4, 2020. Medicare Advantage plans are required to cover all Medicare Part A and Part B services, including COVID-19 testing.

How much do Medicare beneficiaries pay for COVID-19 testing?

Medicare beneficiaries who get tested for COVID-19 are not required to pay the Part B deductible or any coinsurance for this test, because clinical diagnostic laboratory tests are covered under traditional Medicare at no cost sharing. (Under traditional Medicare, beneficiaries typically face a $198 deductible for Part B services and coinsurance of 20 percent.) A provision in the Families First Coronavirus Response Act also eliminates beneficiary cost sharing for COVID-19 testing-related services, including the associated physician visit or other outpatient visit (such as hospital observation, E-visit, or emergency department services). A testing-related service is a medical visit furnished during the emergency period that results in ordering or administering the test. The law also eliminates cost sharing for Medicare Advantage enrollees for both the COVID-19 test and testing-related services, and prohibits the use of prior authorization or other utilization management requirements for these services.

Read the full article here

Telehealth keeping patients and providers connected during coronavirus pandemic

ST. JOSEPH COUNTY, Ind. (WNDU) The coronavirus pandemic is changing the way we interact with each other by the day.

More social distancing means physical and behavioral health care providers are finding new ways to get closer to their patients.

16 News Now learned how telehealth is making that easier.

It’s just like the name sounds, healthcare over the phone or internet. Telehealth is now taking center stage during the coronavirus pandemic as patients look to stay connected to their providers.

“People in mental health crises could increase due to the isolation,” said Oaklawn Adult and Addiction Services Vice President John Horsley

That’s one thing Horsley says Telehealth will be able to help with when continuing services for clients at home.

“Medicaid and Medicare have really loosened their guidelines during this crisis which has been very helpful to people. In terms of accessing care,” he said.

Those Medicaid and Medicare changes happened last week, allowing telemedicine and telephone options for most health care and mental health interactions.

TIPS – Medicare Phone Sales

TIPS FOR MARKETING MEDICARE COVERAGE OVER THE PHONE
Now more than ever, people want Medicare insurance solutions that provide peace of mind. When you’re unable to meet with a client in person, you can often help them get the coverage they need by phone. These simple tips and guidelines are designed to help you be more successful.

TIPS_Medicare_PhoneSales_3-24-20 CSM

TIPS – Handling Objections – Medicare

The biggest difference between in-person and telephonic sales is understanding how to handle objections in an effective manner. Here are a few tips that can be helpful to uncover and address objections.

TIPS_HandlingObjections MEDICARE_3-24-20 CSM

MMO Broker Update – Telehealth/Telemedicine Coverage

Important Clarifications on Telehealth (Telemedicine) Coverage
 
Date: March 24, 2020
Category: News
Applies to: All

In efforts to help slow the spread of the coronavirus disease known as COVID-19, health professionals and their patients may turn more frequently to the use of telehealth (telemedicine) visits. Please review the summaries below: to better understand the coverage for these services.

Telehealth (telemedicine) visits (covered by all plans)

  • Telehealth (telemedicine) visits are primarily scheduled visits between patients and healthcare providers with an established relationship, and may be handled by computer, tablet or smartphone.
  • Telehealth (telemedicine) visits are for patients needing routine care for chronic or general health conditions. They are covered just like any other medically necessary office visit.
  • They are billed with office visit codes; modifiers are not required.
  • Behavioral health visits are included.

On-demand virtual visits (covered by most plans)

  • On-demand virtual visits are a subset of telehealth (telemedicine). These types of visits typically include 24/7 virtual access to licensed healthcare professionals with whom the patients do not have an established relationship.
  • They are similar to visits to an urgent care facility and are typically needed due to an acute health issue.
  • Visits are typically covered like primary care provider visits unless otherwise specified.
  • Behavioral health visits are not covered as on-demand virtual visits.
  • Examples of plan-specific covered on-demand virtual visit providers include the Cleveland Clinic’s Express Care online services and Teladoc.

If you have any questions about telehealth (telemedicine) benefits, please contact your Cornerstone Senior Marketing Representative

 

The Health Plan – Member Costs Waived for COVID-19 Testing

The Health Plan Will Waive Member Costs for COVID-19 Testing

 

The Health Plan announced today it will cover the cost of copays, co-insurance, and deductibles for COVID-19 testing for all Commercial, Medicare and Medicaid lines of business when recommended by a medical professional. Our exclusive independent lab provider, LabCorp is making its NAA test available for ordering by physicians or authorized healthcare providers anywhere in the United States.

For The Health Plan’s self-funded (ASO) members, they will also waive cost-sharing for diagnostic testing related to COVID-19, unless they receive notice in writing of the group’s intent not to implement this temporary relief option.

The Health Plan wants to provide members with peace of mind. “Supporting the health and well-being of our members is important to us. We want to assure our members that we will do all we can to make health care treatment and services available to them at no additional cost, especially for seniors and people with chronic conditions,” said Jeff Knight, Interim President/COO of The Health Plan.

At this time, the Centers for Disease Control and Prevention (CDC) and state labs currently performing the testing are not billing for COVID-19 testing, so members should not incur costs when tested by these labs.

The Health Plan remains committed to ensuring access to medications is available during this time. Members have multiple options to obtain medication through The Health Plan, including the ability for Medicare and fully-insured members to fill 90-day supplies of long-term medications via mail order or local retail pharmacies. The Pharmacy Services Department will be available to assist with any extenuating circumstances such as ensuring formulary flexibility if medication shortages or access issues arise.

The Health Plan recommends contacting your doctor’s office first if you suspect you might have a flu or coronavirus infection. But to help reduce potential exposure, The Health Plan also encourages members to utilize telemedicine services if they are available as part of a member’s plan. The Health Plan will waive member cost share where applicable for telemedicine visits for the next 90 days. Telemedicine is a safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer-enabled web cam.

The Health Plan is providing the latest information on precautions members should take to help prevent the spread of COVID-19 and who should seek medical attention on their website. Visit healthplan.org for more information.

Medicare Center – Agents can sell REMOTELY

Cornerstone Senior Marketing Supports Business Continuity with Telework Technology

MedicareCenter.com supports your business continuity efforts by helping you retain your members and protect your business when working from home.

We are approaching our new normal smartly and with tremendous regard for the safety of our customers, employees and communities.  Please rest assured MedicareCenter is the right technology for quoting Medicare plans and managing your own business remotely, as you provide a comfortable haven for seniors to confidently shop and securely enroll in their best fit plans online.

Make MedicareCenter an integral part of your Business Continuity Plans. Click here to reveal all the benefits of MedicareCenter.

CSM & Anthem Training- With 1 Hour of CE Credit! | Columbus

Cornerstone Senior Marketing & Anthem are hosting a series of Continue Education courses. Don’t miss these great topics and earn 1 hour credit towards your continuing education!

Thurs. April 2- Columbus

9:00am – 11:00am

Location: Wedgewood Golf & Country Club

9600 Wedgewood Blvd. Powell, OH 43065

REGISTER HERE

Colleen Baird joins the CSM Team

Attention:  Toledo area brokers

Welcome!  Colleen Baird, Sales Director, NW Ohio

We’re pleased to introduce Colleen Baird, Sales Director, North West Ohio. Colleen joins the Cornerstone Senior Marketing Sales Team with 25+    years of sales and service experience in the Medicare and Group markets.

Colleen is a graduate of Lourdes University and a member of the Reynolds Corners Rotary Club.  She loves the outdoors and spending time with her family, which includes four horses and a dog.

Colleen can be reached by phone, email or in person at Cornerstone Senior Marketing’s NEW location in Maumee.

1715 Indian Wood Circle, Suite #200

Maumee, OH 43537

Phone: 567-205-2551

colleen.baird@cornerstoneseniormarketing.com

 

Cornerstone Senior Marketing Sales Team

Tim Shook, VP & SW OH

Phone:  513-629-9505

Email: tim.shook@cornerstoneseniormarketing.com

Paul McMillen, National Director Central OH

Phone:  614-763-2551

Email: paul.mcmillen@cornerstoneseniormarketing.com

Jaime Lebron, Sales Director NE OH

Phone:  216-503-4509

Email: jaime.lebron@cornerstoneseniormarketing.com

Michelle Kapp, Sales Director, Proprietary Products

Phone:  614-763-2257

Email: michelle.kapp@cornerstoneseniormarketing.com

Colleen Baird, Sales Director NW OH

Phone: 567-205-2551

Email: colleen.baird@cornerstoneseniormarketing.com