With something as new as the novel coronavirus, things are changing every moment as systems work to adapt.
One of the most pressing questions: Does my health insurance cover testing and treatment for COVID-19? Our Health Care Hacker, Jonathon Hess of Athos Health, has some tips for finding the answers.
If you can get a test, almost every insurance provider has said that it's covered and there will be no out-of-pocket expense. There are a couple caveats to this.
First, if you work for a large employer, typically any company over about 300 people or so, they're often self-insured. What this means is that they tell the insurance company what to cover and what not to cover.
So if you work for one of these organizations, you will want to talk to your HR department and ask them, or see if it's listed on their website. It will just take a little investigation to find out if testing's covered.
The other type of insurance that may not cover testing is short-term medical. If you have a short-term medical plan, do the research. Many times testing will be covered, but don't assume it is.
Many insurers you've seen in the news, like Blue Cross Blue Shield, Aetna and Cigna, have announced that if you or someone in your family gets COVID-19, you won't have to pay anything out of pocket. That means you won't have to pay your deductible, co-insurance, or co-pay.
However, that's typically only for fully insured employers - if you bought it through the exchange, or you work for a smaller employer. If you work for a large employer, you're going to have to call your insurance company to see if that applies to you or not.
If you have Medicaid, testing will be covered with no out-of-pocket. But for treatment, you're still going to have to pay your deductible and your co-pay.
Finally, telehealth is a big topic right now given that we're all stuck at home. A lot of insurance companies are covering telehealth fully, so you don't have to pay anything for it. That includes all health issues, not just COVID-related ones.
But there's no standard, and that's the challenge. Every insurance company, every plan is a little bit different.
Do your research
Jon's advice to you: spend a little bit of time doing research on your own for you and your family. It won't take much.
- Figure out:
- Is testing covered for me and my family?
- If I do get COVID-19, will I have to pay anything out of pocket? And if so, how much?
- Know where you are in your benefit year, know how much you already paid out-of-packet, and what your exposure is. Financial times are tough right now, so you want to understand what you will potentially have to pay.
- Finally, have a plan for where you're going to go if you get sick. You want to make sure you go to an in-network facility if at all possible, so know what that facility is near you. In-patient COVID treatment is extremely expensive if you go to an out-of-network facility, and the last thing you want to do is have a large financial burden for you and your family on top of the health burden.
So take a couple minutes, do the research, and try to figure out what the best options are for you. We're all in this together. It's complex, but with a little bit of time you can limit your financial risk.