Here is a look at virus-related health insurance changes
The coronavirus continues to wreak havoc on the economy. The unemployment rate continues to rise and many businesses may not be financially strong enough to reopen. No one knows how long it will take to reach to a new normal.
There is some evidence that the curve may be starting to flatten. This means certain key metrics – such as number of new cases, hospitalizations or number of deaths – is growing at a slower pace. There are hot spots, such as New York City, where there is a much larger concentration of the disease.
For the government to make decisions on when and how to reopen the economy, it will have to determine what percentage of people were exposed to the virus and how to keep the curve from spiking back up with a second wave of infections. The fear has always been that hospital systems could be overrun with more patients than they can handle. This could lead to many more deaths.
Because this crisis is a health issue, let’s look at some of the emergency changes made to health insurance policies. Most policies have waived deductibles or co-pays for virus testing. This often includes outpatient observations, physician visits and emergency department services – if related to the testing. Testing is going to be a very large part of moving forward.
Several changes have been made to Medicare to deal with this crisis. At this time, there are no vaccines for COVID-19. There are some telephone scams where criminals are trying to sell false cures. Do not fall for these. When a real vaccine is developed, it will be covered by all Medicare Part D prescription drug plans.
Because so many Americans are being told to stay home and people are being encouraged to not go to doctor’s offices, Medicare is expanding telehealth. This allows patients to speak to medical personnel through electronic means. During this crisis, this telehealth is not limited to COVID-19 issues. This could be a source to get your health questions answered. The government has expanded the devices that can be used, including a Smartphone. The cost will be paid by Medicare Part B for those on the program.
Because the government declared a national public health emergency, Medicare Advantage and Part D providers have some new rules. The CARES Act allows beneficiaries to receive health-care services at out-of-network doctor’s offices, hospital facilities and other facilities at no additional charge. The new law waives gatekeeper referral requirements.
It also loosens some of the rules for pre-approvals of care. It also has to cover the maximum supply of drug refills if requested. The skilled nursing care availability of up to 100 days has been modified to remove the hospitalization requirement if the hospital does not have rooms available due to the virus.
Check with your insurance company, if necessary, to deal with the coronavirus. Some of these rules are temporary while this current health crisis continues. We have to defeat the virus first to get the economy moving forward.
We are making progress; it is important that we stay the course to complete the mission.
Gary Boatman is a Monessen-based certified financial planner and the author of “Your Financial Compass: Safe passage through the turbulent waters of taxes, income planning and market volatility.”
To submit columns on financial planning or investing, email Rick Shrum at rshrum@observer-reporter.com.