Health insurer Humana will waive the costs its Medicare customers are normally expected to pick up for primary care, behavioral health and telehealth visits through the end of the year.
The change will apply to Humana's members in Medicare Advantage plans, the company said Tuesday, covering co-pays, co-insurance and deductibles at in-network providers from May 1 through the end of 2020. Humana covers nearly 4.5 million people as the nation's second-largest provider of Medicare Advantage plans. Those are privately run versions of the government's Medicare program for people age 65 and over and those who have severe disabilities or illnesses.
Chief Executive Officer Bruce Broussard said the change should help members who have deferred care because of the coronavirus pandemic and improve the finances of medical practices hurt by the falloff in patient visits. He didn't give an estimate for how much the change would cost Humana but called it "fully manageable."
As an intermediary between patients and doctors, insurers have benefited in the short term from patients staying home. They have continued to collect premiums from employers and government programs even as medical claims dry up.
The services affected include primary care and mental and behavioral health visits for conditions such as depression that could be exacerbated by the pandemic, the company said. The care has to take place inside the health insurer's network of doctors and therapists.
The move is intended to help members reconnect with clinicians they may not have been able to see while states enforced distancing measures to prevent the spread of covid-19. Cost-sharing can discourage people from getting care, potentially allowing medical conditions to deteriorate.
"People that are on fixed incomes, we have found they will delay care for financial co-pay reasons," Broussard said.
Humana has been reaching out to its most vulnerable members to ensure they get needed services, he said. The company is also sending members "safety kits" that include masks and information on how to seek medical care. It is encouraging members to resume in-person care only in accordance with authorities' guidelines on physical distancing.
Many insurers, including Humana, have already waived costs for covid-related care and telemedicine visits.
Humana's new waiver applies to all primary care and to outpatient behavioral health visits. It doesn't apply to costs such as X-rays or hospital stays unless the care is tied to covid-19.
Efforts to slow the spread of the virus by closing much face-to-face business have hit the medical industry hard. Canceled office visits and delayed surgeries have strained hospitals, medical practices and other care providers.
Health insurers have seen drops in medical claims since mid-March, and may book higher-than-expected profits in the second quarter as a result. The largest publicly traded insurers, including Humana, have also maintained their profit forecasts for the year. Some insurers said they expect demand for care to recover later in the year.
The industry may come under more pressure from regulators to expand access for patients. Regulators in New York, for example, last week required insurers to cover essential workers' share of the costs for behavioral-health treatments.
Medicare expert Tricia Neuman said any move to waive costs would provide a "huge relief" to people with limited incomes.
"But this may not be where the big bills are," said Neuman, a senior vice president with the nonprofit Kaiser Family Foundation.
She said a Medicare Advantage customer who lands in the hospital could wind up with a bill of more than $2,000 even with insurance. That depends on the length of their stay and how much care they need.
Humana, based in Louisville, Ky., said late last month that it made $473 million in the first quarter.
Information for this article was contributed by John Tozzi of Bloomberg News and by Tom Murphy of The Associated Press.
Business on 05/06/2020