As COVID-19 cases continue to surge, millions of Americans may need to seek either inpatient or outpatient care while battling the virus. But it's no secret that healthcare costs can be exorbitant, so it's important to be aware of whether or not your insurance plan covers COVID-19 treatment. Like everything else pertaining to health insurance, the answer varies depending on your plan and the type of treatment you require. Here's what experts say you should know.
Chris Abrams, a licenced insurance agent and the founder of Abrams Insurance Solutions [1], told POPSUGAR that the Families First Coronavirus Response Act [2] (FFCRA) requires health insurers to cover the cost of a COVID-19 test [3] — but there's no act that covers coronavirus-related treatment. "As with most types of medical treatment, the costs will ultimately come down to the type of coverage," Abrams explained. "On the bright side, many big-name providers, such as Cigna, have already waived copayments and deductibles related to COVID treatment."
Shirin Peters [4], MD, founder of Bethany Medical Clinic [5] in New York, added that outpatient doctor visits related to COVID care are widely covered by insurance, and so is inpatient care. However, there's one major caveat: hospital stays in the intensive care unit are expensive and only partially covered by insurance. "There are almost always out of pocket care costs for patients admitted to the ICU," Dr. Peters told POPSUGAR, noting that, on average, a night in the ICU costs about $1,100, excluding any tests or treatment. "Insurance usually covers 90 percent of the room cost," she explained — but that could still rack up a hefty bill if money is tight and a person needs to remain in the ICU for an extended period of time.
Because COVID-19 often hits suddenly and can be debilitating, it's wise to educate yourself about what your insurance plan will and won't cover if you do become infected [7]. "Although insurance company websites should have information regarding COVID coverage, it's a good idea to call your insurer to discuss what's covered in your plan," Abrams said. You can do this by calling the customer service number on the back of your member ID card. It's also important to remember that even if your insurance company does cover COVID-19 treatment, you'll likely still need to pay your deductible before that coverage kicks in.
"Ask your insurance company for a refresher on your deductible so you know how much to expect to pay and to help budget for a COVID-related emergency," Abrams said. He also pointed out that, in areas hit particularly hard by the pandemic, COVID-19 patients can have trouble finding treatment within their network. Abrams recommends asking your insurance company what they'll cover if you have to seek out of network treatment due to overcrowding. He added that, because COVID-19 is highly contagious, many healthcare providers are using telemedicine to handle consultations and initial diagnoses — so ask your provider if your plan includes teleheath visits. With any luck, you'll be able to recover at home [8], with the guidance of a doctor, at little to no cost.