Does your Health Insurance Covers for the CoronavirusMarch 21, 2020
With more Americans testing positives for the Coronavirus, people have started practicing social distancing. In addition to it, people are also quite concerned that whether testing for this virus and treatment is covered under their health insurance or not. A law professor at Penn Law School in Philadelphia, Allison Hoffman said “There is no immunization or antiviral treatment for COVID-19” and “If there were immunization, it would almost certainly be covered by all health plans with no cost-sharing, as required by the Affordable Care Act known as the ACA.”
Though Coronavirus testing remains free in most cases and it is even included with individual and family health plans and Medicare plans. Still many people in the U.S do not have access to tests potentially delaying treatment. Most of the people here are concerned that their health insurance plan might not cover Coronavirus treatment.
According to a Bankrate.com report, nearly one in three U.S. families do not seek medical care like doctor visits, medications, vaccinations, and annual exams during the past year because of the rising costs. Around three in ten people with healthcare cost in the past year has to take on substantial debt or borrow money from family or friends to deal with the healthcare costs. Healthcare costs that suddenly pop up due to an unexpected accident or illness can cause lasting financial damage and the best way to protect against this is to save for emergencies.
Though Coronavirus treatment is covered by health insurance providers just like other illnesses, consumers will still require to pay their deductibles that are sometimes thousands of dollars. Coronavirus patient’s hospitalization costs, as well as medical care costs, will be covered as per the rule of their plan. Even their deductible will come into play and rules will vary from one insurer to others. Consumers receiving medical care for Coronavirus are likely to face out-of-pocket costs such as co-pay, deductible or co-insurance before their coverage starts but there are no specific restrictions or limitations for Coronavirus coverage.
Americans pay higher out-of-pocket expenses than people of other country and consumers having a health plan with a $2,000 deductible would first need to pay for the first $2,000 in medical care before the health plan carriers start to pay for the care. Corona patients who end up getting care in a medical facility or by an out-of-network doctor or are taken by an out-of-network ambulance to a hospital then they could be left with a large surprise bill.
Due to the staggering out-of-network bill for COVID-19 care, some states in the U.S. have started to pass laws prohibiting it. There is certainly public pressure for health insurers, hospitals, and doctors to cater to the need of Americans in this unusual moment so that they are not left with unaffordable medical bills.
One of the U.S. largest health insurance providers, Blue Cross Blue Shield will cover the medically necessary diagnostic testing for COVID -19 with no cost share to the member. This will be covered in places where it is not covered as part of the Public Health Service response. Any medical care and treatment required after the diagnosis of COVID-19 will be covered and the company also said that they will waive prior authorization for medically necessary services and diagnostics related to COVID-19.
Hospitalization and Quarantine Coverage
COVID-19 patients who are hospitalized or quarantined in a medical facility are likely to receive the coverage similar to other inpatient stays in a medical facility and specific out-of-pocket costs may apply depending upon their plan. However, medically necessary care is covered by all major medical health insurance plans that also include inpatient hospital stays.
Medical costs like doctor visits, hospitalization, laboratory testing, and support therapy are usually covered under health insurance plans, as most of these services are considered to be essential health benefits under the Affordable Care Act. These services should also be covered by ACA-compliant individual and small group plans. However, individuals who are covered by short-term or limited service plans or healthcare sharing ministries will be covered for COIVD-19 treatment will depend on the limits of their plans.
If people are mandated to self-quarantine at home then their plan will not pay them to stay at home pr compensate for their lost income when they are away from work. Medicare care offered to quarantine patients in their home by a licensed professional may be covered along with the cost for tests or checkups that patients will receive at medical centers. People who will opt to undergo non-standard care for treatment or prevention of the Coronavirus will require to pay the additional cost themselves.