Waived Co-Pays for United Healthcare Medicare Advantage Plans

Waived Co-Pays for United Healthcare Medicare Advantage Plans

By Jessica M. Wade, MHA, Practice Manager

Just to clarify, the UHC copay waiver info is listed  clearly on the UHC website as follows:
“Members will have a $0 copay for covered primary care provider (PCP) and specialist physician services, as well as other covered services (listed below) between May 11, 2020 until September 30, 2020″. By lowering our PCP and specialist copays to $0, along with our telehealth cost-share waiver, we hope to help make it easier for you to access care”

Services included

The following services, if covered by your plan, are eligible for a $0 copay under the cost-share waiver, but do not include diagnostic tests and certain other services.

• Primary care provider (PCP) office visits
• Specialist physician office visits
• Physician assistant or nurse practitioner office visits
• Medicare-covered chiropractic and acupuncture services
• Medical and Podiatry services and routine eye and hearing exams
• Physical therapy, occupational therapy and speech therapy
• Cardiac and pulmonary rehabilitation services
• Outpatient mental health and substance abuse visits
• Opioid treatment services

The $0 copay applies to services from a network provider and out-of-network services covered by the plan. Member cost-share is not waived for the
following services, unless they are related to COVID-19 testing or treatments:

• Lab and Diagnostic tests (radiological and non-radiological)
• Part B and Part D drugs
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies
• Renal Dialysis
• Other services not covered by your plan

Co-pays, co-insurance and deductibles for services in the following settings are not waived. Members will be responsible for their share of the cost under their benefit:• Inpatient hospital and Outpatient surgery or observation services.

• Skilled Nursing Facilities
• Emergency, Urgent and Ambulance services

Source: https://www.uhc.com/health-and-wellness/health-topics/covid-19/coverage-and-resources/cost-sharing-waived

Furthermore, reimbursement is based on the Medicare fee schedule as these plans waiving copay are Medicare Advantage plans and subject
to Medicare guidelines and reimbursement models.



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