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Cigna and COVID-19

Here is a summary of frequently asked questions and answers by Cigna about COVID-19 coverage.

1. Are customers and dependents covered if they contract COVID-19?

Yes. Their Cigna plan will cover diagnosis, testing, and treatment associated with COVID-19 including:

  • COVID-19 diagnostic visits: Cigna is waiving out-of-pocket costs for COVID-19 visits whether at a provider’s office, urgent care center, emergency room, or via virtual care, through May 31, 2020.

  • COVID-19 testing: Cigna is waiving out-of-pocket costs for COVID-19 FDA-approved testing. At this time, only a health care provider or hospital can administer the test and send the sample to an approved lab for results.

  • COVID-19 treatment: Cigna is waiving customer cost-sharing for all COVID-19 treatment through May 31, 2020. The treatments that Cigna will cover for COVID-19 are those covered under Medicare or other applicable state regulations. This will apply to COVID-19 treatment that was administered beginning February 4, 2020.

 

2. What else is Cigna doing to make it easier for customers to get care during COVID-19?

 

In addition, for treatment not related to COVID-19, Cigna has taken the following steps to make it easier to access care:

  • Virtual visits not related to COVID-19 medical care by their physicians: Customers can be treated using virtual care by their physician with virtual capabilities – by video or by phone – through May 31, 2020, using the standard office visit benefit. Out-of-pocket costs may apply.

  • Hospitals transferring patients to long term acute care hospitals (LTACHs) and other subacute facilities: We’re waiving prior authorizations for the transfer of non-COVID-19 customers from acute inpatient hospitals to in-network LTACHs.   

3. Will customers be covered for COVID-19 diagnosis, testing or treatment if they go to an out of network facility?

Yes. While it’s preferred they go in-network, we will waive co-pays and cost shares if they use an out-of-network provider for COVID-19 diagnosis, testing or treatment. The treatments that Cigna will cover for COVID-19 are those covered under Medicare or other applicable state regulations.

However, we do want customers to be aware that unlike in-network providers, some out-of-network providers may also bill them for an outstanding balance for COVID-19 related costs. Cigna will make best efforts to assist customers by working with these providers to discourage this practice known as balance billing.

 

4. Will Cigna waive out-of-pocket costs for COVID-19 virtual care?

Yes. If the visit is related to screening and assessing risk for COVID-19, out-of-pocket costs will be waived.

5.Can customers see their provider virtually for non-COVID medical care?  

Yes. Cigna customers can also receive virtual medical care not related to COVID-19 by physicians and certain providers with virtual care capabilities through May 31, 2020. Out-of-pocket costs may apply.

6. Will Cigna’s out-of-pocket cost waiver for COVID-19 testing apply to the tests that will be available at retail pharmacy locations and drive thru locations?

Yes, Cigna’s waiver of out of pocket cost for COVID-19 FDA-approved testing will apply.

7. Are customers currently traveling overseas eligible for repatriation under their Cigna policy?

As with most any illness as a Cigna policy holder, we would typically cover treatment associated with COVID-19 or similar such diseases in their current location.

8. Will Cigna cover the cost of the vaccine for COVID-19 once it becomes available?

Cigna covers FDA-approved vaccines as recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP).

9. Do customers need a PCP referral to see a different doctor if their PCP is unable to see them?

No. Cigna is waiving PCP referrals to Specialists and other PCPs through December 31, 2020. 

Pharmacy

1. Can customers obtain an early refill of their medications?

At this time, conditions currently do not call for us to enact early refills, but we are monitoring the situation closely and will update our information and policy if or when the situation changes. Customers can view the FAQs available online for the most up to date information. Standard refill policies, which allow customers to refill or renew a prescription medication when 25%-35% of their current prescription is remaining, should help them stay on track with their medication during this time.

Customers can have peace of mind by managing their prescription medications by using the Express Scripts Pharmacy website or Express Scripts Mobile App, where they can sign up to get reminders, auto refills, and more. Express Scripts offers free home delivery of up to 90-day supply of prescription maintenance medications.

Pharmacists are available 24/7 to answer questions, offer counseling and support, and assist with prescription orders. Customers are encouraged to refill their medications responsiblyThey can visit https://www.express-scripts.com/covid19/index.html for more information.

Cigna is committed to taking appropriate actions to ensure customers have the medication they need to stay healthy. Should they have any questions or concerns about their individual situation, Cigna pharmacists are available 24/7. 

Premium Payments & Coverage

1. Can a customer be reinstated if they have received a notice that their plan has been/will be terminated? 

They have 30 days from notice to be reinstated. They can do that by calling you, their broker, or our customer service team using the number on the back of their ID Card (On Exchange 877-900-1237 & Off Exchange 877-484-5967).

2. What can a customer do if their prescription has been denied because they are in a grace period and there is a hold on their account?  

The account is on hold because the premium is past due and claims cannot be processed. They will need to pay for the medications, and when their account becomes current, they will be able to submit for reimbursement.

3. Can a customer receive an extended grace period if they can’t afford their premium because they were laid off from work?   

During this time, please know that premium due dates with Cigna will be extended through May 15, 2020 (or later in some states depending on that state’s emergency regulations – see 3.a.) We continue to assess whether future premium extensions will be allowed. Customers will still receive past due notices, and their billing invoice will correctly reflect all amounts owed.   If they are unable or behind on their premium payments, we can offer a credit card option to help during this time. Please note that we can only allow for credit card payments up to 60 days. Customers will need to return to the standard payment methods after this time frame, which include EFT.

Before a customer cancels their coverage, they may be eligible for a Federal subsidy if their income has changed.

3.a. What are the extensions for each state?

Before a customer cancels their coverage, they may be eligible for a Federal subsidy if their income has changed.

4. Should a customer cancel their Dental/Medical plan because they have been laid off from work?  

Before a customer cancels their coverage, they may be eligible for a Federal subsidy if their income has changed. Customers should update any expected income changes for the year, as this could impact their available premium tax credit or applicable cost share reductions.

5. If a customer has their premium on autopay and they don’t have a paycheck to cover the deduction, can they suspend autopay?  

Yes, we can temporarily suspend autopay, and they can make payments with a check when it is more convenient. Please remind them that to continue coverage, they must remain current with their payments by May 15, 2020 (or later in some states depending on that state’s emergency regulations). We will continuously assess whether it will be extended further.

6. Can a customer use a credit card to pay to keep their insurance?  

Yes, if they are unable or behind on their premium payments, we can offer a credit card option to help during this time. Please note that we can only do so for up to 60 days. The customer will need to return to the standard payment methods after this time frame, which include EFT.

7. Can a customer add a spouse or dependent to their plan if the spouse or dependent lost their job?

Yes, if the spouse/dependent lost their job that qualifies as a Special Enrollment Period. Additionally, in the state of Colorado, people can enroll during an emergency enrollment period until April 30, 2020 if they do not have coverage or have lost it due to COVID-19. 

8. If a customer lost their job due to COVID-19 will they be able to receive additional subsidy for their plan?

Yes, they may be eligible for additional federal subsidy if income or household employment has changed. Click here for more information about qualifying life events.

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