Government Health Plans To Pay For Testing; Private Insurers Vow To Ease Cost Concerns As Well
As federal officials promise that Medicare, Medicaid and ACA plans will have the costs of their tests covered, some private insurers promise they will cover diagnostic testing when ordered by a doctor, ease network, referral and prior authorization requirements and/or waive patient cost sharing. States have been taking steps to ease cost concerns over testing, as well.
A day after Vice President Mike Pence assured Americans that lab tests for coronavirus would be covered by private and government health insurance, that promise appears to be less than airtight. The bottom line: Medicare, Medicaid, and 鈥淥bamacare鈥 insurance plans will cover the tests, officials said Thursday. Major insurers also said they will cover such tests. But people with employer-provided insurance should check with their plan because copays and deductibles may apply. State health departments will test for free. (Alonso-Zaldivar and Murphy, 3/5)
America鈥檚 Health Insurance Plans (AHIP) said its members, which include Cigna Corp (CI.N) and Anthem Inc (ANTM.N), will cover diagnostic testing when ordered by a doctor, ease network, referral and prior authorization requirements and/or waive patient cost sharing. The group also said it will 鈥渢ake action so that patients will have continuous access to their regular prescription medications.鈥 Washington state on Thursday issued an emergency order requiring all state-regulated health insurers to waive co-payments and deductibles for any consumer requiring testing for the new coronavirus. (Beasley, 3/5)
Other states are weighing similar moves. In Rhode Island, where at least two people have been confirmed infected, the state insurance regulator is considering whether to ask or potentially require insurers to waive cost-sharing for coronavirus testing, according to a spokesman. 鈥淲e want to be sure we have an effective response,鈥 he said. The regulator is meeting with insurers Friday. The states are taking action amid concerns that consumers, even those with insurance, might avoid getting tested or treated because they would face large out-of-pocket costs. In a poll in March of last year, the Kaiser Family Foundation found that more than half of U.S. adults said they or a family member had put off health care due to costs. Among those with insurance, 34% said it was difficult to pay the cost of their deductibles. (Wilde Mathews, 3/5)
The California Department of Insurance and Department of Managed Health Care ordered all full-service commercial and Medi-Cal plans to 鈥渋mmediately reduce cost-sharing 鈥 including, but not limited to, co-pays, deductibles or coinsurance 鈥 to zero for all medically necessary screening and testing for COVID-19, including hospital, emergency department, urgent care and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.鈥 (Pender, 3/5)
More than 60 Massachusetts lawmakers signed onto a letter Thursday urging Governor Charlie Baker to require Massachusetts health insurers to waive co-pays for coronavirus testing.The 62 legislators, led by state senators Eric P. Lesser and Joanne M. Comerford and state Representative Mindy Domb, say in the letter that some patients around the country tested for the new COVID-19 virus have been 鈥渉it with large medical bills when they least expected it.鈥 (Fox, 3/5)
It鈥檚 not yet clear how much the commercial tests will cost, but it's likely they will vary. Patients who are tested for the coronavirus might also face costs related to visiting the doctor, emergency room or urgent care. If they test positive and require hospitalization, they would聽face charges for that, too.聽Seema Verma, head of the Centers for Medicare and Medicaid Services, told reporters Thursday that Medicaid and Medicare would cover testing, likely without cost-sharing requirements. But she acknowledged that people with private plans should ask their insurance companies if cost-sharing will be required. (Hellmann, 3/5)
For now, the Centers for Disease Control and Prevention is covering the cost of coronavirus testing, but private labs will soon charge for their own tests.
"Insurers would set a lot of people's minds at ease if they committed to covering coronavirus testing with no patient cost-sharing," Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation, said in an email. "Healthcare providers would still need to ensure that only people who are clinically advised to get tested do so to preserve limited testing resources. But, for the health of individuals and the community at large, cost shouldn't be a barrier to get tested." (Livingston, 3/5)
