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February 22, 2021 | How the Pandemic Co-Pay Waiver Impacts You

Reliable access to care has never been more important. When the pandemic began, the Centers for Medicare & Medicaid Services (CMS) issued a temporary co-pay waiver for Medicare beneficiaries.

This wavier offers an incredible opportunity to people who need care but may be avoiding in-person visits. If you have any health concerns or questions you would like answered, including about COVID-19, this opportunity allows you to get care virtually without the cost responsibility.

This not only makes it easier for people to have their healthcare needs met, but also makes it more affordable, and it is all done without them leaving the safety of their homes. Below, we outline a few questions we received about this waiver to help you better understand its impact.

 

How long will the wavier last?

The Department of Health and Human Services (HHS) extended the COVID-19 public health emergency, which includes waivers for virtual care services until April 2021, according to Fierce Healthcare. It has already been extended a number of times and as long as the pandemic is deemed a public health emergency, the waiver will continue.

 

Which virtual care services are included in the waiver?

Virtual care services such as Chronic Care Management (CCM), Principal Care Management (PCM), and Remote Patient Monitoring (RPM) are all included within this waiver. Depending on which program your provider recommends for your personal healthcare needs, our team can assist you in enrolling in one of them. This way, you can easily receive care when you need it while achieving your healthcare goals.  The waiver is also available for in-person services.

 

What happens if I receive a bill during this time?

For many practices and insurances, bills are auto-generated and released based on visits. If you do receive a bill for a co-pay during this time, you can contact the billing department of the service provider to confirm its status. Our billing department can be reached at 833.935.5269.

It is important to note that although you are not responsible for the co-pay, Medicare and other insurance providers are still processing claims. This ensures that the doctors, nurses, and other healthcare providers are paid for the services they are providing while ensuring patients continue to receive care throughout the pandemic.

For this reason, you should still expect to see an EOB, or explanation of benefits, statement.  These statements typically arrive every few months and show a full view of all visits and claims that your insurance has processed. While an EOB is not a bill, receiving them often causes confusion and concern.

 

The co-pay waiver offered by Medicare allows people the chance to receive personalized care from the comfort of their homes without the cost responsibility. If you would like to take advantage of this co-pay waiver on virtual care services, contact us today!