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Need COVID-19 treatment? You might be billed now

UPDATED: Thu., Sept. 16, 2021

FILE - In this July 16, 2021, file photo, nurses and doctors in the CoxHealth Emergency Department in Springfield, Mo., don personal protective equipment to treat patients with COVID-19.   (Nathan Papes)
FILE - In this July 16, 2021, file photo, nurses and doctors in the CoxHealth Emergency Department in Springfield, Mo., don personal protective equipment to treat patients with COVID-19.  (Nathan Papes)

If you need treatment or are hospitalized for COVID-19, be prepared to pay for those medical bills.

Last year, many insurance companies waived treatment charges for COVID-19, including co-pays or cost-sharing deductibles, for patients who got COVID-19 and needed to be treated or hospitalized.

Now with vaccines widely available and one fully approved by the Food and Drug Administration, some insurance companies are charging co-pays and cost sharing fees for patients who come down with the virus and need to be treated.

Premera Blue Cross stopped waiving co-pays and cost-share fees for COVID on July 1, meaning its clients might pay co-pays or other charges associated with treatment.

That doesn’t mean COVID treatment isn’t covered, however.

“Our customers have coverage for all different aspects of COVID from diagnosis to treatment, so none of that has changed for us,” Chad Murphy, chief clinical officer at Premera Blue Cross, told The Spokesman-Review.

So if you get COVID-19, you can get treated, but you can now also expect to pay your co-pay, your deductible or other fees according to your health plan.

Murphy said vaccines becoming widely available this summer was a factor in Premera’s policy change, but the company is not the only one that has stopped waiving all charges for COVID care.

According to United Health Care’s website, Medicare Advantage, as well as individual and group health plans, will all be charged for COVID treatment according to co-pays and cost-sharing requirements.

Similar to Premera Blue Cross and United Health Care, Kaiser Permanente’s policy that waived out-of-pocket costs for COVID-19 treatment came to an end on July 31 for all non-Medicare plans.

Not every insurance company is charging for COVID treatment again, however, and it’s important to check with your plan directly.

For Regence BlueShield and Asuris Northwest Health members, all COVID treatment will be covered 100% without co-pays or deductibles until Dec. 31.

Additionally, Medicaid recipients will not be charged for COVID-19 treatment co-pays.

The state insurance commissioner’s office is encouraging Washington residents to consult their health plans to see what treatment is subject to co-pays or cost-sharing.

In Washington state, Insurance Commissioner Mike Kreidler’s emergency order is still in effect through Oct. 3.

It prohibits cost-sharing and co-pays for medically necessary COVID-19 testing and the associated provider visit.

The federal CARES Act also requires health insurance companies to cover medically necessary COVID-19 testing.

A heath care provider, not your insurance company, should decide whether you need a COVID test.

If you need a COVID-19 test, there should be no charge for the test or associated visit if it’s deemed truly necessary, under state and federal guidelines.

Your insurer must pay for the testing even if the provider is not in your plan’s network, according to the insurance commissioner’s office, and they cannot bill you for the balance.

The order also prohibits insurance companies from using prior authorization requirements on COVID-19 testing or treatment.

The one caveat, however, is that insurers are not required to pay for COVID tests that are required for employment or travel.

Statewide, vaccines are free to anyone regardless of whether you have insurance .

To find a COVID-19 vaccine near you, use the state’s vaccine locator or call (800) 525-0127, then press #.

Arielle Dreher's reporting for The Spokesman-Review is funded in part by Report for America and by members of the Spokane community. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.

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