March 06, 2020 Detroit, MI (AMN) — Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan will fully cover the cost of medically-necessary COVID-19 tests for members in fully-insured health plans – and will work with employer group customers that are self-insured to make decisions regarding their own benefits.
“These are extraordinary times, and Blue Cross wants to do what we can to provide our members peace of mind during this national public health crisis,” said Daniel J. Loepp, president and CEO of BCBSM. “Having symptoms of coronavirus and waiting for test results to come back is hard enough. Our members shouldn’t have to worry about paying their copays, too.”
The Michigan Blues joined other Blue Cross and Blue Shield companies around the nation today in announcing the following initiatives to help members enrolled in fully-insured commercial health plans, during the current public health crisis caused by the spread of COVID-19:
- BCBSM will waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19. BCBSM will also make dedicated clinical staff available to address inquiries related to medical services, ensuring timeliness of responses related to COVID-19.
- BCBSM will cover the full cost of medically necessary diagnostic tests that are consistent with CDC guidance related to COVID-19. BCBSM will cover, with no cost share to the member, the appropriate medically necessary diagnostic testing for COVID-19, where it is not covered as part of the Public Health Service response, and ensure patient testing and any subsequent needed care are done in close coordination with federal, state and public health authorities.
- BCBSM will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications (consistent with member’s benefit plan) and encouraging members to use 90-day mail order benefits if available. BCBSM will also ensure formulary flexibility if there are shortages or access issues. Patients will not be liable for the additional charges that stem from obtaining a non-preferred medication for COVID-19 Treatment.
- BCBSM will expand access to telehealth and its 24-hour nurse hotline. Given the nature of the COVID-19 epidemic, seeking in-person medical care may lead to further spreading of the virus. BCBSM will encourage the use of virtual care and will also facilitate member access and use of nurse/provider hotlines.
Blue Cross encourages members to work with appropriate public health authorities before seeking testing for COVID-19. The company is posting information on its blog – www.MIBluesPerspectives.com – to inform customers and members of the latest on the national impact of coronavirus and provide counsel on what to do and where to seek care if members come down with symptoms.
The company is also working on other potential and temporary steps during the national public health crisis, including expanding benefits to self-insured customers that may have opted out of telehealth and virtual office visit benefits. Seeking virtual consultations for flu-like symptoms is a safe step for members who want to talk with board-certified doctors and can help avoid the spread of illness in physician office and emergency room settings.
NOTE: The initiatives announced by BCBSM are only applicable to BCBSM and BCN members in commercial health plans that are fully-insured. Medicare Advantage plans, regulated by the federal government, are not included. Large, self-insured customers of BCBSM control their own health benefits and are regulated under the federal ERISA statute, and therefore are not affected by these decisions. BCBSM will work with its self-insured customers over the coming weeks to help them make decisions regarding their own benefit rules.