Benefit and network updates for Humana members

We have received many questions from providers. Our intent is to communicate frequently about changes as they happen, and quickly update as additional information emerges. Please regularly check this page for new information.

  1. Member cost share for all in-network primary care visits is waived for the remainder of the calendar year to encourage members to seek needed care from their primary care provider.
    This applies to Humana individual or group Medicare Advantage members. We want to encourage our members to reconnect with their PCP, particularly for preventive care and chronic condition management. Cost share waivers are retroactively effective as of May 1, 2020. These cost share waivers apply to office visits for all participating/in-network providers as well as any labs performed in the primary care physician’s office during the visit. Labs drawn in the PCP office and sent to a hospital or reference lab are excluded from the primary care cost share waiver, as are radiology, supplies and Part B drugs administered as part of the visit. In support of this waiver, please do not collect a copay from any Humana individual or group Medicare Advantage patients for any of the primary care visits outlined above.

  2. Member cost share for outpatient behavioral health visits is waived to encourage members to seek needed behavioral health care.
    This applies to Humana individual or group Medicare Advantage members and extends through the end of the calendar year. We know that a large number of our members are struggling with social isolation, loneliness, and potentially anxiety and depression as a result of COVID-19 and social distancing, while others have existing behavioral health conditions that they may not have sought treatment for in recent months. To support our members in need of behavioral healthcare, we are waiving all member cost-share on outpatient, non-facility based behavioral health visits with participating/in-network providers. This includes psychiatric medication consults, individual therapy and group therapy. These cost-share waivers are retroactively effective as of May 1, 2020. In support of this waiver, please do not collect a copay from any Humana individual or group Medicare Advantage patients for any of the behavioral health visits outlined above.

  3. Member cost share waivers for in-network telehealth visits are extended to give members flexibility to seek and receive care.
    This applies to Humana individual or group Medicare Advantage members. We have seen considerable adoption of telehealth since we introduced our updated policy in March. Given the important role telehealth is playing in providing access to care for members who are staying at home, we are extending our member cost-share waivers through the end of the year. This waiver applies to telehealth visits with all participating/in-network providers, including primary care, behavioral health and other specialist providers. To support providers with patient engagement and adoption of telehealth, we have developed a toolkit of engagement templates and messaging that your practice can leverage. These tools are unbranded and can be modified to allow providers to customize with their logos, contact information and telehealth channels in use. In support of this waiver, please do not collect a copay from any Humana individual or group Medicare Advantage patients for any of the telehealth visits outlined above.

  4. Member cost share is waived for all covered COVID-19-related medical treatment.
    • All out-of-pocket medical costs (deductible, co-pays, and coinsurance) related to covered treatment for COVID-19—including inpatient hospital admissions— will be waived for enrollees of individual and Group Medicare Advantage plans, fully insured commercial members, Medicare Supplement and Medicaid
    • The waiver applies to all out-of-pocket costs related to the covered treatment of COVID-19 as well as FDA-approved medications or vaccines when they become available
    • Humana will waive the member’s out-of-pocket costs for covered COVID-19-related services delivered by participating/in-network and non-participating/out-of-network providers
    • There is no current end date, but Humana will reassess as circumstances change.

  5. Member cost-share on covered COVID-19 related testing is waived.
    We have expanded our member cost-share waivers for COVID-19-related testing, which includes both the COVID-19 test and viral panels that rule out COVID-19; cost-share waivers now apply to laboratory testing, specimen collection and certain related services that result in the ordering or administration of the test, including physician office or emergency department visits. This change will apply on a retroactive basis to services delivered on or after Feb. 4, 2020.

  6. Quest and LabCorp do not collect samples directly from patients.
    To clarify our previous message regarding COVID-19 testing at Quest and LabCorp, please refer specimens to these labs and do not send patients directly to their patient service centers. Quest and LabCorp do not collect COVID-19 samples.

  7. Members may have several options for prescription delivery.
    Members may be able to have their prescriptions delivered. Check with CVS, Walgreens and other local pharmacies to see if they offer local prescription delivery to support patients in social isolation. As an alternative, providers can support the movement of member prescriptions to Humana Pharmacy’s 90 day mail order by sending orders to Humana Pharmacy - see Humanapharmacy.com/prescribers, opens new window for prescribing information. Please keep in mind that first-time setup takes approximately five days for processing and delivery after prescription orders are received.

  8. Early prescription refills allowed through July 25, 2020.
    Humana is allowing early refills on prescription medicines so our members can prepare for extended supply needs—an extra 30- or 90-day supply as appropriate.

  9. Hydroxychloroquine, chloroquine and mefloquine to be limited.
    In response to the COVID-19 pandemic, regulatory agencies in several states have taken steps to limit the inappropriate use of medications that may have potential to be used for patients with the coronavirus. Humana Pharmacy and potentially other pharmacies in our network, opens new window are planning to limit the supply of hydroxychloroquine, chloroquine and mefloquine to preserve the medications for patients who have an established need for them. Please contact pharmacies directly for more information. See Humana Pharmacy’s message, PDF opens new window for more details.

  10. Member support line available.
    Humana has trained a specialized group of call center associates to help support our members with specific coronavirus questions and concerns, including assistance in accessing their telemedicine benefits. Members can call Humana’s toll-free customer support line, which can be found on the back of their member I.D. card, to be connected to this dedicated team of professionals.

  11. Home oxygen is covered for temporary use.
    Humana is now covering short-term home oxygen usage for members with a COVID-19-related diagnosis