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COVID-19 Coverage: Frequently Asked Questions – AHIP

People’s health and well-being comes first as our country prepares for the possibility of widespread COVID-19 infection and takes steps to mitigate the impact. Health insurance providers are taking decisive action to help prevent the spread of COVID-19, to ensure people have coverage and access to necessary testing, and to help infected patients receive the care and treatment they need. they need. Ahip’s Board of Directors is committed to helping America’s powerful health care system meet the challenges posed by COVID-19.

Below are frequently asked questions from health insurance providers about covid-19. visit this site to view advertisements for individual health insurance providers.

Reading: What is covid 19 insurance coverage

1. Will health insurance providers cover the cost of the covid-19 test, including services related to the test itself?

Health insurance providers routinely cover diagnostic laboratory tests in accordance with a person’s health insurance coverage. initially, covid-19 tests were only available at the cdc and public health departments, and the cost was covered by the government.

As testing becomes available from commercial and CLIA-certified laboratories, health insurance providers will cover testing for their members according to the terms of their plans and any emergency plans they have in place.

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Several labs are preparing to make diagnostic tests much more widely available in the coming days and weeks, including, for example, labcorp, quest diagnostics, and co-diagnostics. Health insurance providers are working with their state and local health departments to learn which facilities have been approved for testing.

Health insurance providers can choose to waive cost-sharing associated with commercial lab tests, and some states have required state-regulated health insurance plans to waive certain costs. People with questions about their coverage should contact their health insurance provider.

2. Will health insurance providers cover testing for members who have been exposed to the condition, those with early symptoms, asymptomatic members, and/or unexposed asymptomatic members?

cdc supports testing a broad group of symptomatic and asymptomatic patients, when referred for testing by a physician. Physicians are advised to use their judgment in determining whether a patient has signs and symptoms consistent with COVID-19 and whether the patient should be tested, based on local impact and exposure to COVID-19, as well as the clinical course of the disease.

3. Will health insurance providers cover covid-19 treatment?

Health insurance providers continue to cover medically necessary health care costs to treat infectious diseases, including COVID-19, under the terms of an individual’s insurance plan. At this time, there is no specific antiviral treatment or vaccine for covid-19. People should receive care from their doctor to help relieve symptoms as they would with other viral respiratory infections.

4. Will health insurance providers cover the cost of the covid-19 vaccine when it becomes available?

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Vaccines are an essential and highly effective way of preventing infectious disease in large populations. Unfortunately, there is no vaccine yet available for covid-19.

Vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (Acip) are covered by health insurance providers. At this time, Acip has not provided guidance on a future vaccine for COVID-19. if and when acip recommends a vaccine, it will be covered similarly to other vaccines.

5. Will health insurance providers cover medical supplies such as masks, gloves, or disinfectants that people may need?

Most of these supplies are not currently covered by insurance plans or reimbursed by insurance providers. Some of these supplies may be included in services provided by home care providers under an individual’s insurance coverage for certain medical conditions currently under treatment, such as wound care.

6. Will health insurance providers cover the transportation of members with covid-19 to designated quarantine or treatment centers?

Generally, health insurance providers cover emergency transportation as medically necessary within the terms of the health plan contract.

7. Will health insurance providers cover hospital quarantine stays for members returning from affected countries, including out-of-network costs?

Health insurance providers are likely to incur these costs, but based on experiences with past epidemics, they may not be able to negotiate payment based on in-network rates.

8. Will health insurance providers cover hospital quarantine stays for members diagnosed with covid-19 as a result of community spread of the virus?

yes. hospital quarantine stays for members diagnosed with covid-19 will be covered in accordance with the terms of the individual’s health insurance coverage.

9. Will health insurance providers cover telehealth services?

This will depend on each individual’s coverage and whether telemedicine is part of their benefits. Health insurance providers are proactively communicating with the people they serve about the telehealth services available to them.

10. Many Americans are concerned about drug shortages for their regularly prescribed medications. Will health insurance providers waive prescription quantity/dispense limits or allow early refills?

At this time, health insurance providers have not seen an increase in these types of requests. however, insurance providers have global pandemic contingency plans that allow for changes to their practices. any changes are carefully implemented to consider the risks of medication misuse, loss, or expiration. Health insurance providers are carefully monitoring COVID-19 developments and may make adjustments to policies as appropriate.

11. Will health insurance providers waive prior authorization requirements for covid-19 testing or treatment?

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At this time, treatment of COVID-19 is approached in the same way as other viral respiratory infections, under the terms of a person’s insurance plan. however, health insurance providers have emergency plans for global pandemics that allow them to modify their practices. any modifications are carefully implemented to balance access to care with ensuring patient safety and evidence-based medicine. Health insurance providers are carefully monitoring COVID-19 developments and will make necessary modifications accordingly.

12. Will health insurance providers waive deductible and/or cost-sharing requirements for covid-19 testing or treatment?

At this time, COVID-19 is treated like other viral respiratory infections and any cost-share or deductible obligation would be in accordance with the terms of an individual’s insurance plan. health insurance providers have emergency plans for global pandemics that allow them to modify their practices. Health insurance providers are carefully monitoring COVID-19 developments and may modify their coverage determinations accordingly. insurance providers will also apply deductible and/or cost-sharing requirements in accordance with federal and state guidelines.

13. Will health insurance providers waive referral requirements for members seeking testing or treatment for covid-19?

Referrals should not be required for patients seeking treatment for covid-19. Referral requirements generally depend on which labs are designated to perform diagnostic tests and whether the insurance provider has a contract with that lab. As diagnostic tests for COVID-19 become more widely available, patients should have access to tests when ordered by their doctor.

14. Will Americans quarantined due to the risk of spreading covid-19 be eligible for private short-term disability income protection benefits?

If an individual has short-term disability coverage and is unable to work due to confirmed covid-19 infection or other illness while in quarantine, disability income protection insurance providers will consider a claim and the applicant you may qualify for benefits.

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A person in quarantine who is not disabled by symptoms of covid-19 or symptoms of another illness will not meet the definition of “disabled” under disability income protection policies. In such cases, insurance providers can work with employers and employees to support remote work.

Private disability income protection policies are designed to integrate with sick leave and paid time off benefits that employers provide to employees. in many cases, employees would continue to be paid during a two-week quarantine period.

In the event of a severe pandemic during which employers are forced to close workplaces, many employers may choose to continue paying wages during the closure.

15. what else are health insurance providers doing to address covid-19?

Health insurance providers are working directly with the CDC and health experts across the country to share information, mitigate health risks and keep Americans informed. For example, insurance providers are:

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  • Educate members about steps they can take to get ready and stay healthy.
  • direct members to cdc for information.
  • track symptoms and patterns that may manifest through data from electronic medical records, phone calls to nurse call centers, and clinic visits.
  • inform doctors to make sure they know what the symptoms of covid-19 look like and how to deal with a possible coronavirus situation.
  • work with federal agencies and local public health officials to help contain any outbreaks.
  • support infection control efforts, including those already in place in hospitals, health care facilities, and other places of care.
  • continually monitor covid-19 developments and assess whether it is necessary to implement emergency plans and modifications to plan practices.
  • donate to non-profit organizations to help with relief efforts on the front lines of the global crisis.

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