(CNN)As coronavirus cases multiply across the nation, many Americans who aren’t feeling too well are worried about how much they’ll have to pay to get checked out.
The answer isn’t simple — it depends on what insurance they have, where they seek care and what tests the doctor orders. This uncertainty may deter some folks from seeing a doctor, which could increase the disease’s spread.
While there’s been no charge for Centers for Disease Control and Prevention tests in public health labs, commercial labs and hospitals are developing their own screenings, which are expected to carry a fee.
Vice President Mike Pence further muddied the waters this week when he said the administration was designating the test as an essential health benefit.
“That means, by definition, it’s covered in the private health insurance of every American, as well as covered by Medicare and Medicaid,” he said.
Coverage, however, isn’t the same as cost. Typically, it means that the test is considered part of one’s benefits package, but it’s still subject to deductibles and copays. Plus, many large employer plans are not subject to Affordable Care Act rules governing essential health benefits. Neither are certain other less comprehensive insurance products, such as short-term health plans.
Several large insurers, including Cigna, Anthem and CVS’ Aetna, have announced in recent days that they’ll pick up the tab for the test … but only for certain members.
Cigna and Anthem will waive any cost-sharing for tests for those in individual market plans, Medicare Advantage, Medicaid managed care and fully insured employer policies, in which the insurers pay the claims.
However, the move does not automatically extend to large-employer policies in which the companies pay the claims. About 61% of workers are covered by these self-insured plans, according to the Kaiser Family Foundation.
Aetna said it will waive copays for tests for all its policyholders, though self-insured employers can opt out. The carrier will also allow members to access telemedicine services at no charge for the next three months.
“Supporting the health and well-being of our members and removing barriers to care are among our key areas of focus as we navigate the spread of COVID-19,” said Karen Lynch, Aetn