What to expect from your health insurance if you experience symptoms of Covid-19

If you have insurance, make sure to use it for any testing and medical exams related to COVID-19 and any other medical services you may need during this time.

If you have Medicaid

Medicaid provides all “medically-necessary” services to its members. If you meet the eligibility requirements for a COVID-19 test, your Medicaid coverage should cover the cost of the test. If you are diagnosed with COVID-19 and require medical treatment, Medicaid should also cover those costs.

Check with your Medicaid insurance company for more information and guidance. Click the name of your Medicaid company to find out more: Amerigroup, CareSource, PeachState Health Plan, and WellCare.

If you need other health care services during this time, check with your insurance company and doctor to see if you can have a “virtual appointment” using the internet or a video call, instead of going in-person.

If you have private insurance

If you have insurance through an employer, the State Health Benefit Plan, or the Affordable Care Act marketplace (also called healthcare.gov), use it for any testing or medical exams related to COVID-19. Laboratory tests are an essential health benefit through the Affordable Care Act (ACA), so your health insurance plan should pick up some or all of the costs of a COVID-19 test. At the request of federal officials and Georgia’s Insurance Commissioner, some insurance companies are offering to waive co-pays, deductibles, and other cost-sharing for the viral tests.

If you are diagnosed with COVID-19 and require medical treatment, you should expect to pay some out-of-pocket costs like your deductible. (We will update this section if Congress or Georgia leaders mandate that insurers waive all out of pocket costs for treatment.)

If you purchased coverage outside of the ACA marketplace or you have a short-term plan or health-sharing ministry, call your insurance company to find out how they are covering COVID-19 testing and treatment.

If you need other health care services during this time, check with your insurance company and doctor to see if you can set-up a “virtual appointment” using the internet or a video call, instead of going in-person.

If you have Medicare

Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs. All necessary hospitalizations are also covered by Medicare, including hospitalizations for quarantine. More information about Medicare’s coverage and services is available here.

If you are uninsured

Georgians should not let their insurance status get in the way of needed testing or treatment. If you are uninsured, Dr. Kathleen Toomey, Commissioner of the Georgia Department of Public Health, has previously stated that testing for COVID-19 will be free. If you need other health care services, find a local community clinic (which offer services for free or on a sliding scale) or apply for financial assistance through a hospital charity care program. Georgians should not let their insurance status get in the way of getting needed testing or treatment.

If you lose your job

Many Georgians in the hospitality, food service, retail, and other sectors are finding themselves without a job and at risk of losing their coverage. If this is your situation, you can keep yourself and your family covered during this health crisis. You may be eligible to apply for a Special Enrollment Period up to 60 days after losing your job. Coverage through the ACA marketplace (healthcare.gov) should cover testing for COVID-19 because laboratory testing is one of the ACA’s essential health benefits. If you are unable to enroll in a health insurance plan you may have other options through services such as a community clinic, which can connect you with the care you need.

Information provided by Georgians For a Healthy Future.