This email is intended for producers with business in all markets and across all regions. PHE COST SHARE WAIVER EXTENSION - ASO CLIENTS & FULLY-INSURED CLIENTS
On January 30, 2023, the Biden administration announced that emergency declarations related to the COVID-19 pandemic would expire on May 11, 2023. There are several coverage and cost-share waivers tied to the federal public health emergency (PHE) affecting Highmark’s Commercial, ASO and Medicare business including:
- $0 COVID-19 vaccines
- $0 COVID-19 diagnostic and antibody testing
- $0 OTC COVID-19 testing
- $0 Prescription antiviral treatment
- $0 Office visits (in-person or telehealth), emergency room visits, or urgent care visits to diagnose COVID-19
Highmark has decided to extend the cost-share waivers above through May 31, 2023, to allow for an orderly transition. After this date, the services above will default to contractually covered benefits and appropriate cost-sharing.
Please keep in mind, state PHE-related cost share waiver mandates may continue to be in place for Commercial Insured lines after the federal PHE ends.
Action Required by our Self-Insured Clients To ensure an orderly transition out of the public health emergency, we encourage our self-insured clients to, likewise, extend cost share waivers through May 31, 2023, as well. If a client does not wish to extend coverage, they will need to let their Client Manager know as soon as possible.
Actions Being Taken by Highmark In alignment with Highmark's goal of seamless and valued service, large group Client Managers have been asked to communicate these changes (for all 51+ clients) and decision opportunities (for self-insured clients) via client email templates. For Small Group clients, the templates are provided for your distribution. Please see the templates below.
Questions Please contact your Highmark Client Manager with any questions. |