California Orders Insurers to Waive Out-of-Pocket Costs for Coronavirus Testing
California on Thursday became the latest state to order insurance companies to waive out-of-pocket costs for coronavirus testing.
The California Department of Insurance and Department of Managed Health Care ordered all full-service commercial and Medi-Cal plans to “immediately reduce cost-sharing — including, but not limited to, co-pays, deductibles or coinsurance — 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.”
It also directed them to let their contracted health care providers and customer service agents know of the change.
Washington’s state insurance commissioner issued a similar order on Thursday, as did New York regulators on Monday.
Earlier this week, White House and public health officials sought to reassure Americans that their health insurance, Medicare or Medicaid will cover the cost of testing and treating the new coronavirus. But that won’t encourage people who have no insurance or large deductibles or co-payments to seek help needed to prevent them from infecting others.
About 9% of the U.S. population, and 7% in California, lacked health insurance in 2018, according to the Kaiser Family Foundation. However, many people with private insurance have large deductibles.
“If you have a $7,000 deductible and don’t have $7,000, you are essentially uninsured,” said Jennifer Tolbert, the foundation’s director of state health reform. “That’s a problem when you are trying to address a crisis like this.”
California’s action should encourage those with insurance to seek testing, although it didn’t promise any relief from out-of-pocket costs for treatment if needed. It also won’t encourage those without insurance to get tested. On Monday, New York Gov. Andrew Cuomo announced a directive by the State Department of Financial Services that prohibits New York health insurers from imposing cost-sharing on customers who visit an in-network doctor’s office or urgent care center or any emergency room to be tested for COVID-19.
On Thursday, the U.S. Senate passed a bill providing $8.3 billion to fight and prevent the coronavirus both at home and abroad. The House passed it Wednesday. Most of the money, $6.5 billion, goes to agencies under the U.S. Department of Health and Human Services, including $2.2 billion to the Centers for Disease Control and Prevention. Almost $1 billion of the CDC money is earmarked for state and local preparedness response. State and local agencies must submit a plan on how they will spend that money to the CDC within 45 days. Each state will get at least $4 million, but the bill doesn’t specify how much each state will get. Some of that will depend on where it’s needed the most.
Nothing in the bill provides money to help individuals who can’t afford to pay for testing or treatment. Nor does it provide any money to help insurance companies subsidize the cost of coronavirus testing or treatment.
“It’s a needed infusion of cash into the public health system as opposed to a health care delivery model,” said Evan Hollander, a spokesman for the House appropriations committee.
Kristine Grow, speaking for the America’s Health Insurance Plans, a trade group, said she “could not speak to the uninsured population. But for people who have health insurance coverage with high deductibles, they should not hesitate to seek treatment because of concerns about costs.” Health insurers “are working with federal, state and local officials to protect people from out-of-pocket costs. We do not want financial concerns to be a barrier.”
On Wednesday, Gov. Gavin Newsom declared a state of emergency for California after a 71-year-old Placer County man died from the coronavirus that he likely contracted on a cruise ship that left from San Francisco Feb. 11 and returned Feb. 21.
The state of emergency provided no funding for coronavirus treatment or testing.
“Money is not the issue for the state of California,” Newsom said in a news conference.
He did say California is getting $37 million from the federal coronavirus bill. On Monday, Newsom asked the Legislature to make up to $20 million available from the Disaster Response Emergency Operations Account, “which will allow state government to respond to the spread of COVID-19. This will be an early action item for the 2020-2021 budget,” according to a news release. It didn’t specify how the money would be spent.
The CDC has been paying for the coronavirus test itself. On Wednesday, the White House announced that 1.5 million more test kits would be going out this week. In California, 10 public laboratories can now do testing. The CDC will not, however, pay for any doctor’s visit that may be required to get the test. That’s up to individuals, and their insurance if they have it. If testing was expanded to private labs, it’s not clear whether the CDC would pay for that.
Under existing federal regulations, the CDC can decide whether to cover bills related to patients who are placed in isolation or quarantine in a hospital. During the Ebola outbreak, it did cover those costs. It has not yet said whether it will cover those costs for coronavirus, Hollander said.
The CDC did not respond to multiple requests for comment.
Contributor: Kathleen Pender – San Francisco Chronicle
The California Department of Insurance and Department of Managed Health Care ordered all full-service commercial and Medi-Cal plans to “immediately reduce cost-sharing — including, but not limited to, co-pays, deductibles or coinsurance — 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.”
It also directed them to let their contracted health care providers and customer service agents know of the change.
Washington’s state insurance commissioner issued a similar order on Thursday, as did New York regulators on Monday.
Earlier this week, White House and public health officials sought to reassure Americans that their health insurance, Medicare or Medicaid will cover the cost of testing and treating the new coronavirus. But that won’t encourage people who have no insurance or large deductibles or co-payments to seek help needed to prevent them from infecting others.
About 9% of the U.S. population, and 7% in California, lacked health insurance in 2018, according to the Kaiser Family Foundation. However, many people with private insurance have large deductibles.
“If you have a $7,000 deductible and don’t have $7,000, you are essentially uninsured,” said Jennifer Tolbert, the foundation’s director of state health reform. “That’s a problem when you are trying to address a crisis like this.”
California’s action should encourage those with insurance to seek testing, although it didn’t promise any relief from out-of-pocket costs for treatment if needed. It also won’t encourage those without insurance to get tested. On Monday, New York Gov. Andrew Cuomo announced a directive by the State Department of Financial Services that prohibits New York health insurers from imposing cost-sharing on customers who visit an in-network doctor’s office or urgent care center or any emergency room to be tested for COVID-19.
On Thursday, the U.S. Senate passed a bill providing $8.3 billion to fight and prevent the coronavirus both at home and abroad. The House passed it Wednesday. Most of the money, $6.5 billion, goes to agencies under the U.S. Department of Health and Human Services, including $2.2 billion to the Centers for Disease Control and Prevention. Almost $1 billion of the CDC money is earmarked for state and local preparedness response. State and local agencies must submit a plan on how they will spend that money to the CDC within 45 days. Each state will get at least $4 million, but the bill doesn’t specify how much each state will get. Some of that will depend on where it’s needed the most.
Nothing in the bill provides money to help individuals who can’t afford to pay for testing or treatment. Nor does it provide any money to help insurance companies subsidize the cost of coronavirus testing or treatment.
“It’s a needed infusion of cash into the public health system as opposed to a health care delivery model,” said Evan Hollander, a spokesman for the House appropriations committee.
Kristine Grow, speaking for the America’s Health Insurance Plans, a trade group, said she “could not speak to the uninsured population. But for people who have health insurance coverage with high deductibles, they should not hesitate to seek treatment because of concerns about costs.” Health insurers “are working with federal, state and local officials to protect people from out-of-pocket costs. We do not want financial concerns to be a barrier.”
On Wednesday, Gov. Gavin Newsom declared a state of emergency for California after a 71-year-old Placer County man died from the coronavirus that he likely contracted on a cruise ship that left from San Francisco Feb. 11 and returned Feb. 21.
The state of emergency provided no funding for coronavirus treatment or testing.
“Money is not the issue for the state of California,” Newsom said in a news conference.
He did say California is getting $37 million from the federal coronavirus bill. On Monday, Newsom asked the Legislature to make up to $20 million available from the Disaster Response Emergency Operations Account, “which will allow state government to respond to the spread of COVID-19. This will be an early action item for the 2020-2021 budget,” according to a news release. It didn’t specify how the money would be spent.
The CDC has been paying for the coronavirus test itself. On Wednesday, the White House announced that 1.5 million more test kits would be going out this week. In California, 10 public laboratories can now do testing. The CDC will not, however, pay for any doctor’s visit that may be required to get the test. That’s up to individuals, and their insurance if they have it. If testing was expanded to private labs, it’s not clear whether the CDC would pay for that.
Under existing federal regulations, the CDC can decide whether to cover bills related to patients who are placed in isolation or quarantine in a hospital. During the Ebola outbreak, it did cover those costs. It has not yet said whether it will cover those costs for coronavirus, Hollander said.
The CDC did not respond to multiple requests for comment.
Contributor: Kathleen Pender – San Francisco Chronicle
