Montana health insurers expanding telehealth coverage to fight COVID-19

From the Office of the Montana Auditor

HELENA — Four major health insurance companies operating in Montana are voluntarily expanding their coverage of telehealth services to aid in the state’s response to the virus known as COVID-19.

Montana insurer actions follow newly released guidance from Centers for Medicare & and Medicaid Services and U.S. Department of Health and Human Services Office for Civil Rights, which expanded beneficiary coverage of telehealth for federal health care programs and relaxed federal guidelines on telehealth delivery.

Each insurance company is taking its own specific steps to expand coverage, and every insurance plan is different. Montanans should follow the guidance of medical professionals and discuss their specific insurance policy with their insurance company regarding coverage for telehealth services.

Blue Cross and Blue Shield of Montana announced that it is temporarily expanding its telemedicine visit coverage to include phone calls and eliminating member cost-sharing for clinically appropriate, covered medical and behavioral health services delivered via telemedicine in response to the COVID-19 public health emergency. This applies to all fully insured members and includes all services retroactive to Monday, March 16.

“First and foremost, we want to make sure our members get the care they need,” said John Doran, divisional vice president of external Aafairs at BCBSMT. “Temporarily removing the cost-sharing encourages our members to consult a qualified health care provider while avoiding unnecessary visits to clinics, hospitals and emergency rooms.”

This benefit enhancement will be effective through April 30. At that time, BCBSMT will consider whether to extend the timeframe.

PacificSource Health Plans has made the decision to extend coverage for telemedicine services consistent with the newly released guidance from CMS to ensure providers can continue to deliver services to its members during this time of extreme disruption. They have also eliminated co-pays for members who have access to telemedicine vendor, Teledoc, as part of their plan design.

“It is important that our members have access to care now more than ever, and we want to remove any obstacles that may stand in the way. We are doing all we can to help flatten the curve of infection rate here in Montana,” said Cody Langbehn, vice president and Montana regional director. “We believe this increased access to telehealth services will help our members adhere to CDC guidelines on social distancing and isolation and help prevent the spread of the COVID-19 virus.”

Montana Health CO-OP is committed to supporting its members and the community through the COVID-19 outbreak. They believe there is an urgency to expand the use of technology to help people who need routine care, and keep vulnerable beneficiaries with mild symptoms in their homes, while maintaining access to the care they need.

As such, the CO-OP has implemented the following enhanced benefits until further notice:

• Extending full telehealth coverage, including audio-only, in accordance to HHS recommendations and consistent with evolving federal and state guidance;

• Waiving copays and deductibles related to all telehealth visits, including Doctor on Demand;

• Allowing early RX refills of medications to ensure members have needed medications on hand. For certain medications, members can also get 90 day supplies.  

“We stand united with the healthcare community and our members as together we meet this crisis head-on,” said Richard Miltenberger, Montana Health CO-OP CEO.

Allegiance Benefit Plan Management’s claims processing system will reimburse in person visits, phone calls, real-time synchronous virtual visits for screening and testing for COVID-19 without co-pay or cost share for all individuals according to the terms of the individual plans when provided by qualified, in-network providers regardless of patient location. Qualified providers include physicians and certain non-physician practitioners such as nurse practitioners, physician assistants and certified nurse midwives and telehealth vendors authorized by the plans.

Allegiance Life & Health Insurance Company will reimburse in-person visits, phone calls, real-time synchronous virtual visits for screening and testing for COVID-19 without copay or cost share at in-network providers.

In addition, AL&H currently covers telehealth visits not related to COVID-19 in accordance with policy coinsurance, deductibles, and copays when those services are provided by qualified in-network professionals, which include physicians and certain non-physician practitioners such as nurse practitioners, physician assistants and certified nurse midwifes.

These guidelines apply to self-funded clients who have opted in.

State and federal mandates may supersede these guidelines.

“Allegiance is committed to taking appropriate actions to ensure that all of our members have access to the care that they need to stay healthy,” said Dirk Visser, chief executive officer, Allegiance. “Expanding access with telehealth allows patients to stay safe at home and connect with their healthcare provider in less time.  Allegiance will continue working diligently to support the health and well-being of our employees, clients, members and communities.”