COVID-19 Important Dates and Reminders

Our response to COVID-19 continues to evolve, in alignment with Governor J.B. Pritzker’s Executive Order about health insurance benefits and new Illinois requirements. We are committed to working with you to inform and offer greater clarity around our expanded telehealth program and other changes related to COVID-19.  See below for a quick overview to help you stay up-to-date on important dates and reminders during the crisis transition time.

Product Legend:

  • PPO = PPO and Blue Choice PPOSM
  • HMO = HMO Illinois®, Blue Advantage HMOSM, Blue Precision HMOSM, Blue FocusCareSM, BlueCare DirectSM, Blue Cross Medicare Advantage (HMO)SM
  • MA PPO = Blue Cross Medicare Advantage (PPO)SM
  • MA HMO = Blue Cross Medicare Advantage (HMO)SM
  • BCCHP = Blue Cross Community Health PlansSM (BCCHPSM)
  • MMAI = Blue Cross Community MMAI (Medicare-Medicaid Plan)SM 

 

Topic

Brief Description

End Date: 

For More Information

Member Cost-sharing Waiver

Applies to PPO, HMO, MA PPO, MA HMO, BCCHP, MMAI**

BCBSIL is waiving member cost-sharing, including deductibles, copayments and coinsurance related to COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies

Oct. 23, 2020

Member Cost-Sharing Waiver for COVID-19 Treatment Extended Until Oct. 23, 2020 
(August 2020,
News and Updates)

Telehealth Program Expansion

Applies to PPO, HMO*

BCBSIL is waiving member cost-sharing, including deductibles, copayments and coinsurance for telehealth visits

Dec. 31, 2020

BCBSIL Extends Telehealth Benefits Through Dec. 31, 2020 
(September 2020,
News and Updates)

Cost-sharing Waiver Extended

Applies to MA PPO, MA HMO and Medicare Supplement***

BCBSIL is waiving MA PPO and MA HMO member cost-sharing, including deductibles, copayments and coinsurance for telehealth services

Dec. 31, 2020

Cost-Share Waiver Extended for Medicare Members
(July 2020,
News and Updates)

Telehealth Program Expansion

Applies to PPO, HMO*

Any telehealth visit, whether in-network or out-of-network, for services related to COVID-19 will not be subject to benefit preauthorization requirements

Dec. 31, 2020 

BCBSIL Extends Telehealth Benefits Through Dec. 31, 2020 
(May 2020,
News and Updates)

Prior Authorization for chest computed tomography (CT) scans

Applies to PPO, MA PPO, BCCHP, MMAI

  

Providers that request prior authorization through eviCore healthcare (eviCore) for chest CT scans with a COVID-19 diagnosis will receive an approval without the need for clinical documentation

Until further notice

Update: Making It Easier to Access CT Chest Scans
(April 2020,
News and Updates)

Joining Our Network

Applies to PPO, MA PPO

BCBSIL is temporarily updating our credentialing policy and processes in response to the COVID-19 emergency

Until further notice

Update: Credentialing Process Simplified for COVID-19
(June 2020,
News and Updates)

Telehealth Services for Medicaid Members

Applies to BCCHP

BCBSIL is covering  telehealth,  virtual check-ins and portal visits by qualifying Medicaid providers for Blue Cross Community Health Plans (BCCHP) members. Benefit preauthorization is not required for medically necessary services and treatment related to COVID-19.

Until further notice

Alert: COVID-19 Updates for BCCHP Providers
(April 2020,
News and Updates)

Eligibility and Benefits – Use Electronic Options

Applies to MA PPO,

MA HMO

You may experience longer than normal hold times on our Medicare Advantage Provider call lines at 877-774-8592 due to the COVID-19 pandemic. Use Availity or your preferred vendor portal for eligibility, claim status and benefit preauthorizations

Until further notice

Medicare Advantage Provider Call Center Lines Experiencing Longer Hold Times
(March 2020,
News and Updates)
Claim Filing and Appeals

Applies to PPO, HMO*

In compliance with Federal guidelines, certain claim filing periods and appeal dates have been suspended.

60 days after the announced end of the National Emergency

 

Federal Agencies Extend Timely Filing and Appeals Deadlines
(June 2020,
News and Updates)

*This applies to members participating in commercial fully-insured PPO, Blue Choice PPO and HMO plans receiving medically necessary health care services and treatments provided by in-network or out-of-network providers.
**Applies to all fully-insured PPO, Blue Choice PPO and HMO members, as well as Blue Cross Community Health Plans (BCCHP), Blue Cross Community MMAI (Medicare-Medicaid Plan).and Medicare Advantage members.

***This applies to Medicare (not Part D) and Medicare Supplement members receiving in-network telehealth services at no cost-share for medically necessary, covered services and treatments consistent with the terms of the member’s benefit plan.

Checking eligibility and benefits and/or obtaining preauthorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member's policy certificate and/or benefits booklet and or summary plan description. Regardless of any preauthorization or benefit determination, the final decision regarding any treatment or service is between the patient and their health care provider.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor directly.