Ebola: Health insurers stay calm but alert

The number of people who have contracted the often-fatal Ebola virus continues to climb worldwide.  More than 6,500 people have been infected and about have died since the outbreak in West Africa began over the summer.  President Obama considers Ebola a matter of national security, as Americans wait to see how many others in the U.S. will be hospitalized.

The events of the last few months have put us on edge: Are Americans at risk at home? Neither the Centers for Disease Control and Prevention (CDC) in Atlanta nor health insurance companies, which would have to bear the brunt of the cost of treatment were there to be an outbreak in the U.S., seem overly concerned about an outbreak here.

Spain is home to the first case of Ebola contracted outside Africa - a nurse who got Ebola while treating a patient who had contracted the disease in Africa. But Dr. Ajani P. Nimmagadda, an infectious disease expert and senior medical director for Cigna, says what happened in Spain isn't likely to happen here.  “We have an excellent infrastructure in place to prevent such outbreaks. Our hospital systems and health care providers are trained to identify high-risk patients and isolate them immediately,” she says.

In Texas, however, a man with Ebola was at first released from a hospital. He is now in critical condition. There is some question about whether Thomas Eric Duncan told a nurse at the hospital that he had been to Liberia and helped a pregnant woman with the virus.

Health care workers follow precautions

Nimmagadda says U.S. health care workers follow universal precautions to prevent the spread of infections between patients and themselves. Despite the Ebola patient in Texas, she says, “the possibility of widespread outbreak similar to what we are seeing in West Africa should be negligible.”

Nimmagadda also says that Cigna is closely monitoring the situation in Dallas and “will work with public health professionals, customers, clients, and local health care professionals as necessary.”

Aetna, too, is monitoring the situation closely but agrees with the CDC, which has said that even with the latest developments, Ebola poses no significant threat to the general population in the U.S.,  says spokeswoman Cynthia Michener.

Duncan has been given brincidofovir, an anti-viral drug that has shown promise in the laboratory but had not yet been tested in humans. The manufacturer of the drug, Chimerix, received special permission from the Food and Drug Administration to provide it to him.   

Generally, health insurance companies don't cover the cost of “experimental” treatments. Michener says Aetna would “continue to follow the guidance of health authorities closely on any treatment options they determine are viable.” Currently, she notes, the treatment given Duncan “is still in trials, unproven in humans, and not yet approved by the FDA.”

In fact, "experimental" is one of 12 words never to say to your insurance company.

Manufacturers generally cover the cost of such ad-hoc treatments that have not yet gone through FDA trials and approval. So health insurance companies would not be on the hook for what could be costly medications.

Health insurance companies help keep everyone informed

While an Ebola outbreak is not likely here, Nimmagadda says, Cigna, like all health insurance companies, takes any possibility of an outbreak seriously and works with its providers and patients to keep them informed about unusual health threats.

Health insurance companies, including Cigna and Aetna, also are taking steps to raise awareness of Ebola among their customers, clients, health care professionals and employees.

Cigna continually educates its health care providers and members about what they can do to prevent the spread of infectious diseases, whether it's the flu, whooping cough or other viruses and infections. For example, Nimmagadda says, "We remind them of the need to wash their hands and to avoid coming in contact with bodily fluids from infected patients," she says. In today's health care settings in the U.S., she says, "you can isolate any contagious [patients] pretty effectively and you take precautions even if you didn't know what it is they might have."

Should an outbreak of infectious disease occur, Cigna would follow the guidance of the CDC and local health authorities, Nimmagadda says. It would inform its providers and members about the steps patients should take and how they can receive the best possible care if they are affected, Nimmagadda says. "We help our customers get the care they need, regardless of the disease -- whether it's an Ebola outbreak or any situation."

Aetna issued a statement saying it is “on the front line of treatment during epidemics” and that its health professionals “constantly monitor reports of infection diseases including the Ebola virus. The release also encourages people to learn about prevention, symptoms and treatment and provides links to the Centers for Disease Control and Prevention and the World Health Organization so that they can.

In addition to staying up-to-date on developments, the Cigna Foundation announced it had made a $50,000 donation to the United Nations Emergency Relief Fund, with funds directed to Ebola-related services.

Nimmagadda leads a work group at Cigna that includes doctors, customer service reps and provider-relations personnel who look ahead and are charged with supporting unusual situations such as an Ebola outbreak. The team makes sure Cigna's providers would have the resources they need to assist their subscribers in the event of an outbreak or natural disaster. How often the team meets depends on the need. "During the influenza season," Nimmagadda says, "we might meet once a week." Other times, it's less often.

Benjamin Haynes, a spokesperson for the CDC, says health insurance companies can play a role in helping prevent outbreaks by raising awareness among their health care providers and subscribers of the need to take precautions.

"Anything that they can do to help make people aware of what's going on where they live or where they travel is helpful," he says. During the flu season, for example, health insurance companies alert their members to the need to get the flu vaccine. "That's not the same as an Ebola outbreak," he says. "But that's an example of how health insurance companies can play a role in prevention of contagious diseases."

Warning travelers about Ebola also a good idea

Devon Herrick, a senior fellow at the National Center for Policy Analysis in Dallas, a think tank that covers health insurance, says health insurers also need to inform their subscribers who travel back and forth to Ebola hot spots (Sierra Leone, Liberia, Guinea and Nigeria) of their risk of exposure and what they can do to protect themselves.

While Herrick, too, believes that the risk of Ebola coming to the U.S. is small, he says, hospitals like Dallas' Presbyterian Hospital undoubtedly will have their hands full treating patients like Duncan. “It's presumably not a hospital bill he can afford to pay - or anyone who lacks very comprehensive insurance,” he says.  A few people - and potentially a few health plans - may find they're on the hook for very costly hospital bills, he says.

Insure.com receives compensation from carriers when readers choose to request insurance quotes. This article is provided by an external partner that is solely responsible for the content.

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