UHC Waiving Cost Share for Medicare Advantage Members

May 11, 2020

UnitedHealthcare Is Waiving Cost Share for Medicare Advantage Members

Thank you for your continued efforts toward helping our members and communities stay healthy. We’re supporting you, your staff and members as they get ready to visit their primary and specialty health care providers for preventive care and for chronic conditions – care that may have been delayed.

NEW – Waiving Cost Share for Medicare Advantage Members
UnitedHealthcare is waiving cost share (copays, coinsurance and deductibles) for UnitedHealthcare Medicare Advantage plan members for all covered office-based professional services performed by both primary care physicians and specialists with dates of service starting May 11, 2020 until at least Sept. 30, 2020. Waiving cost share for primary care and specialty care can make it easier for members to get the care they need, however they choose to access it. 

This applies to all UnitedHealthcare Medicare Advantage members, including Group and all Special Needs Plan (SNP) members. More information about the Medicare Advantage cost share can be found here

COVID-19 Cost Share Recap
Waiving cost share for Medicare Advantage members is in addition to actions we’ve already taken to waive cost sharing across our Medicare Advantage, Medicaid, and Individual and fully insured Group Market health plans for telehealth visits, as well as COVID-19 testing and testing-related visits, treatment and antibody testing.

Updated Telehealth Audio-Visual Requirements
Starting May 11, 2020, telehealth visits for Medicare Advantage members, including DSNP members, must be an interactive audio-video visit (such as Zoom, FaceTime, Skype, Google Duo or dedicated telehealth solutions) to qualify for reimbursement, except for certain audio-only visits classified by CMS on May 1, 2020. Medicare fee schedule rates for audio-only evaluation and management codes have been adjusted retroactively for dates of service March 1, 2020 or later, such that reimbursement aligns with in-office fee schedule rates for comparable codes.

Cost share for both covered interactive audio-video telehealth visits and audio-only telehealth visits will continue to be waived.

The COVID-19 public health emergency continues to evolve and we’re working to get updated information to you as quickly as possible. Please visit UHCprovider.com/covid19 for our complete COVID-19 resources – and check back frequently, as we’re making regular updates to the site.