AHIP
Health Insurance Provider Actions Concerning The COVID-19 Vaccines
posted by AHIP
on January 15, 2021
- Aetna is waiving member cost-sharing related to the COVID-19 vaccination for Commercial and Medicaid members. For Medicare, CMS has indicated it will cover the full cost of the vaccine for all Medicare beneficiaries, including those in a Medicare Advantage plan, in 2020 and 2021.
- Blue Shield of California is supporting Gov. Gavin Newsom’s strategy to efficiently and equitably administer vaccines to fight COVID-19. Blue Shield will work closely with Yolanda Richardson, secretary of the Government Operations Agency, who leads the state vaccine team, to help expand the efficient and equitable distribution of COVID-19 vaccines across the state. Blue Shield’s role will be to maximize the speed at which vaccinations are made available across California with a focus on disparately affected communities. More details about the Blue Shield’s role on the program will be released in the coming days.Blue Shield of California has signed a contract with the state of California to be its Third Party Administrator to help optimize and accelerate the allocation and distribution of COVID-19 vaccines equitably, efficiently, and safely throughout the state. The nonprofit health plan is not charging the state for its staff time devoted to this effort. It will only bill the state actual expenses to support the vaccine network up to the limit of the contract.
- Blue Cross Blue Shield of Massachusetts has released a public service announcement promoting the COVID-19 vaccine. The 2-minute video features Dr. Katherine Dallow, vice president of clinical programs and strategy at Blue Cross, discussing the promise of COVID-19 vaccines. The video is free for use for any media, governmental, educational, or public health messaging effort.Blue Cross Blue Shield of Massachusetts – announced a new effort with the Massachusetts League of Community Health Centers to help provide equitable access to COVID-19 vaccinations.Blue Cross will contribute $1 million to fund free rides to and from COVID-19 vaccination sites across the state to support community health centers, underserved communities, and vulnerable populations.Blue Cross’ contribution will support tens of thousands of free rides to and from COVID-19 vaccination sites. The goal is to launch the program in the next few weeks in coordination with the League, which will assist in identifying participating community health centers.
- Blue Cross Blue Shield of Michigan will waive all copays, deductibles, and coinsurance for the administration of COVID-19 vaccines to commercial members.
- BlueCross BlueShield of North Carolina will provide members with cost-free access to the COVID-19 vaccine.
- CalOptima is collaborating with the Orange County Health Care Agency to ensure that communications to key groups reinforce the benefits of the COVID-19 vaccine for individuals and the community. CalOptima will engage community-based organizations to reach out low-income members so they have trusted information in multiple languages that builds their confidence and offers direction on obtaining COVID-19 vaccines at no cost.The CalOptima Board of Directors has approved $45.6 million in funding and programs in response to the ongoing COVID-19 crisis and start of vaccination efforts. The increased support will reach health networks, providers, and nursing homes, and offer incentives to members who receive the COVID-19 vaccine once it is available to them. Vaccine distribution will follow a federally approved phased approach that prioritizes high-risk groups first, followed by the general public later in the year.The actions include:
- Launching a Vaccination Incentive Program to offer two $25 nonmonetary gift cards to CalOptima Medi-Cal members who get both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima plans a multipronged member outreach program to promote vaccination and will work with the Orange County Health Care Agency (HCA) on the administration of the incentive program, which is approved to spend up to $35 million.
- Creating a Vaccination Intervention and Member Incentive Strategy to promote vaccination of members experiencing homelessness. Medi-Cal members who are homeless and age 14 or older will be eligible for two $25 nonmonetary gift cards for receiving both required doses of the COVID-19 vaccine, subject to state regulatory approval. CalOptima will coordinate with community health centers, shelter operators and others to reach homeless members and promote vaccine access in the $400,000 program.
- CalOptima members age 65 or older may receive the COVID-19 vaccine within the next few weeks through the COVID-19 Vaccine Equity Pilot Program, a joint effort between CalOptima and the Orange County Health Care Agency. The program is designed to improve direct access to vaccinations for CalOptima members who live in the hardest-hit communities by COVID-19.
- CareFirst BlueCross BlueShield will fully cover all member costs associated with all FDA-approved COVID-19 vaccines, including for members in self-insured plans.CareFirst BlueCross BlueShield has launched a wide-ranging campaign to help educate and encourage people living throughout Washington, D.C., Maryland, and Northern Virginia about the importance of everyone taking the COVID-19 vaccine when they are eligible. The effort will urge people to get vaccinated against COVID-19 when they can and support public health officials’ work to achieve target vaccination rates that will end the pandemic.Over the next several months, CareFirst will expand its ongoing collaboration with public health officials and community leaders to support coordinated vaccine communications and distribution processes. These efforts will include online forums and educational opportunities with medical experts and influential community spokespeople targeting populations and locations most in need and the customers we serve.
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Centene’s Medicaid, Medicare Advantage, and Marketplace members can access COVID-19 vaccines at no cost as they become available to them in accordance with state and federal (CMS) requirements and timelines.
- Cigna is covering the cost of approved vaccines without any cost share. The vaccine is currently purchased by the federal government and provided free of cost to individuals. Cigna covers the cost of administering the vaccine at 100% without any out-of-pocket costs when done by any in-network or out-of-network provider.
- CVS Health will administer COVID-19 vaccinations to the public when authorized and available. CVS Health already announced it would provide COVID-19 vaccinations to long-term care facilities when the vaccine become available. CVS Health has formally launched its COVID-19 vaccination program for long-term care facilities, whose residents have been disproportionality impacted by the pandemic. CVS Pharmacy teams will administer the first dose of the Pfizer vaccine in facilities across 12 states this week, and the company expects to vaccinate up to four million residents and staff at over 40,000 long-term care facilities through the program. CVS Pharmacy teams will make three visits to each long-term care facility to ensure residents and staff receive their initial shot and critical booster. The majority of residents and staff will be fully vaccinated three to four weeks after the first visit, depending on which vaccine they receive. CVS Health expects to complete its long-term care facility vaccination effort in approximately 12 weeks. CVS Health will administer COVID-19 vaccinations starting this week in the following states: Connecticut, Florida, Kentucky, Maine, Maryland, Nevada, New Hampshire, New York, Ohio, Oklahoma, Oregon, and Vermont. Vaccinations will begin in 36 more states, as well as the District of Columbia, on December 28. Puerto Rico will activate on January 4.CVS Health has administered the first round of COVID-19 vaccine doses to nearly 8,000 skilled nursing facilities across the country, delivering on goals established early in the process and communicated to participating states and jurisdictions months ago. Administration of second doses is well underway and expected to be complete within four weeks. CVS Health will begin to offer COVID-19 vaccinations to eligible populations at a limited number of CVS Pharmacy locations across 11 states, beginning February 11. Supply for the initial rollout, which is sourced directly from the federal government through the pharmacy partnership program, will be approximately 250,000 total doses. As more supply becomes available the company will expand to additional states while increasing the number of stores offering vaccinations. CVS Health announced its community-based strategy to address potential inequities related to COVID-19 vaccine access in vulnerable communities, with a particular focus on Black and Hispanic populations.In communities where COVID-19 vaccines are currently available at CVS Pharmacy locations, the company is working to help ensure Black and Hispanic patients have equitable access to appointments. CVS Health will reach out to CVS Pharmacy patients, Aetna members, and CVS Caremark members in vulnerable communities to help them make an appointment and to answer questions or concerns they may have about being vaccinated.To further increase access to vaccines, the company is planning to use mobile vaccination vans and launch community-based clinics in March and April, working closely with nonprofit organizations including the YMCA.
Lyft will also work with CVS Health and non-profit partners to help underserved communities access vaccination appointments by providing free or discounted rides for those in need.
- Empire BlueCross BlueShield will cover the cost of the COVID-19 vaccine. Empire members won’t have out-of-pocket costs for the vaccine during the national public health emergency. This applies to all members, regardless of the type of health plan they have, or which doctor or healthcare professional they choose to visit for COVID-19 vaccinations.
- Excellus BlueCross BlueShield will provide the COVID-19 vaccine at no cost to members, and members may access the vaccine from any service provider that offers it, regardless of whether the provider is in the Excellus network.
- Florida Blue is waiving all copays, deductibles, and coinsurance for the administration of the COVID-19 vaccine for members. The vaccine will be available at $0 cost share to members with employer health plans, individual plans, and Medicare Advantage plans.
- Harvard Pilgrim Health Care Foundation and Tufts Health Plan Foundation are giving $1 million to 42 organizations across the region to expand vaccine education, awareness and outreach in communities of color. Grant recommendations were informed by community organizations, public health leaders and other key stakeholders engaged in the vaccine rollout in Connecticut, Maine, Massachusetts, New Hampshire and Rhode Island.Grants will support a range of organizations—from statewide organizations to local community nonprofits. They include faith-based organizations, trusted Black/Latinx-led community nonprofits, and organizations with experience coordinating multilingual efforts.
- Health Net is supporting California Governor Newsom’s new Vaccinate All 58 social media campaign. To assure Californians that the vaccine is effective and safe to get when it becomes available, Health Net is sharing content from the campaign’s social media tool kit across channels.
- Highmark members will receive the COVID-19 vaccine free of charge.
- Independence Blue Cross is waiving all cost-sharing for the administration of the COVID-19 vaccine to commercial group and individual members. For Medicare Advantage members, the cost of the COVID-19 vaccine and its administration will be covered by Medicare.
- Member health plans in the Minnesota Council of Health Plans will waive copays, deductibles, and coinsurance for the COVID-19 vaccine as it becomes available through the government’s multi-phased approach.
- Providence Health Plan members can receive COVID-19 vaccines at no cost. Additionally, the cost of administration of the vaccine is covered in full by any in-network or out-of-network provider.Medicare beneficiaries can receive their COVID-19 vaccination from any Medicare provider even if the provider is out of network for their Medicare Advantage Plan, while all other members can receive their COVID-19 vaccination from any provider, even if the provider is out of network.
- SCAN Health Plan is offering members access to SCAN TeleTalks, a series of large-scale conference calls addressing the COVID-19 vaccine.
- Harvard Pilgrim Health Care Foundation and Tufts Health Plan Foundation are giving $1 million to 42 organizations across the region to expand vaccine education, awareness and outreach in communities of color. Grant recommendations were informed by community organizations, public health leaders and other key stakeholders engaged in the vaccine rollout in Connecticut, Maine, Massachusetts, New Hampshire and Rhode Island.Grants will support a range of organizations—from statewide organizations to local community nonprofits. They include faith-based organizations, trusted Black/Latinx-led community nonprofits, and organizations with experience coordinating multilingual efforts.
- UPMC Health Plan is covering the COVID-19 vaccine as a preventive service at no cost to members. UPMC will cover COVID-19 vaccinations regardless of whether they are received from a hospital, pharmacy, or other licensed health care provider.
- Wellmark Blue Cross and Blue Shield will cover COVID-19 vaccinations with no member cost-sharing payments, deeming it a preventive service under the ACA.
