Mar 6, 2020 - Health

Insurers and states move to cover cost of coronavirus testing

Photo: Kena Betancur/Getty Images

Both health insurers and regulators are working to make sure that coronavirus diagnostic tests will be covered — but that doesn't necessarily mean coronavirus treatment will be affordable.

Driving the news: California, New York and Washington state have announced that health plans are required to cover the diagnostic tests and the associated provider visit, without cost sharing.

  • Many health plans — including members of America's Health Insurance Plans are voluntarily saying that the tests will be covered. Cigna announced specifically that it will waive all cost sharing.
  • The Centers for Medicare and Medicaid Services emailed Medicare beneficiaries yesterday saying that the tests are covered. Lab tests generally don't have cost sharing under Medicare.

Yes, but: State insurance commissioners don't have the authority to regulate self-insured plans, which cover 61% of workers with employer-provided health benefits, according to the Kaiser Family Foundation.

  • And, as WSJ points out, the state actions "focus on diagnosis, not treatment of COVID-19. ... Older people and those with underlying health conditions have in some cases needed extensive, and costly, hospital care."

And while state regulators are addressing the provider visit associated with testing, insurers themselves generally aren't.

  • "We will cover needed diagnostic testing when ordered by a physician. We will take action to ease network, referral, and prior authorization requirements and/or waive patient cost sharing," AHIP said in a statement by its board of directors.
  • But the related provider visits and other services "would be covered in accordance with a person’s policy," an AHIP spokesperson said.

Go deeper: Coronavirus test kit affordability could hurt U.S. containment efforts

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