Waiving Medicare Deductibles And Copays
Why Can’t Co-Pays and Deductibles Be Waived? The main reason is the federal Anti-Kickback Statute (AKS). –Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced today it is waiving all copays for in-network primary care and outpatient behavioral health visits for Medicare Advantage members from June 1 through the end of 2020. Visits do not have to be related to COVID-19 and can be done in person or virtually through. Why Can’t Co-Pays and Deductibles Be Waived? The main reason is the federal Anti-Kickback Statute (AKS). With waived coinsurance and deductibles for COVID-19 treatment, savings can add up Cigna and Humana both waived COVID-19-related cost-sharing for their Medicare Advantage (Medicare Part C) plans. Medicare Advantage plans cover the same inpatient and outpatient services and items that are covered by Original Medicare (Medicare Part A and Part B). Secondly, routinely waiving co-pays can be considered a breach of the practice’s contract with the insurance company. Most private insurers contractually require practices seeking reimbursement to make reasonable efforts to collect co-pays from patients.
DURHAM, N.C. –Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced today it is waiving all copays for in-network primary care and outpatient behavioral health visits for Medicare Advantage members from June 1 through the end of 2020. Visits do not have to be related to COVID-19 and can be done in person or virtually through telehealth. This measure benefits Blue Cross NC’s nearly 69,000 Medicare Advantage members. All copays for in-network primary care and outpatient behavioral health visits will be waived in full when not already $0 through a member’s health plan.
The move represents Blue Cross NC’s commitment to help members prepare, stay healthy, and get the care they need during the COVID-19 pandemic.
“Blue Cross NC is committed to doing all we can to best serve our members during this public health crisis,” said Rahul Rajkumar, chief medical officer at Blue Cross NC. “By eliminating these copays, we hope that it will make it easier, and encourage our senior members to get the care they need.”
The copay waiver is specific to the primary care medical visit or behavioral health therapy visit. Members may have costs for other services unless they are related to COVID-19 treatment or testing.
Blue Cross NC has already taken significant actions to help members during this public health crisis, including waiving cost-sharing for testing and treatment related to COVID-19, expanding virtual care coverage, and increasing access to medication. In addition, Blue Cross NC has taken multiple steps to make things easier for providers by speeding payments and removing barriers to care.
The COVID-19 crisis is requiring everyone in the health care community to work together and do their part. Blue Cross NC will continue responding to this crisis to best serve its members and support doctors, nurses and hospitals. You can find more information at BlueCrossNC.com/Coronavirus.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to making health care better, simpler and more affordable. We have been driving better health in North Carolina since 1933, working to tackle our communities’ greatest health challenges. Blue Cross NC serves its customers and communities of more than 3.8 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at www.bluecrossnc.com. All other marks are the property of their respective owners.
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