The spread of the coronavirus (COVID-19) across the United States has left many people with questions about health insurance coverage. HealthMarkets answers some of the most frequently asked questions.
Will My Health Insurance Cover Coronavirus Testing?
Yes, your health insurance will most likely cover necessary coronavirus (COVID-19) testing during the national emergency period, if your doctor or another medical professional orders a test for you. Many private health insurance companies and state-run healthcare exchanges, which offer Affordable Care Act (ACA) plans, have waived diagnostic testing copays for the coronavirus. Also, you aren’t held to any cost-sharing requirements such as deductibles, copayments, or coinsurance, per the recently enacted Families First Coronavirus Response Act.
Bottom line: Generally, you should not have to pay anything out of pocket for coronavirus testing.
Do I Have to Pay If I’m Not Tested for the Coronavirus at My Doctor’s Appointment?
Most likely. Go to your doctor or a healthcare provider within your health insurance’s network to avoid any unexpected charges. Because of the limited availability of coronavirus (COVID-19) tests, your doctor may use other exams or procedures to rule out a coronavirus diagnosis. If the doctor does not order a coronavirus test based on your symptoms, you might have to pay a copay or deductible, depending on your health insurance plan. Many health insurance companies also have waived copayments for telemedicine appointments.
Will Health Insurance Cover Coronavirus Treatment?
Yes, your health insurance may cover your coronavirus treatment — but not for free — if you are diagnosed with the coronavirus (COVID-19). Many insurance companies’ plans will give you access to covered coronavirus testing and treatment. You will most likely have to meet your deductible before insurance will pay for treatment, or you might be responsible for a copay. Details vary from plan to plan. Generally, you should not have to pay anything out of pocket for testing.
I’m Concerned About the Coronavirus. Can I Still Get Health Insurance for 2020?
Several state-run health insurance exchanges have created or adjusted Special Enrollment Periods (SEPs) in response to the coronavirus (COVID-19) outbreak. These SEPs allow uninsured state residents to enroll in ACA health plans, which cover coronavirus testing as an essential health benefit.
The following states have opened coronavirus-related SEPs or extended their existing SEPs.
|State||April 1 Effective Date Deadline||May 1 Effective Date Deadline||June 1 Effective Date Deadline||July 1 Effective Date Deadline|
|California||March 31, 2020||April 30, 2020||May 31, 2020||June 30, 2020|
|Colorado||April 3, 2020||April 30, 2020||–||–|
|Connecticut||April 2, 2020||April 17, 2020||–||–|
|Maryland||April 15, 2020||May 15, 2020||June 15, 2020||–|
|Massachusetts||March 23, 2020||April 23, 2020||May 23, 2020||May 25, 2020|
|Minnesota||April 21, 2020||–||–||–|
|Nevada||April 1, 2020||April 30, 2020||May 15, 2020||–|
|New York||–||April 15, 2020||–||–|
|Rhode Island||March 31, 2020||April 15, 2020||–||–|
|Washington||April 8, 2020||May 8, 2020||–||–|
|Washington DC||March 31, 2020||April 30, 2020||May 31, 2020||June 15, 2020|
|Vermont*||April 17, 2020||April 17, 2020||–||–|
*Vermont residents may choose either April 1, 2020, or May 1, 2020, for their coverage start date.
I’ve Lost My Job. Can I Still Get Health Insurance?
Yes, you may still be able to get insurance if you have recently lost your job. The loss of a job generally is considered a qualifying life event, which could make you eligible for a Special Enrollment Period (SEP). Usually, you have up to 60 days following the loss of your job to enroll in an individual health insurance plan that’s not connected to an employer.
If you miss this 60-day window, you’ll have to wait until fall when the Open Enrollment Period begins for 2021 ACA or see if you qualify for a short-term health insurance plan. If you’re eligible for Medicaid and/or the Children’s Health Insurance Plan (CHIP), you can enroll any time of year, whether you qualify for an SEP or not.
My State Doesn’t Have an SEP for the Coronavirus. Do I Qualify for a Special Enrollment Period?
To qualify for a Special Enrollment Period (SEP), you must have experienced a qualifying life event that prevented you from enrolling in a plan before the Open Enrollment Period deadline. Some qualifying life events include:
- Losing employer health insurance as the result of a layoff
- Changes in your household such as getting married or having a baby
See a full list of qualifying life events. If you qualify, you have 60 days to enroll during an SEP. If you miss that 60-day window, you’ll have to wait until the Open Enrollment Period to get an ACA health insurance plan for 2021 or find out if a short-term health insurance plan may be an option for you.
I Don’t Qualify for an SEP. What Can I Do?
If you missed the 2020 Open Enrollment Period, do not qualify for an SEP, and do not live in a state with a coronavirus-related SEP, you may qualify for a short-term health insurance plan. These plans may be a good fit for healthy individuals who need temporary coverage. The plans weren’t designed to cover everything, such as pre-existing conditions, and they don’t provide coverage for all the ACA’s essential benefits. If you want a plan that covers all the essential benefits, you’ll have to wait until Open Enrollment begins this fall for 2021 ACA plans.
Explore Your Health Insurance Options
Don’t wait. If you qualify for a Special Enrollment Period (SEP) or live in a state with an extended enrollment deadline, discover what health insurance plans are available to you before you miss the deadlines. Get a free quote through HealthMarkets, or talk to an agent at (800) 304-3414 about your coverage options, which also could include short-term health insurance. We’re here to help you find coverage for your needs, and our counsel is free.