COVID-19 coverage facts at-a-glance
- The Families First Coronavirus Response Act (H.R.6201) requires Medicare, Medicaid, and private health insurance plans to fully cover the cost of COVID-19 testing.
- Free COVID-19 tests are available at health centers and select pharmacies nationwide. You can get a free test even if you don’t have insurance.
- Once the COVID-19 vaccine is widely available, most Americans will be able to get it at no cost (at least through April 21, 2021). This includes the uninsured.
- COVID-19 treatment costs vary according to the patient’s health plan.
- Many insurance providers have waived cost sharing for COVID-19-related hospital admissions and telehealth services.
- If you don’t have insurance, your COVID-19 treatment (or a portion of it) may be covered through the CARES Act Provider Relief Fund.
Q: Will my health insurance cover COVID-19 testing?
A: The Families First Coronavirus Response Act (H.R.6201) requires Medicare, Medicaid, and private health insurance plans to fully cover the cost of COVID-19 testing. This includes health plans that were already in effect when the Affordable Care Act (ACA) came on the scene in 2010 (also known as grandfathered plans).
Even if you don’t have insurance, you can get a free COVID-19 test at health centers and select pharmacies nationwide. Some health centers and pharmacies even offer drive-thru testing sites. Check here to find a testing location near you.
Q: Will my health insurance cover the COVID-19 vaccine?
However, H.R.6201 did not extend requirements for vaccine coverage to grandfathered plans. If you have a grandfathered health plan, you may have to worry about cost sharing. (Cost sharing refers to out-of-pocket costs like deductibles, coinsurance, and copayments.) Some states may require grandfathered plans to waive cost sharing, so check with your insurance company to determine if you can get the vaccine at no cost.
We don’t know whether or not COVID-19 vaccines will still be covered after the pandemic.
Q: Will my health insurance cover COVID-19 treatment?
A: If you or a loved one winds up in the hospital due to COVID-19, you may get some coverage. But while hospital stays are considered an essential health benefit (these are benefits that all health insurance plans must cover under the ACA), what and how much is covered may vary from one state to another.
Many insurance providers have waived cost sharing for COVID-19-related hospital admissions and telehealth services. Check out this list to see if your insurance provider is among those who have waived cost sharing. Whatever you find, be sure to confirm with your insurance provider.
If you don’t have insurance, your treatment (or a portion of it) may be covered through the CARES Act Provider Relief Fund. However, this depends on whether or not your healthcare provider signed on to be part of the Health Resources & Services Administration (HRSA) COVID-19 Uninsured Program.
If they’re not part of the program or your treatment wasn’t eligible for reimbursement, you may have to pay the full health bill.
If they are part of the program, you may still have to pay a portion of the bill.
For more information about treatment coverage, click here.
The bottom line: COVID-19 treatment costs vary according to your health plan and the state in which you live. Check with your insurance carrier to find out what’s covered.
Need insurance? Check if your state is offering a special enrollment period. If not, you may still be able to enroll in a plan if you lose coverage, get married, or have a baby. Remember that you can apply and enroll in Medicaid or CHIP at any time of the year.