COVID-19 update: Cost shares for PCP and mental health clinician visits waived for ConnectiCare Medicare Advantage members

08/17/2020

ConnectiCare Medicare Advantage members can visit in-network primary care providers (PCPs) and in-network behavioral health clinicians for covered services in person or by telehealth from Aug. 1 through Dec. 31, 2020 without paying cost shares.* Copayments, deductibles, and coinsurance costs — listed in a member’s 2020 Evidence of Coverage – will be waived through the end of 2020.

This does not apply to Medicare members with ConnectiCare Choice Dual (HMO D-SNP). Medicaid covers these cost shares.

Cost-share waivers are part of ConnectiCare’s response to the coronavirus (COVID-19) pandemic. We want to help our Medicare Advantage members stay healthy and safe and encourage them to see their primary care doctors for needed preventive care, medication management, screenings and immunizations, including the flu shot.

We also want members to be able to seek the care of mental health clinicians during the public health crisis. This policy does not cover behavioral treatment at a facility-based inpatient setting or partial hospitalization services.


Medical specialist care

Please note: this temporary policy does not apply to medical specialist care. Medicare Advantage members can continue telehealth visits with medical specialists for covered services without a cost share through Sept. 9, 2020. After that date, members will be responsible for cost shares for medical specialist visits that take place in person or by telehealth.*

 

Other COVID-19 news

  • COVID testing coverage: Visits, including telehealth visits, by Medicare Advantage members for a COVID-19 test continue to have no cost share for both in-network and out-of-network providers through the declared national public health emergency. Members also have no cost share for the lab test during the public health emergency. Refer to Payment Policy: COVID-19 Billing Guidelines (Commercial/Medicare Advantage) for more information.

  • Teladoc® telemedicine visits: Members whose plan benefits include Teladoc will also have no cost share for those services through Dec. 31, 2020.

 

 

*This assumes the Centers for Medicare & Medicaid Services will continue to allow health plans to adjust benefits mid-year during the public health emergency. As a result, the end date of the waiver is subject to change.