Aloha PMAG Physicians,
Major updates are extension of coverage period from March 1, 2020 to December 31, 2020.
1. What kinds of services will be covered under HMSA’s expanded telehealth policy?
HMSA is waiving all cost sharing and deductibles for fully insured commercial, Medicare Advantage, and Quest Integration members who use telehealth visits, virtual check-ins, and e-visits with a participating provider during the COVID-19 public health emergency. For visits with nonparticipating providers, standard plan benefits will apply for commercial and Quest integration members. This applies to visits from March 1 through December 31, 2020. Telehealth visits will still be available after Dec 31, 2020, but with a cost share.
6. Do HMSA’s telehealth services include physical, occupational, and speech therapy?
On April 1, 2020, HMSA’s telehealth services were expanded to include physical therapy, occupational therapy, and speech therapy. We will make this retroactive to dates of service beginning March 1 through Dec. 31, 2020. This is consistent with CMS’s Medicare guidelines to lower exposure risk while enabling services to continue. HMSA will temporarily allow physical therapists, occupational therapists, and speech therapists to bill for these services.
11. Are there out-of-pocket costs for my patient for telehealth services?
To ensure that members are able to access care from the appropriate setting and avoid unnecessary exposure to the coronavirus, HMSA will wave copayments, deductibles, and coinsurance for all fully insured commercial, Medicare Advantage, and QUEST Integration plan members from March 1 through Dec. 31, 2020.
12. Is member cost share waived during this emergency period for nonparticipating providers?
For telehealth visits, virtual check-ins, and e-visits with a nonparticipating provider, standard plan benefits will apply for fully insured commercial and QUEST Integration members. All cost sharing and deductibles are waived for Medicare Advantage members who use services from participating and nonparticipating providers. HMSA is waiving all cost sharing and deductibles for fully insured commercial, Medicare Advantage, and QUEST Integration members who use these services with a participating provider from March 1 through Dec. 31, 2020
Sincerely,
PMAG
