The National Association of Insurance Commissioners (NAIC) has released a survey that found 47% of consumers don’t understand what their health insurance plans will pay for when it comes to coronavirus testing and treatment.
Potentially because of that misunderstanding, 34% of respondents who had been tested or treated for coronavirus received a bill that they expected their health insurance to cover. Over seven million Americans have tested positive for COVID-19 and with more expected on the way this winter, it’s essential to understand how COVID-19 could impact your finances.
Half of respondents don’t fully understand their health insurance coverage
The NAIC survey found that insurance companies, regulators and healthcare providers have failed to make cost information clear to its customers. “The health insurance knowledge gap goes beyond the pandemic to understanding basic health insurance plan features,” the writers of the report state.
Source: July 2020 Health Insurance Knowledge Survey / NAIC
Younger audiences are even less familiar with their policies — “45% of those ages 18 to 29 didn’t know their deductibles and 39% didn’t know their co-pay amounts.”
These disparities in knowledge persist for COVID-19 related coverage, with 47% of consumers expressing they didn’t understand what would be covered for testing and treatment of this virus.
Health insurance and COVID-19 FAQ
The coverage you are eligible for could vary based on your provider, state and plan. For the most part, your insurance will likely cover costs for FDA-approved testing and treatment for COVID-19. Cost-sharing (deductibles and copays) may also be waived if a doctor has medically ordered the testing. Coverage could vary depending on whether the provider is in or out of network, but most insurers are making exceptions during this time. The best way to understand how you may be insured for COVID-19 is to check your insurance plan with your provider.
Is COVID-19 testing covered by health insurance?
Many state commissioners have ordered insurers to waive any testing fees and copays, coinsurance or deductibles for testing-associated visits. Check with your specific insurer, as some providers require testing to be medically recommended by a doctor based on your symptoms. If you have Medicare or Medicaid, tests are 100% covered. Some locations offer free COVID-19 testing, regardless of insurance status.
Is COVID-19 treatment covered by health insurance?
Most health insurance providers will cover necessary medical treatment for COVID-19. If diagnosed with COVID-19, your insurer will likely cover related office and urgent care visits, observation stays, inpatient rehab, inpatient hospital stays and ER visits. During this time, some insurers (like United Healthcare) are waiving cost-sharing for COVID-19 treatment as well. If COVID-19 is not your primary diagnosis, your coverage could vary.
Is COVID-19 antibody testing covered?
Probably. Most insurers have announced they will cover COVID-19 antibody testing without cost-sharing. With Medicare, for example, costs for an antibody test are covered. There’s a good chance getting tested for COVID-19 antibodies will be free to you. If you go to a private lab for testing or order an at-home antibody test, you may incur a fee that could range from $ 10 to $ 50 depending on the lab and your healthcare plan.
Will COVID-19 treatment be covered if I’m traveling?
If you are traveling out of state and need COVID-19 related medical services, your coverage could be up in the air. Coverage plans and prices vary by state and your specific plan could be ineligible where you get treatment. Usually, emergency and urgent care visits are covered but not every provider defines “emergency” the same. It’s best to research your eligibility if you plan to travel out of state.
Too long, didn’t read?
It may be more important now, during a global pandemic, than ever to understand your medical coverage. An NAIC survey found a large portion of Americans aren’t aware of how their policy will cover COVID-19 related medical expenses. For the most part, insurers and legislatures have announced they’ll be waiving most associated costs. You’ll need to verify and learn about your own plan to be sure.
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