Waiving cost share for Medicare Advantage members for primary care and specialist office visits
Our member’s health is our priority. To help you get the care you need, we are waiving cost-share (copays, coinsurance and deductibles) for our Medicare Advantage plan members 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, 2020.1 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.
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
- 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
Copays, coinsurance 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
The cost-share waiver applies to all UnitedHealthcare Medicare Advantage members, including members of Special Needs Plans (SNP) and UnitedHealthcare Group Medicare Advantage plans.
What to do if you paid for one of the waived services after May 11, 2020
If you paid a copay for one of the waived services listed above, your provider should refund you after they file the claim for your visit with the plan. Contact your provider’s office for refund information.
We’re committed to keeping you up to date on COVID-19. We’re taking note of your questions and working hard to provide answers. Let us know how we’re doing.
We’re making daily updates to the site. Please check back often for the latest information.
- The end date of this waiver is subject to change based on direction from Centers for Medicare and Medicaid Services (CMS).
This page describes benefits we offer to all members in all states. They also include federal requirements. More benefits may be available in some states and under some plans.
We have created rules and practices that may apply to some of our products at this time. The information is a summary and is subject to change. For more information, contact your account representative or call the number on your member ID card.