Humana to pick up tab for Medicare Advantage visits

Slowdown in elective procedures opens door for funding

The health insurer Humana will cover the whole bill for millions of customers when they are ready to ease COVID-19 social distancing and return to seeing doctors in person.

The insurer said Tuesday that it is waiving co-payments, deductibles and other out-of-pocket costs for the rest of the year for all Medicare Advantage customers who visit their primary care doctor or see a behavioral health specialist. The care has to take place inside the health insurer’s network of doctors and therapists.

Humana Inc. covers nearly 4.5 million people as the nation’s second-largest provider of Medicare Advantage plans. Those are privately run versions of the government’s Medicare program for people age 65 and over and those who have severe disabilities or illnesses.

Many insurers, including Humana, have already waived costs for COVID-related care and telemedicine visits. Humana’s new waiver applies to all primary care and to outpatient behavioral health visits.

Company leaders say they are trying to make it easier for people to keep up with their health, especially older customers who may have a few chronic problems.

CEO Bruce Broussard noted that many doctor visits have been postponed or canceled since the global pandemic started spreading through the United States earlier this year. He said company research shows that costs like co-payments can force Medicare Advantage patients to put off care even more.

“These individuals are on fixed incomes, a lot of them are living on less than $20,000 a year, so $35 or a 20% copay is meaningful to them,” he said.

Humana’s waiver doesn’t apply to things like X-rays or hospital stays, unless the care is tied to COVID-19.

Medicare expert Tricia Neuman said any move to waive costs would provide a “huge relief” to people with limited incomes.

“But this may not be where the big bills are,” said Neuman, a senior vice president with the nonprofit Kaiser Family Foundation.

She said a Medicare Advantage customer who lands in the hospital could wind up with a bill of more than $2,000 even with insurance. That depends on the length of their stay and how much care they need.

Health insurers have seen a drop in claims for things like elective surgeries over the past several weeks due to the pandemic. Broussard said Humana is using that break to help cover the fee waivers.

Humana also said Tuesday that it also will send safety kits that include two washable face masks to customer homes starting later this month.

Broussard said the expenses will be immaterial to the company’s financial books.

“We feel very comfortable that this investment is going to continue to allow us be a financially sound and growing organization,” he said.

Humana, based in Louisville, Kentucky, said late last month that it made $473 million in the first quarter. The performance topped Wall Street expectations.