In this post we will cover the coronavirus and how it will interact with individual and small group health insurance coverage in Georgia for individuals and small groups.
*UPDATE* CMS just released a “Coronavirus FAQ” here: https://www.cms.gov/newsroom/press-releases/cms-publishes-faqs-ensure-individuals-issuers-and-states-have-clear-information-coverage-benefits?utm_campaign=hcgov_ab&utm_content=english&utm_medium=email&utm_source=govdelivery
*UPDATE* Most major medical insurance companies are waiving copay’s for for Coronavirus testing. https://www.marketwatch.com/story/pence-americans-wont-get-surprise-medical-bills-for-coronavirus-tests-2020-03-10
*UPDATE* Kaiser has been selected by the National Institute of Health to launch the first clinical trial of an experimental coronavirus vaccine! First dose to be given to participants 3/16/2020! https://finance.yahoo.com/news/report-seattle-coronavirus-vaccine-trial-055006697.html
About the Coronavirus – COVID-19
First, the best place to stay up to date with REAL information about the virus is the CDC’s website:
There is plenty false information out there about the virus so the best source for updates and health information is the Center for Disease Control. Information that includes who is at risk, how it spreads, symptoms and prevention/treatment can be found on the CDC’s site. You can also sign-up on their site for weekly coronavirus updates.
I cannot stress enough that there is a massive amount of reliable information about COVID-19 on the CDC’s website!
One other important website is the Georgia Department of Public Health. This website is a great source of information on COVID-19 in Georgia. As of writing this article, there are 6 confirmed cases and 11 presumptive cases in Georgia according to the DPH site:
Coronavirus Health Insurance coverage in Georgia
How is Coronavirus covered under health insurance in Georgia? According to the CMS, “Existing federal rules govering health insurance coverage, including with respect to viral infections, apply to the diagnosis and treatment of coronavirus (COVID-19).”
CMS is basically saying that the Coronavirus will be covered under your plan according to the plan details. Anyone who has coverage that conforms to the ACA (most major insurance plans) will be covered in some manner.
In addition, CMS just released that they developed an additional code for COVID-19 lab tests. This is significant because this will encourage doctors and hospitals to test for coronavirus. The change makes it easier to administer, track and receive payment for tests. Learn more HERE!
The IRS has issued guidance that high-deductible health plans can pay for coronavirus related testing and treatment without jeopardizing their status. This also means that individuals that have these plans can continue contributing towards their HSA. Read more HERE!
The main services that come into play with the Coronavirus will be:
- Diagnostic & Laboratory Services – Your plan will have provisions on how this service is covered.
- Vaccines – Your plan will have provisions on how this service is covered. However, a vaccine is not yet developed and if one is guidance will be provided by the government. A vaccine could be labeled as preventative care and be covered for free under ACA plans. We do not know yet.
- Hospitalization & Ambulatory Patient Services – Your plan will have provisions on how this service is covered.
- Telehealth – Your plan will have provisions on how this service is covered. Many carriers offer telehealth services either free or at a low copay cost. This is great option to limit visits to potential areas of infection such as hospitals and doctors’ offices.
- Prescription drugs – Your plan will have provision on how this service is covered. Each insurance company will have guidance on what drugs are covered for treatment of COVID-19.
No need to panic! If you have major medical insurance your plan will cover treatment of COVID-19 in some manner. The best way to check how your insurance carrier is covering specific services related to Coronavirus is to call them or check the information below.
Specific information related to Individual and Group Health Insurance providers in Georgia:
Aetna – https://www.aetna.com/individuals-families/member-rights-resources/need-to-know-coronavirus.html. Aetna is waiving copays for all diagnostic test related to the virus!
CareSource – https://www.caresource.com/
Humana – https://press.humana.com/press-release/current-releases/humana-takes-steps-care-members-response-coronavirus. Humana will waive out-of-pocket costs associated with testing for COVID-19 for patients who meet CDC guidelines at approved laboratory locations. This will apply to Humana’s Medicare Advantage, Medicaid and commercial employer-sponsored plans. Humana is also announcing the following resources for its members:
- Telemedicine costs waived for all urgent care needs for next 90 days
- Early prescription refills allowed for next 30 days
- Member support line available by calling our customer service team
National General – uses the Aetna network: https://www.aetna.com/individuals-families/member-rights-resources/need-to-know-coronavirus.html
This is a daily update on the number of coronavirus cases in Georgia: https://dph.georgia.gov/covid-19-daily-status-report
Per Governor Kemp on 3/9/2020, officials intend to use Hard Labor Creek State Park (Rutledge, GA) to isolate COVID-19 patients in Georgia. https://www.gpbnews.org/post/officials-use-state-park-isolate-covid-19-patients-georgia
On 3/9/2020 a teacher at Fulton County Schools Bear Creek Middle School and Woodland Middle School has been diagnosed with COVID-19 resulting in the closure of all Fulton County. https://www.wtoc.com/2020/03/09/fulton-county-schools-employee-tests-positive-covid-impacted-schools-immediately-dismissed/
As of 3/10/2020 there are 17 presumed coronavirus cases in Georgia. https://dph.georgia.gov/