Coronavirus and Your Health Plan

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The global spread of a new COVID-19 virus – commonly referred to as “coronavirus” – is dominating the news-cycle and daily conversation. Thankfully, the Centers for Disease Control and Prevention (CDC) has offered guidance to keep your family protected from infection at home as well as helpful information on how to care for yourself, including when to seek medical attention if you become sick.

But amid all the news and info, you may be left wondering if your health insurance plan covers coronavirus, or how to make use of your coverage in case you become ill? Here are some quick FAQ to bring you up to speed:

Will my health insurance plan cover coronavirus?

Yes. Coronavirus is just like any other illness and therefore your health plan will cover it in the same way it would cover the flu or pneumonia. When you receive medical care for coronavirus, you may face out-of-pocket costs in the form of a copay, deductible, or coinsurance before your coverage kicks in, but there are no specific restrictions or limitation for coverage of coronavirus. However, in some cases (depending on your insurer and the state in which you live) fees associated with coronavirus testing are being waived.

What if I am hospitalized or quarantined in a medical facility?

Again, this would be covered just like any other inpatient stay in a medical facility. Specific out-of-pocket costs may apply, depending on the rules of your plan. But medically necessary care is covered by all major medical health insurance plans, including inpatient hospital stays.

What if I have to self-quarantine at home?

Your health insurance plan will not pay you to stay at home or compensate you for lost income when you’re away from work. Talk to your employer about taking paid time off or a leave of absence if you are asked by a medical provider to self-quarantine. Some self-quarantine patients leave home to visit medical providers for tests or check-ups, however, and these would be covered according to the standard rules of your plan. Medical care rendered in your own home by a licensed professional may also be covered.

What if I want to undergo non-standard care for treatment or prevention of coronavirus?

Generally speaking, health insurance companies will only cover you for care that is deemed medically necessary and appropriate. Experimental or alternative forms of medicine may not be covered. Contact your health insurance company for more information about coverage of non-standard care under your plan.

Am I covered for immunization against coronavirus?

There are no available immunizations against coronavirus at this time. It remains to be seen when or if such immunizations will become available. If an immunization became broadly accepted and available, it is likely that your health plan would cover it in the same way it would any other immunization.

In summary, while the coronavirus is frightening to some and getting a lot of press and political attention, it is just like any other virus in the eyes of your health insurance plan. Though it is a novel virus, there are no special restrictions associated with care of coronavirus. For more information on how your health plan would cover care for this or any other disease, contact your insurer.

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