CVS Health said Wednesday it is waiving cost-sharing for certain Aetna plan members who are admitted to the hospital for COVID-19 treatment or health complications associated with the disease.
The pledge will likely make it easier for patients to access and afford care during the worsening pandemic should they need it. It applies to Aetna's commercially insured members when they seek treatment at in-network hospitals. Aetna covers 3.6 million fully insured commercial members and serves 14.2 million people in self-insured employer plans. Self-insured plan sponsors will be able to opt out of the policy, a CVS spokesman said.
"We are doing everything we can to make sure our members have simple and affordable access to the treatment they need as we face the pandemic together," Aetna President Karen Lynch said in a statement.
Aetna, which was acquired by CVS in 2018, and many other insurers had already committed to eliminating copays, deductibles and other forms of cost-sharing for COVID-19 diagnostic tests, even before President Donald Trump signed a bill into law last week requiring them to do so. The new law further forces insurers to cover related hospital and physician visits at no cost.
But the cost of testing pales in comparison to that of an inpatient hospital stay for treatment, which Congress didn't address. The prospect of a massive medical bill could deter sick patients from seeking care. An inpatient admission for coronavirus could top $20,000 for people with employer coverage, according to a recent analysis by the Peterson Center on Healthcare and Kaiser Family Foundation.
CVS also said that hospitals in states with the greatest prevalence of COVID-19 cases, including California, Connecticut, New Jersey, New York, Pennsylvania and Washington, will no longer need advance approval from Aetna for members requiring hospitalization for the disease. Aetna is also working with hospitals to transfer and discharge patients with conditions unrelated to COVID-19 to other settings to make room for more patients.
The board of directors of insurance industry lobbying group America's Health Insurance Plans issued a statement Monday encouraging health insurers to accelerate patient discharges to build capacity at hospitals.
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