Does health insurance cover coronavirus?

The coronavirus is fairly new, but health professionals have worked quickly to develop accurate tests and treatment for COVID-19. Your health insurance policy will cover the test, but you may have to pay some of the treatment costs out-of-pocket if you contract the virus.

Does health insurance cover the coronavirus?

Yes and no.

On March 18, Congress passed the Families First Coronavirus Response Act, a new law that requires private health insurers to cover diagnostic testing for the coronavirus while the country is in a state of emergency. Currently, medical clinics, hospitals and private laboratories can administer the tests, according to the Kaiser Family Foundation.

But the new law doesn’t require carriers to cover treatment. Depending on your age and the severity of the case, treatment may involve respiratory therapy or hospitalization.

However, around 80% of people who contract coronavirus will recover without needing specialized treatment, according to the World Health Organization.

Coronavirus risk factors

How health insurance companies are handling the coronavirus

Under the Families First Coronavirus Response Act, private health insurers are waiving copays and cost-sharing for COVID-19 testing at in-network facilities. Many are also expanding access to telemedicine consults and authorizing early medication refills so patients can have a 60- to 90-day supply of their prescriptions, according to America’s Health Insurance Plans (AHIP).

A handful of insurers are also voluntarily waiving cost-sharing for some coronavirus-related treatment, as of March 31.

Private health insurers covering coronavirus treatment costs

Health insurance premium relief during the coronavirus

Many state insurance departments across the country have mandated that insurers help any policyholders in financial hardship because of the coronavirus.

This assistance may involve:

• Relaxing or postponing due dates for premium payments
• Extending grace periods
• Offering flexible payment plans
• Waiving late fees and penalties
• Avoiding cancelling coverage due to non-payment

States with premium relief programs in place

Here’s where each state stands on premium relief and forgiveness, as of March 31. Many of the bulletins are general, but we’ve noted specific timeframes as they apply.

These directives are in force until the end of the national emergency, unless another date is stated.

What should I do if I don’t have health insurance?

With business closures and the changing economies, many Americans have lost their jobs in recent months — and the group health insurance they had through work. According to Families USA, 5.4 million Americans are now uninsured as a result of the pandemic, which is the greatest health insurance loss in the country’s history.

If you lost your job, you may have health insurance through the end of the month, depending on the policy details. And losing your job is a “qualifying event,” which means you can shop around for new health insurance coverage.

You have a few options to get health insurance.

Medicaid

If you’re eligible for Medicaid, you can apply for coverage at any time. The requirements vary by state, but you’ll typically qualify if your income is at or below 138% of the federal poverty level.

Affordable Care Act (ACA) coverage

You can sign up for ACA coverage — colloquially known as “Obamacare” — within 60 days of losing your health insurance. You’ll likely need to submit documentation proving that you no longer have coverage.

In most states, you can enrol in an ACA plan on HealthCare.gov — though some states have their own marketplaces.

COBRA

The COBRA Act allows you to hold on to your employer’s health insurance plan for up to 18 months. You’ll need to sign up within 60 days of losing your job — but your premium will no longer be subsidized. This means you’ll have to pay 100% of your premium to maintain COBRA coverage.

Spouse’s plan

If your spouse has employer-sponsored health insurance, you may be able to join their plan. You have 30 days to do this — otherwise you’ll need to wait until the employer’s annual enrolment period.

Parents’ plan

Similarly, if you’re under 26, you can ask to be added to your parents’ plan. However, you might not be able to do this if you’re married.

Short-term health insurance plan

Some insurers offer temporary health insurance plans. The length of coverage varies between states, but the plans typically last up to a year.

There are drawbacks: Coverage can be limited, and people with preexisting conditions may be denied a policy.

Sign up for a telehealth service

To get medical care online or over the phone, look into a telehealth service — like Teledoc or Doctor on Demand. With these telemedicine services, you can have virtual consults with doctors and specialists and get a diagnosis, treatment plan and prescription medication as needed.

Most insurance companies have expanded policyholders’ telehealth access to line up with social distancing guidelines.

Health insurance 101

Bottom line

The coronavirus is an evolving pandemic, but health insurers and state insurance departments are working to expand access to COVID-19 tests and treatments. Some insurers are also offering premium relief, so please contact yours if you’re struggling to make your premium payments.

In the meantime, stay on top of changing coronavirus news.