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.

HMIA008144 4-2020

References

https://www.wsj.com/articles/what-will-coronavirus-testing-and-treatment-cost-me-11584902030?ns=prod/accounts-wsj | https://www.nytimes.com/2020/03/19/health/coronavirus-tests-bills.html | https://www.washingtonpost.com/health/what-your-health-plan-will-cover-if-you-get-coronavirus/2020/03/12/5349d5d0-646c-11ea-b3fc-7841686c5c57_story.html | https://khn.org/news/fact-check-vice-president-pence-leaves-out-details-about-health-coverage-of-coronavirus-testing/ | https://www.kff.org/private-insurance/issue-brief/private-health-coverage-of-covid-19-key-facts-and-issues/ | https://www.marketwatch.com/story/pence-americans-wont-get-surprise-medical-bills-for-coronavirus-tests-2020-03-10 | https://khn.org/news/trump-wrongly-said-health-insurers-will-pay-for-all-coronavirus-treatment/ | https://www.kff.org/global-health-policy/issue-brief/the-families-first-coronavirus-response-act-summary-of-key-provisions/ | https://www.cnn.com/2020/03/22/health/coronavirus-testing-priorities-doctors/index.html | https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/

Call us Now at (800) 304-3414 or Get a Quote Online