How do insurance pay for COVID-19 & Free Preventative Care

by | Feb 11, 2021 | Affordable Health Insurance, COVID-19, Telemedicine

While we are still in the middle of the COVID-19 pandemic which has impacted Americans for more than a year now, depending on your health insurance plan many insurance carriers are still waiving the member cost-shares for the testing, treatment, and vaccination for COVID-19. Some carriers have stopped waiving the cost-share for treatment but are still waiving the cost-share for testing and vaccinations. For those not impacted by COVID-19, you can still get your preventative care free of charge at an in-network provider.

Since late March of 2020, health insurers have responded to the influx of COVID-19 cases by waiving member cost-shares for screening, testing, and treatment of COVID-19. Please note, it is important to review the CDC guidelines for the necessity for COVID-19 testing as the health insurers only cover the tests based on the guidelines set forth by the CDC.

COVID-19 testing & treatment for the individual insurance market and small group ACA health plans in CA.as of 2/12/2021

  • Blue Shield of CA – waived through February 28th
  • Anthem Blue Cross- January 31st for treatment, testing through April, March 31st for telehealth
  • Oscar – unspecified end date
  • Health Net- unspecified end date
  • MolinaCare- unspecified end date
  • Kaiser – unspecified end date
  • UnitedHealthcare – waived through April 20th
  • Aetna Group – waived through February 28th

Along with the waived COVID-19 cost-shares, members will continue to receive their free preventative care, including vaccinations, in all Affordable Care Act-compliant plans. Self-insured and grandfathered plans are not required to cover preventative care and COVID-19 for free. Please request from your health insurance carrier clarification.

Free Preventative Care

  • Annual wellness exam
  • Child screenings – Diabetes, Weight, Height & BMI, Vision and hearing tests, Pelvic exam, Pap and HPV tests, sexually transmitted infections (STIs) for adolescents
  • Child immunizations – Hepatitis A & B, Tetanus, Influenza, Haemophilus Influenza Type B (HiB), Inactivated Poliovirus Vaccine (IPV), Measles, Mumps & Rubella (MMP), Pneumonia, Varicella (chickenpox), Rotavirus, Meningococcal & Human Pappilomavirus (HPV)
  • Adult screenings – blood pressure, diabetes, colorectal cancer, breast cancer, cervical cancer, prostate cancer, sexually transmitted infections, HIV, osteoporosis
  • Adult immunizations- Hepatitis A & B, Human Papillomavirus (HPV), Measles, Mumps & Rubella (MMP), Pneumonia, Tetanus, Varicella (chicken pox), Influenza (flu) and Zoster (shingles).
  • Adult counseling – Domestic Violence, Family Planning & Breast-feeding Support

If you have any questions about your health insurance benefits and/or would like an independent health insurance quote please contact us at info@solidhealthinsurance.com or at 310-909-6135. At Solid Health Insurance Services, we strive to keep our clients informed about their benefits so that they may get the most benefit out of their health plans.