Coronavirus is a respiratory disease that has infected millions of people worldwide. Some people who are experiencing symptoms are postponing coronavirus testing and treatment because they aren’t sure what’s covered by their health insurance.
Many private insurance providers voluntarily waived payment for coronavirus tests, and on March 18, President Trump signed a bill that requires most private health insurance companies to waive all out-of-pocket costs for coronavirus testing. One out-of-pocket cost you’ll likely still need to pay is the premium.
However, whether or not treatment for coronavirus is covered and how much it costs depends on the terms of your health insurance plan. You may have to pay out of pocket for coronavirus treatment, including the deductible if necessary.
If you are experiencing symptoms related to the coronavirus, call your doctor or health care provider first. Depending on what they say, they will decide whether or not you should get tested and may be able to give you proper instructions on where to get tested in your area. Testing for COVID-19 was first conducted only at CDC centers and state-approved labs, but now the tests are becoming more widely available at commercial laboratories, like Quest and LabCorp, as well as hospitals and urgent care clinics. New testing centers are opening up daily.
Short-term health plans and health care sharing ministries are not covered under this new directive, but if you receive health coverage this way, you may still be able to get free testing.
How health insurance covers coronavirus testing
Testing for the coronavirus is free for people with most health insurance plans. All costs will be waived for both COVID-19 testing and the visit associated with testing.
How health insurance covers coronavirus treatment
There is currently no vaccine for coronavirus. Many people infected with COVID-19 do not need special treatment, but others, especially older individuals and people with compromised immune systems may need to be hospitalized and require a ventilator to alleviate the symptoms. An antimalarial drug called chloroquine may also become available by prescription.
Fortunately, most coronavirus-related treatment will fall under the ten essential health benefits that all health insurance plans are required to cover by law. For example, hospitalization and emergency care should be included in your health plan, so if your doctor recommends that you are hospitalized, your plan will cover it.
However, the exact cost of treatment for coronavirus will be determined by the specifics of your health plan. Depending on the metal tier of your health plan, you may have to pay different costs, like copayments, coinsurance, and deductibles.
(Learn more about the health insurance plan metal tiers.)
In general, your health insurance should cover and bill you for medical care the same way it would for any other illness or viral infection, not just coronavirus. You may still need to pay the same out-of-pocket costs that you normally pay.
Telehealth benefits
Most major health insurance providers, including United Healthcare, Aetna, and Blue Cross Blue Shield, are offering free telemedicine for a period of time. That means you can make virtual calls and video conferences with in-network doctors. Telemedicine benefits should be available for any health issue, not just those related to the coronavirus. Virtual doctors can even write prescriptions for you and send them to your pharmacist. Log on to your health insurance account online or contact your physician directly for more information.
Prescription drug benefits
Many health insurance companies are also extending benefits to include early refills for prescription drugs as well as free mail-order service. This could be helpful for people practicing social distancing, one of the most effective ways of staying healthy during the coronavirus outbreak.
High-deductible health plans (HDHP)
If you have a high-deductible plan, the insurance company may cover the cost of coronavirus-related care before you meet your deductible, thanks to a regulation issued by the IRS. Make sure to confirm this benefit with your health insurer.
Does short-term health insurance cover coronavirus testing?
Coronavirus testing and treatment benefits may not extend to short term health plans, which are not considered a full-coverage health insurance because they do not meet the standards set by the Affordable Care Act. However, it is still possible that your health insurance company or state has waived the costs of the coronavirus test. Reach out to your provider if you’re unsure.
What if I don’t have health insurance?
The government has not announced whether people without health insurance would qualify for free coronavirus testing. If you are uninsured and have little or no income, you can apply for Medicaid, which would cover coronavirus testing and related treatment.
Immigrants who are concerned about seeking medical care services, because it might affect their ability to gain lawful permanent residence, should be able to access public benefits, including health coverage. The U.S. Citizenship and Immigration Services (USCIS) recently dropped their public charge rule, which had prohibited this use in the past.
If you don’t have health insurance and contract coronavirus, this should not affect your eligibility when purchasing a plan. Insurance companies cannot deny you because of health problems and pre-existing conditions.
How do I buy health insurance during the coronavirus?
Here are three ways to buy a health plan (or read the full guide on how to find affordable health insurance.):
Health insurance marketplace
If you don’t have health coverage, you can buy an individual plan on the health insurance marketplace — but you’ll need a qualifying life event in order to do so. Those who recently lost health coverage from being let go due to the coronavirus outbreak should qualify for what’s known as a special enrollment period.
Additionally, some states (like Connecticut, Colorado, Maryland, Massachusetts, New York, Nevada, Rhode Island, and Washington) have reopened their marketplaces and a special enrollment period allowing for insured people to get coverage.
COBRA
People who lost their jobs and health insurance provided by their workplace can continue their coverage by getting COBRA. Also known as continuation coverage, COBRA lets you convert your employer’s group health insurance plan to an individual one when you lose your job. But COBRA coverage can be very expensive — much more than what you were paying through your employer — and temporary, so be sure to look at all your options.
Learn more about COBRA insurance.
Medicaid
Medicaid is a federal health insurance program run in conjunction with the states. Unlike buying a plan on the marketplace, you can apply for Medicaid and get health insurance coverage at any time, including right now — you will need to fall within the income limits and meet other necessary qualifications. There are no premiums for using Medicaid, and many services are covered for free or have a very low copay. However, most people do not qualify for Medicaid because they earn too much over the federal poverty level.
To get started, read this state-by-state guide to Medicaid.
