May 11, 2023, end of COVID-19 emergency status to change coverage for services

As the U.S. Department of Health and Human Services (HHS) plans to end the COVID-19 public health emergency (PHE) on May 11, 2023, many states anticipate changes to consumer health insurance.

The PHE went into effect Jan. 31, 2020, and the anticipated end marks a significant change for infrastructure that has relied on the PHE declaration for many emergency measures that have stuck around for more than three years. While coronavirus deaths continue to trend down, more than 1,000 people a week still die from the disease.

A bulletin from the Alabama Department of Insurance notes the primary concerns for health insurance consumers in the state:

COVID-19 testing

For people with private health insurance plans, COVID-19 testing coverage may no longer be free, and plans may require cost-sharing fees. Medicare enrollees will also be unable to procure over-the-counter COVID-19 tests for free unless their healthcare provider orders one.

The state notes those who are underinsured or uninsured may be able to obtain free COVID-19 tests from USPS, community partners, pharmacies, and the federal Centers for Disease Control and Prevention (CDC).

COVID-19 vaccines

People with private health insurance can still receive COVID-19 vaccines at no cost if they are in-network. Medicare enrollees will still be able to get COVID-19 vaccines without cost-sharing. Medicaid or Children’s Health Insurance Program (CHIP) enrollees will continue to have access to COVID-19 vaccines without cost-sharing or co-pays through Sept. 30, 2024. After that, states will determine vaccination and treatment coverage for Medicaid and CHIP recipients.

COVID-19 treatment

According to the Alabama DOI, COVID-19 treatment coverage will not change. Those with health insurance will have the same cost-sharing and deductible requirements as they currently do. For Medicare recipients, the plan will continue covering oral antiviral medication and other in- or outpatient treatments the same as it currently does.

Telehealth

Many states used the PHE conditions to order insurers to rely on telehealth in several situations, sometimes incentivizing or even requiring telehealth usage. So, insurance carriers will undoubtedly implement many changes as state statutes for standards of care revert to their pre-pandemic situation. In Alabama, Medicaid or CHIP enrollees will continue to have access to telehealth services, per federal recommendations. Medicare conditions for telehealth services will still apply until December 31, 2024.