As the COVID-19 outbreak continues to spread, you may be getting questions from employees about their health plan’s coverage for COVID-19 testing, including whether they will need to pay a deductible or copayment.
This is a rapidly evolving issue, with many health insurance issuers announcing that they will voluntarily waive any cost sharing for COVID-19 testing.
A new federal law may be passed in the future requiring health plans and health insurance issuers to cover COVID-19 testing without cost sharing.
This requirement is included in the coronavirus relief bill that was passed by the House of Representatives on March 14th, 2020.
In the meantime, you should consult with your plan’s issuer or benefits administrator regarding your health plan’s coverage for COVID-19 testing.
Federal Guidance
The federal government has released the following guidance on health plan coverage for COVID-19 testing:
- Insured health plans in the individual and small group markets must cover COVID-19 diagnosis and treatment as an essential health benefit, although the exact coverage details and cost-sharing amounts may vary by plan.
- High deductible health plans (HDHPs) that are compatible with HSAs can pay for COVID-19 testing and treatment before an individual has met the plan’s minimum deductible for the year.
State Requirements
Many state insurance commissioners are requiring or encouraging health insurance issuers to waive cost sharing for COVID-19 testing. For example, at this time California, New York, Washington and Massachusetts have directed issuers to cover COVID-19 testing without imposing any deductibles, copayments or other cost sharing.
In Closing
Check with your plan issuer or benefits administrator about coverage for COVID-19. If you have your benefits plan with O’Neill Insurance, reach out to our Benefits Department by filling out the form below. We’re here to help!