Aetna Eligibility Response Changes Regarding Covid-19

Aetna just sent out the following message:

Overview:

Eligibility and Benefits Inquiry (270/271):

We’ll make the following change:

• To support our policies regarding member access to telemedicine and diagnostic testing in response to the novel coronavirus (COVID-19), we’re adding the following messages to our Eligibility and Benefits Inquiry responses:
  • Telemedicine cost share
    • Medicare Advantage Plans – While the COVID-19 public health emergency is in effect, there is no cost share for a Medicare member for covered Telemedicine services performed by a PARTICIPATING provider only. Cost share is required if a member sees a non-par provider.
    • Commercial Plans – There is no cost share for a Commercial member for covered Telemedicine services regardless of provider’s participating status with the plan.
  • Diagnostic
    • All Plans – While the COVID-19 public health emergency is in effect, there is no cost share for the member for all COVID-19 and SARS-CoV-2 diagnostic testing performed in an approved laboratory location.

These messages will be available to providers on March 28, 2020. Providers will be able to see these messages when they submit an Eligibility and Benefits Inquiry transaction with any service type code.