Health and Science

The coronavirus test will be covered by Medicaid, Medicare and private insurance, Pence says

Key Points
  • The COVID-19 test will be covered by Medicaid, Medicare and private insurance plans, Vice President Mike Pence said Wednesday.
  • "HHS has already denominated a test for the coronavirus to be an essential health benefit," Pence said.
  • Under the Affordable Care Act, health insurance plans must cover essential health benefits.
U.S. Vice President Mike Pence speaks during a briefing on the Trump administration's coronavirus response in the press briefing room of the White House on March 04, 2020 in Washington, DC.
Tasos Katopodis | Getty Images

The COVID-19 test will be covered by Medicaid, Medicare and private insurance plans, Vice President Mike Pence said Wednesday.

"HHS has already denominated a test for the coronavirus to be an essential health benefit, which ensures that it will be covered by people's private health insurance. It will be covered by Medicare and Medicaid," Pence said at a news briefing alongside diagnostic laboratory executives.

Essential health benefits were established under the Affordable Care Act, according to the American Physical Therapy Association, which is a hallmark piece of legislation passed under the Obama administration. Under the ACA, health insurance plans must cover essential health benefits.

The designation also means that Medicaid, which applies to people who fall below a certain income threshold, and Medicare, which applies generally to all Americans over 65, covers the cost of the test.

Private insurance plans will also cover the test since it is an essential health benefit, but unlike other mandated diagnostic tests like a mammogram, they will still require cost-sharing.

The potential for out-of-pocket costs poses a barrier to getting tested for people who are uninsured and may be infected with COVID-19.

Democratic chairs of the House Oversight Committee wrote the Department of Health and Human Services about the issue Wednesday, asking how HHS plans to ensure that the uninsured and underinsured are tested and treated for COVID-19. 

"Testing and treatment costs of thousands of dollars will cause many uninsured and underinsured individuals to avoid care for coronavirus-like symptoms," the chairs wrote. "That will not only hurt those who go untreated, but it will also hasten the spread of COVID-19."

An underinsured man in Miami recently went to a hospital to be checked for the coronavirus after traveling to China, and although a routine test revealed that he only had the flu, he received a bill for $3,270, according to the Miami Herald.

As of Wednesday, there are at least 138 COVID-19 cases in the U.S. across 13 states, according to the Centers for Disease Control and Prevention, and 11 deaths, according to state and local officials. The CDC said it has tested 1,235 people for the virus as of Monday.

States and city officials across the country said this week that they are ramping up their capacity to test more people. The recent designation of the test as an essential health benefit will remove the cost for patients associated with the test.

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