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Major Insurers Waive Coronavirus Testing Costs, Unpacked

March 13, 2020

A number of large and regional insurance companies have announced that they will cover members’ out-of-pocket costs for COVID-19 testing.  This move is expected to increase access to testing by removing out-of-pocket costs from members’ list of concerns when they seek care.  

This fix by the insurance companies affects a smaller portion of the population than many would expect.  Insurers may waive costs for plans where they insure the risk and therefore pay the costs of care, known as “fully insured” plans.  Americans who have plans where the employer assumes the financial risk for providing health care to its employees, known as “self-funded” plans, will make their own choices as to participation in any special programs associated with COVID-19 testing. 

If your organization operates a self-funded health plan, you may want to consider participating in the same COVID-19 related testing programs offered by fully insured plans.  Removing the cost factor for employees to receive testing may be an effective way to mitigate the spread of COVID-19 within your organization.

Additionally, CMS announced today that Medicare will fully cover COVID-19 tests with no copayment for the patient so long as the deductible has been met.  In addition, CMS is allowing Medicare Advantage plans to waive the copayment for COVID-19 testing. 

COVID-19 will remain an ongoing issue for the foreseeable future and the situation is dynamic.  Stay informed by reviewing updates to guidelines put out by some of the following organizations:

If you have any questions regarding appropriate responses to COVID-19, please do not hesitate to contact any member of Shipman & Goodwin's Health Law Practice Group.

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