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As many of you know, the costs of treating a new disease or virus are often astronomical, and most insurance companies are in flux as they incorporate these therapies into their step therapies and tier programs, and work to come up with medical necessity criteria to allow coverage for experimental treatments.
There are many potential financial impacts and, as a result, many resources emerge to help mitigate these impacts. Thanks to the wide array of organizations dedicated to helping people dealing with cancer, resources have been extended to assist with some costs associated with Covid-19. The list below is just a few of the many options available; I highly recommend working with a financial advocate to see what may be available specifically in your area as well.
Medicare currently provides coverage for the following Covid-19 related services:
One other item that has probably changed drastically is the venue in which you see your doctor. Many providers have switched to telehealth visits, or visits through a video conferencing platform like Zoom or Skype. With that comes a plethora of medical necessity criteria as well that insurance companies need to account for. It looks like Medicare is following suit and has posted on their website that they will cover virtual visits at 80% under Medicare Part B, and the remaining 20% and/or deductible will default to patient responsibility.
Telehealth coverage varies by state, some states are integrating more coverage on their insurance plans as well. For example, Oregon recently announced that their commercial plans should provide expanded access to telehealth visits through the end of the year. It is always important to call your provider’s office to see if they offer the option and to check with your insurance company if they provide telehealth coverage and in what circumstances, a price estimate, and some insurance companies may even offer a free advice line as well. I have provided a link below that may help identify what’s available for telehealth options.
Oregon specific:
As policies are being created and insurance companies determine how to pay for these situations, I highly recommend reaching out to the insurance commissioner to ensure insurance companies are handling these claims appropriately. Many insurance commissioners have been pushing for insurer flexibility in light of the recent increase in health emergencies, and I recommend working with a financial advocate to pursue this route.
Lastly, there are currently several clinical trials that are monitoring Covid-19 and patients with cancer. Clinicaltrials.gov is a great resource to see if there are any trials in your area.
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Welcome to the new CancerGRACE.org! Explore our fresh look and improved features—take a quick tour to see what’s new.
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