March 6, 2021

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Insurers remain silent about the "Covid fee"


While doctors, especially dentists, demand that insurers cover the "Covid fee" for their patients, most health companies have remained silent regarding their positions on the controversial tax that has begun to be charged for to cover the expenses related to the new protocols to avoid contagions with coronavirus.

Only MMM and First Medical responded to the request made by Primera Hora regarding the placement made yesterday, Tuesday, by the College of Dental Surgeons for insurers to pay the code D1999. This is related to the personal protective equipment they have to acquire to avoid contagions with the deadly virus.

In general terms, the insurers replied that they are only obliged to cover the charge for those patients who are insured by the health reform from the government, known as the Vital Plan. The order to pay $ 35 per patient was imposed by the Health Insurance Administration (ASES).

“It is important to highlight that the ASES normative letter is addressed exclusively to the Vital Plan services, and in MMM Multi Health the code already is being recognized and processed for Vital providers. However, under CMS the service is not covered, "said Dr. Waldemar Ríos, chief Medical Officer of MSO of Puerto Rico, a company that administers and manages the provider network for MMM, in written statements.

For his part , the response of "First Medical Health Plan, Inc., was that" it is in solidarity with the situation that our Country is going through in attention to the current State of Emergency caused by COVID-19. First Medical has complied with the ASES requirements by offsetting the amount required by the agency for the D1999 code for Vital. On the other hand, First Medical is considering possible short, medium and long-term scenarios regarding this matter. ”

MMM and First Medical were included in the list disclosed by the president of the College of Dentists, David Kerr, who did not they cover the “Covid fee” to patients who are not covered by the Vital Plan. Humana, Triple S, Mapfre and MCS also appear on the list of dentists.

Primera Hora also requested a reaction from these insurers. Only Triple S issued a response, by its press spokesperson María Teresa Morón, in which it was established that the insurer “will not issue a reaction.”

Dentists insist that insurers pay for this service so as not to pass up the charge to the patients.

Luis Rivera, owner of the Jireh Dental Clinic in Dorado and Toa Baja, is one of those who claims that the insurers pay for “the Covid fee.”

“A box mask than before $ 6 now it is $ 60; gowns used to cost us $ 12, now $ 50; a box of gloves was $ 7, now at $ 20, "he denounced.

It is expected that, starting tomorrow, Thursday, the cameral Consumer Affairs Commission will begin evaluating the need to ban this tax.

Representative Joel Franqui , who filed a legislative measure to address the problem, reported that the public hearings will begin and hopes that a bill will be approved next week. In essence, he said, it seeks to prevent consumers from paying this tax both in doctors and in shops.

"It should be the insurers that pay, but never the patient," said the Camuyan.

For the time being , people who have private plans have had to pay between $ 10 to $ 50 as part of the “Covid fee.”

What dentists do is invoice patients and guide them to go to their medical plan to claim the money, Rivera explained.



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