Covid-19 Related Health Insurance Update

The U.S. Department of Health and Human Services (HHS) announced on October 2, 2020 that it has extended the period of the national public health emergency related to Covid-19 for a third time.  So, health insurance plans* may now extend the end date of any Covid-19 specific plan related cost sharing waivers and benefits to dates of service up to January 20, 2021.

* As we have previously indicated, not all health insurance policies are alike in how they treat Covid-19 related benefits.  So it’s extremely important to access the appropriate resource to determine your particular plan’s extension of benefits (e.g., Human Resources department, company intranet site, insurance company web portal, etc.).  Generally speaking, most plans have waived any plan related cost sharing (i.e., copay, deductible, coinsurance) related to testing and test related visits associated with Covid-19, through the end of the period of the national public health emergency.  Most plans are subject to this particular mandate which is part of the Families First Coronavirus Response Act (FFCRA).  See –

Note: Fully insured health plans are required to waive cost sharing for Covid-19 testing, per the FFCRA.  However, the cost share waiver is discretionary for partially self-funded plans.

There may be additional relaxations and/or benefit extensions tied to the timeframe of the national public health emergency, such as:

  • – Waiving cost sharing for COVID-19 treatment
  • – Waiving cost sharing for Telehealth (also know as virtual care, tele-medicine, tele-doc) for certain or all diagnoses
  • – Adding coverage for telehealth visits
  • – Allowing earlier re-filling of prescription drugs