FAQ: COVID-19 & How It Affects Arizona Insurance Policies
Insurance Professionals of Arizona | March 24th, 2020
With states declaring curfews, stores closing, and empty toilet paper shelves, coronavirus has hit America hard. Phrases like “social distancing” and “quarantine” have become commonplace, and there is a lot of fear and misinformation going around. If you’re concerned about the disease, and possibly needing testing or treatment, you’ve also probably wondered about your health insurance coverage.
Below are the answers to the questions you might have about coronavirus and your health insurance.
Yes, all major medical, Affordable Care Act (ACA) compliant plans, should cover medically appropriate COVID-19 diagnostic testing and associated treatment. This includes plans bought through the federal marketplace (www.healthcare.gov). Many insurance companies, such as Blue Cross Blue Shield and Aetna, have already announced they will cover medically appropriate COVID-19 testing without any copays, deductibles, or cost-sharing for consumers. They are also waiving pre-authorization for tests and increasing telehealth options if you need to talk to a doctor but don’t want to visit a clinic.
Medicaid/AHCCCS covers laboratory testing for COVID-19 without any copayments. Associated treatment for COVID-19 is also covered, although there may be a nominal copay. If you cannot afford the copay at the time you receive the service, you will not be denied treatment although your provider may send you a bill for the copayment amount.
Excepted benefit policies, short-term policies, limited duration health insurance coverage, and/or health care sharing ministries can have significant limitations on coverage and may not provide the same level of access. If any consumer has a question about their insurance policy, contact your insurer.
The federal Centers for Disease Control and Prevention (CDC) is currently performing tests without charge for COVID-19. The Arizona Department of Health will answer questions about testing, isolation, and quarantine at 1-844-542-8201.
Labs are in the process of implementing testing capabilities, with tests performed at several private laboratories in Arizona and at the Arizona State Public Health Laboratory. While some have begun to perform tests, there is currently a testing shortage. Thus far, less than 300 people have been tested.
Hospitals and providers will likely bill insurance companies for collecting the specimens, and labs are expected to bill patients or the patient’s health insurance provider for the cost of testing.
Many providers have already announced that they will cover medically appropriate COVID-19 testing and waive copays, deductibles, or cost-sharing for patients.
Medicare covers testing at no charge, but only if you are referred by a doctor or healthcare provider.
In the event that you need emergency medical services because you’ve contracted COVID-19 or believe you may have come in contact with the virus, your insurance carrier must cover emergency services at in-network levels. Emergency services include transportation services, such as an ambulance, as well as inpatient and outpatient hospital services needed to evaluate or stabilize the patient.
Medical Assistance covers emergency services, although there may be a nominal copay for certain services. If you cannot afford the copay when at the doctor’s office, you will not be denied treatment although your provider may send you a bill for the copayment amount.
No. The Arizona Department of Insurance prohibits individual or group accident and health insurance carriers from imposing any pre-existing condition exclusions, including in connection with COVID-19.
In addition, Federal law and state regulations protect against pre-existing condition exclusions in health insurance coverage. However, consumer protections related to pre-existing conditions do not apply to short-term, limited-duration health insurance coverage or excepted benefit policies.
Yes. If you receive an unexpected bill related to COVID-19 or other health care services, call the Arizona Insurance Department at 1-844-542-8201.
If you have questions regarding Medicare coverage, please contact your Medicare plan provider or visit https://www.medicare.gov/medicare-coronavirus.
You can also contact Medicare at 1-800-MEDICARE (1-800-633-4227).
Yes. If you are enrolled in Medicaid and have questions regarding coverage, you can contact your local office through this website.
With so much misinformation online, make sure that you’re getting answers from a reputable government agency or a trusted insurance agent. The agents at Insurance Professionals of Arizona are always willing to answer questions and share their expertise.