What You Need To Know About Coronavirus and health insurance

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What You Need To Know About Coronavirus and health insurance

Coronavirus vaccines
All COVID-19 vaccines are free, with no out-of-pocket costs. This applies regardless if you have health insurance, Medicare or no insurance. Learn more about COVID vaccines in Washington state.

Coronavirus testing and billing
Under the Federal CARES Act (Coronavirus Aid, Relief, and Economic Security) , all health insurers must pay for medically necessary COVID-19 testing.

The provider will decide if the test is medically necessary – not the insurer. The insurer cannot second-guess the provider.
There is no copay or deductible for the test and associated visit.
Your insurer must pay for the testing whether the provider is in your plan’s network or not. And they cannot balance bill you.
However, insurers are NOT required to pay for COVID tests that are required for employment or travel. You should check with your insurance company if you’re worried about whether or not you’ll be charged.

If you receive a bill related to COVID-19 testing or you’re unsure about coverage, let us know. We can explain your rights and talk to your insurer on your behalf, if needed.

Cost-sharing for COVID-19 treatment varies. Check with your insurance plan to see what your responsibilities will be.

Frequently asked questions about coronavirus and health insurance
Get answers to frequently asked questions regarding health insurance and the coronavirus pandemic
Answers to frequently asked questions about insurance coverage for coronavirus testing and lab fees (PDF, 238.32 KB)
Health insurance information for people who don’t have immigration status (columbialegal.org)
Frequently asked questions about coronavirus and health insurance in other languages
Spanish (PDF, 89.76 KB)
Vietnamese (PDF, 109.63 KB)
Russian (PDF, 88.25 KB)
Traditional Chinese (PDF, 177.97 KB)
Simplified Chinese (PDF, 234.74 KB)
Korean (PDF, 120.27 KB)
Employer-sponsored health insurance
Many employers have contacted our office about how to maintain their employees’ health coverage during the coronavirus pandemic. We have let all health insurers know they have flexibility in defining who is eligible for coverage under the employer-sponsored health plan. If an employer would like to try to keep their employees covered or have other questions about their health insurance, they should reach out directly to their health insurer or insurance broker.

Unemployment benefits are not regulated by our office. If you have questions about unemployment benefits, please contact the Employment Security Department (www.esd.wa.gov).
Kreidler encourages health insurers to work with employers who want to maintain employee coverage
Dental insurance and PPE
We’ve heard from consumers that some are being billed an out-of-pocket surcharge for personal protective equipment (PPE) by their dentists if their insurance won’t cover the cost. We have heard of patients being charged $10 to $30 for PPE.

Dental insurers can choose to cover PPE costs.

The following insurers have notified us they will cover the cost of PPE during dental procedures:

Delta Dental
Emergency orders and announcements
Commissioner Kreidler has the authority under state law to give direction to health insurers on coverage issues once an emergency has been declared by the governor. Here are the emergency orders currently in effect:

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