Philadelphia — December 23, 2020 — Independence Blue Cross (Independence) is waiving all cost-sharing (such as copays, deductibles, and coinsurance) 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.
To date, the U.S. Food and Drug Administration (FDA) has authorized the emergency use of vaccines developed by Pfizer, Inc. and Moderna, Inc. The federal government is initially supplying the vaccines to health care providers to administer to their staffs who are on the front lines of treating people who are sick with COVID-19. The Centers for Disease Control and Prevention also recommends that the vaccine be given first to residents of long-term care facilities, who are at especially high risk of dying from the disease.
As with all vaccines, Independence has no control over the availability and prioritization of distributing the vaccine. Distribution of the COVID-19 vaccine will be controlled by the federal government, in collaboration with state and local governments.
Independence has also extended a number of other waivers related to COVID-19 care, including:
- Waiving member cost-sharing for diagnostic and antibody testing related to COVID-19 for commercial members through March 31, 2021 and for Medicare Advantage plan members during the public health emergency, which is currently extended through January 21, 2021.
- Waiving commercial member cost-sharing for in-network, acute in-patient treatment of COVID-19 through March 31, 2021. Starting January 1, this will be covered for Medicare Advantage members through their new 2021 plans.
- Waiving Medicare Advantage member cost-sharing for in-network and out-of-network acute in-patient treatment of COVID 19 for the duration of the public health emergency, which is currently extended through January 21, 2021. This waiver of cost-sharing for Medicare Advantage members will also be applied to the post-acute care settings. Starting January 1, these existing waivers will be covered for Medicare Advantage members through their new 2021 plans regardless of the duration of the public health emergency.
- Waiving member cost-sharing for telemedicine services related to COVID-19 from primary care doctors and specialists (urgent care, behavioral health specialists, nutritionists, and occupational, physical, speech therapists) for commercial plan members through March 31, 2021. This is effective for Medicare Advantage plan members during the public health emergency, which is currently extended through January 21, 2021.
- Waiving the need for providers to call Independence prior to transferring members without a COVID-19 diagnosis from acute in-network inpatient facilities to in-network post-acute facilities (long-term acute care hospitals, inpatient rehabilitation, skilled nursing facilities) and other in-network inpatient facilities through January 31, 2021. This also applies to in-network ambulance transfers.
- Waiving prior authorizations for acute inpatient admissions for any COVID-19 diagnosis from the emergency room for commercial members through March 31, 2021. This includes transfers from acute in-network, in-patient facilities to in-network long-term ambulatory care, rehabilitation, or skilled nursing facilities; transfers from acute in-network inpatient facilities to other in-network in-patient facilities, transportation between facilities. This is effective for Medicare Advantage plan members during the public health emergency, which is currently scheduled through January 21, 2021, and includes out-of-network providers.
At-home test kits and at-home self-sample collection kits are also being covered by Independence when they are medically appropriate and processed at an approved laboratory following FDA Emergency Use Authorization (EUA) guidance (the self-collection materials, including kits, also need to have specific FDA EUA approval in order to be covered).
For more information about Independence’s response to the COVID-19 pandemic, visit ibx.com/covid19.