The impact of COVID-19 on us as individuals and on the American economy is without precedent, as the Press and Broadcast media constantly remind us. The politicians, pundits, and public opinion formers assault us from all sides with facts and opinions in a constantly changing series of real-time events.
As a Health Insurance Exchange, it is our role to advise our clients on their best course action based on their informed judgment.
Nothing is more important to any of us than our health and welfare and that of our loved ones. The purpose of this digest is to present a summary of the ‘new health insurance landscape’.
Why is COVID-19 different?
COVID-19 is not so different from other Coronavirus infections. The symptoms are hard to distinguish and the processes are identical. COVID-19 is different because the rapid spread has outpaced the ability of the scientific community to develop antiviral drugs to cure it, and to develop a vaccine to protect the population. We can be sure that, given time, these will be available but, in the meantime,…
What we can do?
Worldwide the major contribution we as individuals, and as communities, can make is to implement the instructions to: –
- Rigorously handwash
- Observe social distancing
- Stay home as much as possible
Read our article on Symptoms and prevention from Coronavirus
Of course, there will be more detailed instruction (see healthcare.gov and your State regulations) but these are the essential principles which will lessen your chances of infection by COVID-19 and slow the spread of the disease. In this way we will reduce the number of people needing medical interventions and save as many lives as possible.
The other side of the coin and the consequence of staying home is that for many people who cannot work from home there will be no work to go to and only limited income. In the first week of April alone the jobless total rose by 3.3 million. The federal government is injecting $2.2 trillion to lessen the impact of the subsequent economic slowdown.
Whatever we do to limit the spread of COVID-19 some of us will need to turn to healthcare providers and medication. This is where the health insurance industry is playing its part in securing the nation’s health.
Testing and treatment cost waived off
Open enrollment closed on December 15th. Nobody could have foreseen the COVID-19 pandemic with its effects on family life and the economy. In response, major insurers such as CIGNA and HUMANA have committed to cover 100% of the costs of DIAGNOSTIC TESTS and TREATMENT for COVID-19 related issues. AETNA, ANTHEM, and BLUE CROSS BLUE SHIELD have already followed suit and many more are expected to do the same. These coverage changes to existing plans vary among insurers and you should check both the extent and duration of the changes with your insurer.
Read our article on Coronavirus treatment cost waived off by Humana & Cigna
[Please note that some employers, both large and small, operate ‘self-insured’ plans. They may opt NOT to join the program].
Get covered under Special Enrollment Period
If your insurer has not informed you of their approach to covering the healthcare costs of COVID-19 for you and your dependents, YOU CALL THEM. However, the Administration makes it clear that over 3 million people (see above) have the opportunity to take advantage of the Special Enrollment Period (SEP) which opens if you have become unemployed or lost your health insurance coverage as a result of job separation.
Check whether you are eligible for Medicaid
Depending on your state regulations, you may be eligible for Medicaid, which for the ‘duration’ of the pandemic, guarantees free testing and treatment for COVID-19 related events. Talk to your exchange – you may find a plan that better suits your altered circumstances (see our article …..).
It is unlikely that the Trump Administration will offer a new ‘Open Enrollment Period’ as this would run counter to the stated aim to reduce federal involvement in a national program of health insurance.
The White House has, however, made the unprecedented decision to pay for COVID-19 testing and treatment for uninsured American citizens. The funding will come from the $2.2 trillion (see above).
Medicare and other federal entitlement programs already cover Coronavirus testing and treatments.
Check our article on Do medicare plans cover Coronavirus?
The Vice President Mike Pence summarized the Administration’s position: “No American will ever have to worry about paying for testing or for Coronavirus treatment”.
There is no clear position on how ‘illegal’ immigrants will fit into the plan. If the Administration has formalized its position, we will include it in our next UPDATE.