April 5, 2021

Since the epidemic began, insurers have waived cost-sharing for Covid-19. Is that changing?

Daily Briefing

    With the end of the current public health emergency declaration coming this month, insurers around the country are considering rolling back waivers they instituted last year suspending cost-sharing for coronavirus-related care—although Covid-19 testing and vaccination remain no-cost under federal law.

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    Background

    According to NerdWallet/Associated Press, the Families First Coronavirus Response Act and the CARES Act require that insurers cover Covid-19 testing and vaccinations at no cost to members. In addition, under the CARES Act, insurers are required to cover Covid-19 treatment costs at no cost for Medicare patients.

    While four states and Washington, D.C., have mandated that insurers cover the cost of coronavirus-related care, Modern Healthcare reports, the federal government hasn't issued any mandates to that effect. However, amid the public health emergency declared by the federal government for the pandemic, many private health insurers across the country voluntarily suspended cost-sharing for coronavirus-related care, including copays, deductible payments, and coinsurance.

    Insurers consider reinstating Covid-related cost-sharing

    As the epidemic continues, however, some insurers are considering rolling back their cost-sharing waivers.

    For instance, Blue Cross Rhode Island in March announced plans to reinstate cost-sharing for coronavirus-related care. However, the organization rolled back those plans after the state's Office of Insurance Commissioner pushed back, saying instead that it would restart cost-sharing for those services only after the public health crisis had subsided, Modern Healthcare reports.

    Similarly, Blue Cross Blue North Carolina (Blue Cross NC) previously announced plans to begin charging fully insured and group members for all copayments, coinsurance, and deductibles related to Covid-19 treatment on April 1, but it has since extended its cost-sharing waivers through June 30, 2021.

    In a statement, a Blue Cross NC spokesperson explained, "New Covid-19 cases and hospitalizations have recently increased nationally, after weeks of declines. Although vaccination rates are rising, more-contagious variants of the virus are spreading, meaning many North Carolinians are still vulnerable. It's important that we remain vigilant and continue to take precautions" (Tepper, Modern Healthcare, 3/30; Jayakumar, NerdWallet/Associated Press, 3/30).

    This story was updated on April 8, 2021, to reflect developments that occurred after it was written, including that Blue Cross NC extended its cost-sharing waivers through June 30, 2021.

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