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Health plans and COVID-19

By for CAES News

Several weeks before the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law, the Families First Coronavirus Response Act (FFCRA) provided provisions to remove barriers to testing and treatment of COVID-19.

The CARES Act built on several of the new health coverage provisions in the FFCRA. Some important provisions of these Acts are outlined below.

All comprehensive private health plans will cover the costs of tests to diagnose and treat COVID-19 with no out-of-pocket costs for insured patients. All deductibles, copayments and coinsurance will be waived during the COVID-19 pandemic.

Additionally, barriers such as prior authorizations will not be required. These plan changes apply to COVID-19 testing and screening received during an in-person or telehealth doctor’s visit, at an urgent care facility or an emergency room.

If individuals have a flexible spending account they use to pay out-of-pocket healthcare costs, these funds won’t have to be used for COVID-19 testing and screening.

For individuals with high-deductible health plans (HDHP), COVID-19 testing and treatment may be provided without paying the deductible or a deductible that’s below the minimum annual deductible usually required.

Therefore, funds in health savings accounts (HSAs) used in conjunction with HDHPs to cover out-of-pocket costs may not have to be used. These health plan changes may apply to both in-person and telehealth services.

There also have been some changes to qualified expenses that can be covered with money in HSAs and FSAs.

Over-the-counter medication can now be covered without a doctor’s prescription. Menstrual care products can also be paid for with funds in these accounts. Over-the-counter medical expenses incurred after Dec. 31, 2019, qualify as eligible expenses.

As of now, there is no expiration date for these expenses being covered.

If a person is not able to use their HAS or FSA debit card at the point-of-sale to purchase these over-the-counter medications, the merchant may not have updated its system. Individuals can pay for the medication and submit a claim, along with their receipt, to get reimbursed.

As always, individuals should check with their health plan provider to determine their specific plan coverage for COVID-19.  They should also inquire about how long the new provisions will last.

It’s possible the expiration date for the expanded coverages may differ from one health plan to the next. Individuals should also check with the entity that manages their HSA or FSA for any possible future changes.

Joan Koonce is a Professor & Extension Financial Planning Specialist in the UGA College of Family and Consumer Sciences