Trustees of the DGA’s Health Plan have waived all co-pays, co-insurance and deductibles for in-network coronavirus-related testing through June 15, and have approved temporary coverage of tele-medicine and tele-psychology doctor visits until further notice.
Trustees of the SAG-AFTRA Health Plan have adopted similar waivers for its participants.
“During this challenging and unprecedented time caused by the coronavirus outbreak, many physicians’ offices and therapists’ offices are not seeing patients in-person to prevent further spread of the virus,” the DGA said. “For the continued protection and safety of all Health Plan participants, the Board of Trustees has approved temporary changes to Health Plan coverage in response to the evolving coronavirus crisis. These changes take into account the importance of COVID-19 testing and related treatment, as well as the need for limiting in-person interactions and social gatherings to the extent possible, as recommended by health authorities.”
The DGA said that, through June 15, all patient cost-sharing, including co-pays, co-insurance and deductibles will be waived for all in-network COVID-19 related testing when the administration of the test is deemed medically necessary, ordered by a network provider and performed at a network lab/facility.
COVID-19 testing via in-network telemedicine without cost sharing also is effective now. This includes patient cost-sharing for office visits, tele-medicine visits, urgent care centers and hospital emergency room visits for the purpose of COVID-19 testing. After June 15, the COVID-19 testing and associated visits will continue to be covered at the usual benefit level.
“If you have already incurred a claim for services affected by the aforementioned Health Plan coverage changes,” the DGA told its members, “you may be eligible for reimbursement.”
“All other Health Plan rules remain in effect,” the guild said, “including but not limited to the exclusion of services that are not medically necessary, the exclusion of marriage, family or relationship counseling and/or therapy, and the exclusion for charges in excess of the Allowable Charge limit – meaning you will be responsible for any out-of-network charges above the allowable charge or reasonable and customary charge limit.”
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