When COVID-19 escalated in the United States, Aetna, a CVS Health Company, was among the first in the industry to implement short-term crisis policy changes to support you and your workforce. As we shift to recovery planning, some of these policies will remain, while others will end.
The benefit liberalizations list below applies to all Crescent Aetna insured People and summarizes their updated policy changes and effective dates. Crescent and Aetna are closely monitoring the progress of the pandemic, federal and state policies and the associated impact on our People, Aetna members, customers and providers. Aetna will continue to adjust policies, as appropriate, to ensure access to care.
In addition to supporting members’ access to needed care, we continue to focus on protecting patient access to medication.
Provisions that have been extended:
- Waiving early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark.
- Continuing to encourage members to take advantage of plan benefits for 90-day maintenance medication prescriptions.
Provisions that are nearing completion:
Telemedicine cost share waiver
- Member cost shares are waived for all in -network telemedicine visits, including general medical, behavioral health and dermatology (see below for more detail on behavioral health telemedicine visits). Ends June 4th.
MinuteClinic virtual visit cost share waiver
- MinuteClinic Video Visit providers can answer questions about the virus, assess member risk, and provide support to help relieve symptoms. Ends June 4th.
Provisions that will be extended:
COVID-19 testing cost share waiver
- As mandated by the Families First Coronavirus Relief Act, members are eligible for COVID-19 testing and doctor visits at no cost. Extended for the duration of the federal mandate.
Inpatient COVID-19 treatment cost share waiver
- Member cost shares are waived for inpatient admissions at all in-network and out-of-network facilities for treatment of COVID-19 or associated health complications. Extended to September 30th.
Behavioral and mental health telemedicine visits
- Member cost shares are waived for all in-network outpatient behavioral and mental health telemedicine visits. Extended to September 30th.
Prior authorization: Medication
- Clinical prior authorizations are extended to prevent gaps in therapy (includes Specialty). Extended by an additional 90 days, up to nine months, not to exceed the member’s plan benefit year or December 31, 2020.
