What to Know About Coronavirus Testing and Treatment if You Have No Health Insurance
A pandemic is a scary time for everyone, but it’s particularly terrifying if you don’t have health insurance. In 2018, that was 8.5% of the US population, or 27.5 million people, according to the most recent numbers from the Census Bureau.
Now a new report from the Kaiser Family Foundation estimates that many as 27 million Americans may have lost their job-based health insurance coverage amid widespread layoffs due to the coronavirus epidemic. Many of these people may be eligible for Medicaid or for subsidized coverage through the Affordable Care Act (ACA) marketplaces. But the foundation estimates that as many as 5.7 million people will face a gap in coverage.
Being tested for COVID-19 costs money—not to mention treatment for the virus if you need it—and the uninsured have no medical coverage for any of it.
Congress is addressing this issue piece by piece. On March 18, the Families First Coronavirus Response Act became law, making coronavirus testing free for everyone—provided states use their Medicaid programs to cover the uninsured. This is good news, although the uninsured face other testing hurdles, such as not having a regular place to go for medical care. And in the case that someone tests negative for coronavirus, they may face out-of-pocket costs for other tests, such as for flu or strep.
Does the stimulus bill cover care or treatment for coronavirus?
The latest stimulus package, which passed on March 27, has no provisions for free or reduced medical care for the uninsured. “It helps those who are at a certain level of income get the stimulus funds, and that goes out regardless of whether you’re insured or uninsured,” Marcy Buckner, vice president of government affairs for the National Association of Health Underwriters, tells Health.
In other words, if you’re eligible for a stimulus check for $1,200, you’ll receive that. (The bill offers $1,200 to individuals earning $75,000 in adjusted gross income or less, and $2,400 to married couples earning up to $150,000, plus $500 per child.)
That’s the extent of assistance legislation has extended so far to those without insurance. But on April 3, the White House announced that it will be aiming $100 billion in emergency spending toward hospitals and health providers for treating uninsured coronavirus patients. Experts aren’t sure yet what that will mean, practically.
“We really don’t know how this will work,” Cheryl Fish-Parcham, director of access initiatives at Families USA, a nonprofit consumer health advocacy organization, tells Health. “We want to be sure that uninsured patients are not charged for either the hospital bill or for doctors that treated them or for labs that were provided within the hospital. We have a list of concerns.”
What if you need medical help?
Until there’s more clarification on how the federal government’s hospital aid will impact uninsured medical care, you should proceed the way you would have previously. If you have serious symptoms of coronavirus, use the CDC’s Self-Checker to see if the website recommends seeking medical care. You can also call a nurse hotline, such as the one provided by Research Medical Center, which is available to everyone, insurance or not, 24/7.
If you need a doctor or hospital, call health care providers and ask how they’re providing treatment for those who are uninsured. If you don’t have a primary care physician, this means calling your local urgent care clinics or hospitals. Ask for their billing or financial assistance department. (This is a good thing to do while you’re healthy, so you know which hospital in the area to aim for in an emergency.)
“I imagine it varies from hospital to hospital and provider to provider,” Buckner says. “Call before to see if they might be offering care at a reduced price for the uninsured for this specific pandemic.”
If you do receive large medical bills for treatment, don’t pay them immediately; upcoming legislation may help with medical payments. But do call the hospital or doctor and explain your situation. Ask to speak to someone in the financial assistance department. Barring direct government assistance to you or the hospital for your charges, you may be able to negotiate down your total bill or they may offer you a payment plan.
Can you sign up for insurance?
Ideally, the US government would also open the federally operated health insurance exchanges for a special enrollment period, but so far, that hasn’t happened. In the meantime, the best way to make sure you’re covered is to get health insurance another way. Whether or not you can purchase coverage depends on your situation:
Did you lose your job? Losing your job (and your health insurance) is considered a life event, and you’re eligible for a special enrollment period (SEP) through the ACA marketplace, accessible at healthcare.gov or via your state-run exchange. Use the Kaiser Family Foundation’s subsidy calculator to see if you qualify for any assistance with premiums.
Do you live in a state offering open enrollment? Twelve states created a special open enrollment period allowing uninsured residents to purchase ACA coverage, whether or not they’ve had a life event (like a job loss). This is for residents of California, Colorado, Connecticut, District of Columbia, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont, and Washington. (Some states' special enrollment periods have lapsed, so check with your state's ACA website for details. You can look up your state insurance exchange at healthcare.gov.)
Do you qualify for Medicaid? If your income is low enough (and it might be if you’ve stopped working), you might qualify for Medicaid, which provides free or low-cost health coverage. In 37 states, you can qualify if you make up to 138% of the federal poverty level, or $1,467 per month for an individual or $3,013 per month for a family of four. “Medicaid eligibility is based on monthly income, not annual income, so people who’ve been laid off might qualify,” Fish-Parcham says. You can check your eligibility here.
Could you afford a high-deductible plan? Many of the plans available on the federal and state exchanges are high-deductible health plans (HDHPs), meaning you must meet a large out-of-pocket deductible before insurance will kick in. HDHPs tend to have lower monthly premiums. But the IRS has advised that HDHPs can cover coronavirus-related testing and treatment before plan deductibles have been met. (It does not require that they cover treatment before the deductible is met, however, so you’ll need to check with each insurer specifically.)
Over the long term, the best situation might be a combination of both strategies: sending aid to hospitals to cover treatment costs for the uninsured and opening the federal marketplace exchange for a special insurance enrollment period.
“There will be people who will remain uninsured for a variety of reasons, whether it’s financial or because of immigration status issues that make them ineligible for coverage,” Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation, tells Health. “Some reimbursement for people who are uninsured is necessary. But there are also huge benefits to providing people with broader, more comprehensive insurance coverage rather than relying on a hospital reimbursement plan.”
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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