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Are COVID-19 Testing and Vaccinations Covered Under Your Insurance?

Are you wondering whether your insurance covers covid-19 testing and vaccinations? Never fear, the Departments of Labor, the Treasury, and the Health and Human Services (HHS) have come up with an answered list of FAQs to clarify health coverage requirements related to COVID-19.

Guidance on Covid-19 Testing

Health plans and sponsors/issuers must cover COVID-19 diagnostic services without cost-sharing. The FAQs state that plans or issuers:

  • May not use medical screening criteria to deny or force cost-sharing on claim for COVID-19 diagnostic testing for an ‘asymptomatic’ person with no known or suspected exposure to COVID-19.

  • May distinguish between COVID-19 diagnostic testing of ‘asymptomatic’ people that must be covered and testing for general workplace health and safety or other purposes not mainly intended for individualized diagnosis or treatment of COVID-19.

  • Must assume that a test is for individual clinical assessment if it is provided by a licensed or authorized provider, including at a state or locality-administered site, a drive-through site, or a site that doesn’t require appointments.

Other Guidance

The agencies provided guidance on other issues as well, including:

  • Coverage of COVID-19 vaccines and other preventive care services;

  • Notice requirements for plans and issuers regarding coverage of preventive care services, and

  • Requirements for EAPs (employee assistance programs) and on-site medical clinics that administer COVID-19 vaccines to be considered as ‘excepted benefits’.

In short, plans, issuers, and employer sponsors are supposed to ensure clear communications about testing coverage as soon as possible, and try to detect and address fraud or abuse of coverage benefits.

Health insurance is always changing, and so are your employees’ needs and yours. Getting the best bang for your buck, especially during these times, is essential to the very survival of your business. NY Small Health partners with health insurance providers like the New York Health Alliance, which serves up a platter of the best benefits from various competing insurers for your choosing. The best benefits for your employees, multiple options to choose from, and just one bill for you.

For more information on how health insurance and coverage impacts the costs and benefits to your small business, visit NY Small Health and consult with the insurance experts.

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