Since early 2020, the U.S. has been under national and public health emergencies in response to COVID-19, but with the federal emergency declarations set to expire May 11, many consumers face the likelihood of increasing costs for COVID-19 prevention and treatment.
As part of the federal emergency declaration, COVID-19 tests and treatments were provided to consumers at little or no cost, sometimes through private insurance. But when the emergency declaration ends, the Biden administration will no longer require insurers to pick up the cost of some services and items, including eight free at-home COVID-19 tests a month.
Relevant:— Margaret (@VT_Vagabond) January 31, 2023
Today I went through every single one of my health insurance claims for '22, which is how I know that every time I got a COVID test at a clinic (rapid & PCR), it cost my insurance either $425 or $525 (don't ask me why it varied).
Dreading the changes this will bring https://t.co/1c7BbnA9o2
Instead, the decision whether to continue covering at-home test costs is at the discretion of insurance companies, leaving consumers with private insurance to possibly dig into their own pockets. "For the most part, health plans aren't probably going to cover it," says Jennfier Kates with the Kaiser Family Foundation, a nonprofit focused on health issues. "Some might, but most won't."
Uninsured consumers likely will have to pay for their own at-home tests, as will those insured under Medicare, unless they are covered by Medicare Advantage, which picks up costs for some additional services. Consumers covered by Medicaid will still have access to free at-home tests under the American Rescue Plan Act, but for only about a year after the emergency status ends.
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When it comes to PCR tests, a more sensitive COVID-19 test processed in a laboratory, most private insurance companies will continue to cover costs as long as the tests are administered by in-network providers, but they may impose additional costs or conditions, Kaiser says. Medicare will also continue covering PCR tests, but uninsured patients will have to foot their own expenses unless their tests are administered at a free clinic or community health center.
For COVID-19 treatments, Paxlovid and other oral antiviral medications that were purchased by the federal government will still be free for consumers — that is, until the supply runs out. Once the federal supply diminishes, patients will be charged for treatments through their insurance companies. Seniors with Medicare Part D will have access to free treatments through December 2024, according to Kates.
Under the federal emergency declaration, COVID-19 vaccinations were free to consumers, resulting in 68% of the U.S. population now being fully immunized. Anyone covered by Medicare, Medicaid, or private insurance will still be able to get both vaccines and boosters for free, though some individuals with private insurance could be charged if they receive their vaccinations from an out-of-network provider. The federal government also still has COVID-19 shots available, so uninsured patients will be able to get vaccinated for free until the supply runs outs.
Through the CDC's Vaccines for Children program, uninsured children will also have access to free shots.