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Allwell Extends $0 Member Liability for Primary Care, Behavioral Health and Telehealth Services

Date: 06/22/20

Since March, Allwell from Superior HealthPlan has waived pre-authorizations, co-pays and other costs related to coronavirus testing, screening and medically necessary treatment. Allwell has also waived prescription refill limits, and members are able to refill prescriptions prior to their refill date during this crisis.

As seniors face increased social and economic barriers to care amid the pandemic, Allwell is now offering a number of expanded benefits to help eligible Allwell members address issues such as out-of-pocket medical costs, food insecurity and medication assistance.

Effective July 1, 2020, expanded benefits will include:

  • $0 Member Liability Extension – Allwell will waive in-network member costs for all primary care visits for the rest of 2020. Allwell will also waive member costs for outpatient, non-facility-based behavioral health visits and are extend telehealth cost share waivers for all telehealth visits (primary care, specialty and behavioral health) for in-network providers for the remainder of 2020. This does not include inpatient hospital, behavioral health facility or urgent care visits. Medicare members with state benefits will continue to receive support through coordination with their states.
  • Extended Meal Benefits Members eligible for meal benefits due to a chronic condition or recent discharge may receive an additional 14 meals delivered to their home at no cost.
  • Increased Annual Wellness Visit Incentives – Members may be eligible for an increased incentive for completing their Annual Wellness Visits, a benefit offered at no cost to the member.
  • Additional Over-The-Counter (OTC) Benefits – Plans with an OTC benefit may now receive additional allowance dollars in monthly or quarterly increments, adding up to as much as $150 for the remainder of 2020.
  • Access to WellCare’s Community Connections Help Line – The Community Connections Help Line is a toll-free line provided by Allwell’s partners at WellCare and available to anyone in need. It is staffed by peer coaches and support specialists who can refer individuals and caregivers in need to a database of more than half a million social services in local communities across the country. By calling the line at 1-866-775-2192, members can also receive help coordinating of the expanded meal program benefits, OTC allowances and annual wellness visit incentives via the line.

Beginning July 1, 2020, providers should waive the member liability for the eligible primary and behavioral health care claims at the point-of-service, and forego the collection of the member cost share. This is a benefit change for Allwell members, and Allwell’s claims system will be configured to administer these adjusted benefits. Allwell recognizes that providers have different reimbursement/accounting arrangements, and the costs associated with this benefit change will follow the accounting processes as outlined in the provider’s contract with Allwell.

For services rendered to Medicare members with state benefits, providers should continue to collect that member cost share from their State Medicaid Agency as per usual.