Positives

kept at the hospital while the samples are being tested.

Results from laboratories other than through the CDC are considered presumptive positive until the CDC tests the sample. According to Dr. Rachel Levine, secretary of health, no presumptive positive cases have been wrong following CDC testing.

Who pays?

As the testing capabilities have expanded, there have been concerns of who would pay and the cost for testing. Each test costs $150 to $200, according to the Department of Health.

Testing done at the state lab is being covered by the state at no cost to the patient. Testing done at commercial labs would be billed to the patient’s insurance.

Gov. Tom Wolf announced Monday that all major health insurers providing medical coverage in the state will

CORONAVIRUS cover medically appropriate coronavirus testing.

“The opportunity to conduct in-state testing without putting the financial burden on consumers allows us to better identify those at risk,” Levine said in a press release. “Removing the financial consumer obligations associated with tests and care will allow more individuals with symptoms to come forward and be tested.”

The state’s major health insurers taking part include Highmark, UPMC Health Plan, Geisinger, Independence BlueCross, Capital Blue Cross, Aetna, Cigna, UnitedHealthcare, Pennsylvania Health & Wellness and Oscar.

Testing will be done without co-pays, deductibles or cost-sharing for patients. Treatment associated with coronavirus will also be covered, but there might be a nominal co-pay.

Patients with Medicaid coverage and the Children’s Health Insurance Program (CHIP) will not be expected to pay a co-pay for any testing related to the virus.

There may be significant limitations for people with excepted benefit policies; short-term, limited duration health insurance coverage; or health care sharing ministries. Self-funded coverage may also have different limitations.

The Pennsylvania Insurance Department is encouraging health insurers to coordinate with the business they administer on behalf of employers who self-fund their health benefits to ensure consistency in access across all forms of coverage.

Insurers are required to cover emergency services for an emergency medical condition at in-network levels. Services include transportation, and inpatient and outpatient services needed to evaluate or stabilize a patient. Medical assistance also covers emergency services, but may include a nominal co-pay for certain services.

No one will be denied treatment or services if any co-pay is not affordable at time of treatment or service, officials said. The insurance provider may send a bill for the co-pay amount.

Limiting impact

On Tuesday, the insurance department in collaboration with the Department of Health announced the submission of a notice to the Pennsylvania Bulletin outlining proactive steps and recommendations for individuals and major health insurers to help mitigate the potential impact of the virus.

Recommendations for insurers provided in the Notice Regarding Coronavirus (COVID-19) include:

• Providing access to accurate information, informing insureds of available benefits and quickly responding to inquiries about coverage.

• Providing telehealth delivery of services instead of in-person health care services and being prepared to meet any increased demand for that means of delivery.

• Verifying provider networks are adequate to handle a potential increase in the need for health care services related to the virus.

• Easing preauthorization requirements so they are not a barrier to access necessary treatment for the virus, and being prepared to expedite utilization review and appeal processes for services related to the virus.

• Easing access to prescription drugs, making expedited formulary exceptions, and permitting the temporary use of out-ofnetwork pharmacies (at innetwork cost-sharing) in the event of medication shortages at in-network pharmacies.

Anyone with questions on coverage should contact his or her insurance provider, officials said.

The Insurance Department has a team available to answer questions about insurance coverage and benefits at 877-881-6388. The department can also be contacted in the event of an unexpected bill related to the coronavirus.

Updated information on the virus, including insurance coverage questions, is available at health.pa.gov.