We now live in a world of self-isolation and social distancing, and many people are using this time to complete overdue projects, enjoy a hobby, or binge-watch a favorite show. This home-bound life also offers a great opportunity to review your health insurance policy so you are prepared if you or a loved one need to access medical care.

What to Review

As you review your policy, pay close attention to:

• Authorized Services – every policy details what services are and are not covered, including testing and specialty services. Review and understand what resources are available.
• Approved/In-Network Providers – These are the healthcare facilities and providers who are have negotiated with your insurance provider and will have the lowest out-of-pocket costs to you.
• Exceptions for Out-of-Network Services – although you will pay more when utilizing out-of-network healthcare providers, there are exceptions to these rules. Review the policy to learn exactly what these exceptions are in the event that you need to access these services.
• Pre-Authorization – Understand if or when you need pre-authorization (pre-approval) to access specific services, especially specialists.

Ultimately, you want to understand what is and isn’t covered and which healthcare providers are in your network.

How Insurance Companies are Responding to COVID-19

With COVID-19 now present in all 50 states the US government and the insurance industry is working to assure the coverage is available to meet our needs. Here is what you need to know:

• Testing kits are now available throughout the country and private companies, including Lab Corp and Quest Diagnostics, will be providing the majority of the testing. This means that more people will have access to this testing.
• Testing for COVID-19 has been designated an Essential Health Benefit (EHB), which means that testing services must be covered by all ACA compliant plans.
• For those with healthcare insurance through their employers, COVID-19 testing will depend on the size of your company and the specific policy. For companies with less than 50 full-time employees, this testing will be covered in most cases. For larger companies, coverage is dependent on the terms of the policy.
• Many health insurance providers have announced that the COVID-19 test will come with no copy and no cost to the patient.
• Many insurance companies will also begin covering telemedicine services to allow those who have coverage to access medical care at home through web-based conferencing. You should contact your provider directly to learn more.
• While treatments and hospitalization for COVID-19 will be covered the same as any other illness under your policy, some companies are waiving co-pays for this treatment.

One of the best resources you have to learn about coverage offered by various insurance companies is this list developed by America’s health Insurance Plans. It details the coverage available by a specific company with regard to coverage adjustments due to this pandemic.

What To Do If You Do Not Have Health Insurance

If you do not have insurance, you will be responsible for the cost of all testing and treatments associated with COVID-19. The cost for testing alone can range from $500 to $1,000. The costs of treatments will be even higher.

There are still opportunities to purchase health insurance. Several states have opened Special Enrollment Periods to help those without coverage to purchase insurance. If your state does not offer this option, check to learn if you have a qualifying life event that allows you to purchase coverage now.

Medicaid and Children’s Health Insurance Program (CHIP) may be an option to receive coverage. However, each state has unique eligibility requirements and you should check their websites to determine if you qualify for coverage.

If you need health insurance, please call (866) 771-4715 to speak with one of our agents to discuss options or go online to receive a quote. At Alliance, we are insurance experts and represent the best providers in the state. We may not have all of the answers but we can help you identify potential resources.