Insurance companies respond to increased demand for COVID-19 healthcare needs

Insurance carriers make adjustments for COVID-19
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Posted at 7:48 AM, Apr 15, 2020
and last updated 2020-04-22 17:33:55-04

BALTIMORE, Md. — Healthcare for COVID-19 is estimated to total hundreds of billions of dollars in the U.S.

Insurance carriers might be footing much of the bill for treatment, which begs the question if the number of claims for COVID-19 could put a strain on the health insurance industry and raise the price of premiums.

For insurance customers, the cost of an unexpected hospital bill for COVID-19 might catch people some off guard.

Maryland insurance commissioner Al Redmer said "it doesn’t matter whether it is coronavirus or a car accident somewhere, you had the potential to run up those expenses."

Expenses such as a high deductible or out of pocket maximum.

“As an example, you might have a $5,000 deductible, but the out of pocket maximum may be $10,000. so while that’s a significant amount of money, that’s a debt that could probably be worked out with the hospital," Redmer said.

In March, Governor Larry Hogan ordered insurance companies to cover the cost of coronavirus diagnosis, testing and lab fees.

Meanwhile, co-pays, deductibles, and out-of-pocket expenses for those who might test positive and end up with a lengthy and costly hospital stay are not guaranteed to be covered.

“A lot of the carriers have waived cost sharing for the treatment itself, but that’s not universal, again, you really have to check with your insurance carrierl," Redmer said.

It's good news if your insurance company has your share of expenses covered for COVID-19, but not all of them do.

Considering there are thousands seeking treatment and others hospitalized, it raises the concern if these numerous claims could lead to higher healthcare insurance premiums for everyone; however, it may be too soon to tell.

“The folks that are in the hospital are running up huge bills, but again, the flip side is, folks are not going into the hospital for the knees, and the hips, and other things. So at this point I don’t think that we are seeing things that are going to be catastrophic from a claim perspective," Redmer said.

Because of the coronavirus, the Maryland healthcare exchange has opened up a special enrollment period through June 15th for people who don't have coverage.

If you enroll as of April 15th, coverage will be retroactive to April 1st.

People who enroll between April 16th through May 15th will have their coverage active as of May 1st, while coverage for enrollment from May 16th through June 15th will start June 1st.

The Maryland Health Connection plans will help cover out of pocket expenses like copays and deductibles for COVID-19.

The Maryland insurance commissioner also said he's had five conference calls with insurance carriers over the last few weeks to either improve access to care or remove some financial burdens during the outbreak.

This includes expanding tele-health capabilities, not just for COVID-19 treatment but for other healthcare concerns such as primary care and physical therapy as well as mental and behavioral health .

Some insurance carriers will pay for home delivery of prescriptions so you don't have to bother to leave the house and can continue your social distancing.

Some companies also will waive time restrictions for ordering prescription refills so you don't have to wait the usual 30 or 60 days.

Many carriers are extending timelines for pre-authorization for elective surgeries that have been postponed due to the coronavirus.

If you end up testing positive for COVID-19 and need to seek treatment, some insurance carriers are even waiving the costs of co-pays and deductibles.

For those having trouble paying their premium, contact your insurance company to let them know as many will work with you to figure something out.

“Most of the carriers are making significant accommodations, not just in helping folks who are having struggles paying the premium, but also the administrative burden of having employees get furloughed, and come back onto the plan, and all of those restrictions," Redmer said.