Insights

New Guidance on Health Insurance Coverage of Coronavirus


On March 10, 2020, the Department of Insurance published Notice Number 2020-03. The new bulletin relates to health insurance coverage of coronavirus (COVID-19). According to the bulletin, the Department expects medically prescribed diagnostic testing for COVID-19 to be covered without prior authorization requirements that might ordinarily apply to diagnostic testing. The Department also urges health insurers to waive any cost sharing for COVID-19 laboratory tests, in-network provider office visits, in-network urgent care center visits and emergency care services (when related to COVID-19).

In addition, with regard to prescription drugs, carriers are encouraged to make expedited formulary exceptions and to permit the temporary use of out-of-network pharmacies (at in-network cost sharing) in the event of medication shortages at in-network pharmacies. The Department also encourages insurers to cover refills even when the scheduled refill date has not been reached (although that recommendation does not apply to opioids).

Notice Number 2020-03 applies directly to carriers, but is an important reminder on coverage of COVID-19-relates services and items.

Notice Number 2020-03 »