Last update: May 28, 2020, 11:30 a.m. CDT
We want care providers to focus on delivering care and providing support to our members. During the COVID-19 national public health emergency period, UnitedHealthcare is implementing a cost share waiver for COVID-19-related care and treatment for in-network and out-of-network services. Some services or facility exclusions may apply. Implementation for self-funded customers may vary. We will adjudicate benefits in accordance with the member’s health plan.
UnitedHealthcare is waiving member cost sharing for the treatment of COVID-19 until July 24, 2020, for its Medicare Advantage, Medicaid and Individual and Group Market fully insured health plans. Implementation for self-funded customers may vary.
If a member receives treatment under a COVID-19 admission or diagnosis code between Feb. 4, 2020 and July 24, 2020, we will waive cost sharing (copays, coinsurance and deductibles) for the following:
- Office visits
- Urgent care visits
- Emergency department visits
- Observation stays
- Inpatient hospital episodes
- Acute inpatient rehab
- Long-term acute care
- Skilled nursing facilities
If a member receives treatment under a confirmed positive diagnosis of COVID-19 or COVID-19 admission between Feb. 4, 2020 and July 24, 2020, providers will need to use code U07.1.
For a full list of associated codes and sequencing codes for COVID-19-related visits, see the ICD-10-CM Official Coding and Reporting Guidelines.
For members with a confirmed positive diagnosis of COVID-19, we will waive cost sharing (copays, coinsurance and deductibles) for all COVID-19-related care during inpatient treatment. Non-COVID-19-related services will be covered in accordance with the member’s benefit plan.
For members with a confirmed positive diagnosis of COVID-19, we will waive cost sharing (copays, coinsurance and deductibles) for COVID-19 office visits, including telehealth visits, initial office visits, post-inpatient transitional visits and other visits where COVID-19 is on the claim as a diagnosis. Office visits for conditions not related to COVID-19 are not waived for cost sharing, such as an existing condition or newly diagnosed conditions not related to COVID-19.
Until July 24, 2020, we will waive cost sharing (copays, coinsurance and deductibles) for ground emergency and medically necessary non-emergency ambulance transportation for COVID-19-related or suspected COVID-19-related services. We will also waive cost sharing for ground transportation from facility to facility (acute to acute or acute to post-acute) for patients with a positive COVID-19 diagnosis.
We will cover cost-effective non-emergency transportation alternatives (i.e., Lyft, Uber, taxi) when a personal vehicle or other transportation is not available at the time of member discharge for an inpatient or post-acute stay, or for members who have tested negative for COVID-19 and need transportation after discharge.
This applies to UnitedHealthcare Group Market fully insured health plan members. We will also work with self-funded customers who want us to implement a similar approach on their behalf. Member cost sharing will apply.
We’re committed to keeping you up to date on COVID-19 – we’re monitoring your inquiries and working hard to answer your questions. Let us know how we’re doing.
We’ll be making daily updates to this site. Be sure to check back often for the latest information.
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The benefits and processes described on this website apply pursuant to federal requirements and UnitedHealthcare national policy during the national emergency. Additional benefits or limitations may apply in some states and under some plans during this time.
We will adjudicate benefits in accordance with the member’s health plan.
Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.