A stethoscope in the form of a heart

Shelley Grandidge is a healthcare educator and owner of Southwest Health Options in Glendale.

Arizona is reopening, but coronavirus is still top of mind for many residents as new cases of COVID-19 are confirmed every day. The fact that we will be living with this virus for a while means every Arizonan should understand the role of health insurance in regards to what treatments and testing are covered.

 

Testing

The Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief and Economic Securities Act (CARES Act) require that all marketplace insurers cover 100% of coronavirus testing costs. This includes testing during a visit to the ER or any doctor’s appointment that leads to testing for coronavirus. The results of the testing also do not affect the cost.

Antibody testing is also important as more people contract and recover from COVID-19. Antibody testing is only readily available to health care workers and first responders in Arizona, but the cost of all antibody testing is free when it becomes available to the public.

Coronavirus testing and antibody testing is also free for anyone who is uninsured. No one should avoid getting testing because they are worried they can not afford it.

 

Treatment

Testing for coronavirus may be free, but treatment cost for COVID-19 can vary depending on the insurer and if the hospital you are treated at is out of network.

A lot of insurers have some form of copays, deductibles for COVID-19 treatments along with your premiums. However, some insurers have waived copays for COVID-19 treatments.

Medicare recipients with supplemental Medigap are in great shape regarding treatment cost, because copays, deductibles and other costs are covered by cost sharing.

Recipients with Medicare Advantage Plans can have also have their cost covered, but most of those plans use a network, so it is important to seek treatment at a hospital in your network.

COVID-19 patients who don’t have insurance or go out of network can end up paying anywhere from $42,486 to $74,310 for any extended hospital treatment. Many hospitals offer charity care programs; if you qualify for this type of program, you may have access to free or reduced-cost care.  

Discuss with your insurer about the closest hospital in your network, and seek treatment there if you become sick.

 

Unemployment

and insurance

 The coronavirus economy has left many Arizonans unemployed and their health insurance options in limbo. People who lose their jobs can use COBRA insurance to keep the plan their employer provided them, but COBRA can be too expensive for many people.

I would recommend taking advantage of your eligibility for Medicaid, which is known as the Arizona Healthcare Cost Containment System in Arizona. Anyone who loses their job or has their hours reduced qualify for special enrollment into AHCCCS.

You can also apply for special enrollment for an Affordable Care Act Plan, and if your employer has reduced your income or hours you may be eligible for a subsidy. The subsidy can be really helpful during this time.