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What does COVID-19 mean for your healthcare?

As COVID-19 changes the way we all live, we continue to receive questions about what it means for your healthcare. We gathered our experts to get you answers.

What does job loss or furlough mean for my benefits?

This will work like any other termination, and you’ll be offered COBRA. Your benefits administrator has to send you an election notice letting you know that you have the right to choose COBRA coverage when they learn about your qualifying event (when you become ineligible to receive employer health benefits). You’ll then have 60 days to inform the administrator whether or not you want to continue insurance coverage through COBRA. You will have to pay the full premium at the employer-negotiated group rate, which is typically less expensive than it would be to buy an individual policy on the open market.
If you become ineligible to receive an employer's health insurance benefits - which can happen for a variety of reasons (such as getting laid off or falling below a minimum threshold number of hours worked per week), the employer may stop paying its share of the employee's health insurance premiums. In that case, COBRA allows an employee and their dependents to retain the same health insurance coverage for a limited period of time, provided they are willing to pay for it on their own. In this circumstance, COBRA will last 18 months.
This depends on your insurance. If an active, enrolled employee working 30 hours or more per week as of March 1, 2020 is furloughed or has hours reduced below 30 hours per week, some major insurers will agree, at the request of the employer, to allow the employee to remain on the plan for the duration of the extended relief period as long as fee or premium payments are made. The changes to eligibility would typically be available for all funding types. Clients may have to confirm that the employees who remain on the plan through these relaxed eligibility guidelines were active and covered by the plan as of March 1, 2020. The extended relief period likely starts on or around March 16, 2020 and goes through May 31, 2020.

I lost my insurance. How do I get care?

It’s hard enough having to pay entirely out of pocket for your medical care normally, let alone during a pandemic. But don’t give up on your health. You deserve the same quality healthcare as anyone else, regardless of how you pay.

Here are a few ideas to help you save:

1. Don’t Procrastinate.

Putting off routine care can lead to even more costly emergency treatment for potentially life-threatening conditions. Right now, most doctors and hospitals are postponing non-essential services, but that won’t be the case forever. Once providers go back to business as usual, get into a regular schedule with a doctor you trust.

2. Shop Around.

The days of hidden healthcare costs are gone. Get ready to Google! You have choices when researching good deals in your local area:

Online healthcare marketplaces like MDsave show you the complete price upfront for your procedure, including the most commonly related fees, and let you buy your procedure beforehand, so all you need at the doctor’s office is a voucher. It’s just like booking a flight online.

An important feature of online healthcare marketplaces is that they bundle all the parts of your service into one price. You can’t know if you can afford something if you only see one part of the total cost. Even something as simple as an x-ray is going to have multiple fees for the scan and the radiologist’s interpretation.

Transparency Websites like Healthcare Bluebook help you find fair prices in your city or state. You can use these numbers to help you negotiate fair self-pay rates. Be sure to double-check the Fair Price Fee Details to see if the price listed includes fees for any of the related services.

3. Negotiate.

If you can’t pre-purchase a procedure through a marketplace, be upfront with your doctor’s office about paying out of pocket. Ask them for their self-pay or cash-pay rate, and don’t be afraid to ask about pay over time options if you can’t float the full amount at once.

1. Try MDsave Rx.

MDsave Rx is our own pharmacy discount program. You can print out your card for free and use it to get discounts on out-of-pocket prescriptions at more than 56,000 pharmacies.

2. Compare Pharmacy Prices.

Check out GoodRx* before you fill your next prescription. They show you the price of the same medicine at different pharmacies in your area, so you don’t have to pay more for the same drug. GoodRx also offers coupons and includes information on manufacturer assistance programs where applicable.

*We aren’t partners or sponsors of GoodRx—we just think they offer a great service.

3. Go Generic.

Also consider getting the generic version of your prescription. Your doctor will specify if you need a name brand – otherwise, you can save money by going generic. Generics are cheaper for you and your insurer, and many insurance companies will cover more of the cost of a generic than a name brand.

Ask for the self-pay or cash-pay rate when you schedule or check in for your appointment. If the amount is more than you can float, don’t be afraid to ask about pay-over-time options, too.

Most providers are willing to offer lower prices to cash payers and avoid the headache of insurance claims. After all, they’d rather get paid what you can afford than not get paid at all!

What COVID-19 costs will my insurance cover?

Many insurance companies have waived cost-sharing for coronavirus testing and treatment—many including deductibles, copays, and coinsurances. Find your insurer on this list from America's Health Insurance Plans to see their special arrangements for COVID-19. Pay special attention to whether or not you have to go to in-network hospitals to have your cost-sharing waived.
Many insurance companies are waiving deductibles and other forms of cost-sharing for testing and inpatient treatment of COVID-19. Check this list from America's Health Insurance Plans to see how your insurance is handling deductibles. Pay special attention to whether or not you need to stay in-network for the waived fees to apply.

Testing

If your doctor or healthcare provider has ordered a coronavirus test, Medicare Part B and Medicaid will both cover COVID-19 testing with no out-of-pocket costs.

Treatment

Medicare Part A will cover all medically necessary hospitalizations. If you don’t have supplemental benefits and you haven’t met your $1,408 deductible, you may be charged the remainder of your deductible. There’s a $0 coinsurance for days 1-60 of your hospitalization.

Medicaid typically has low cost sharing but it varies by state. Check your state’s Medicaid website for specific coverage.

Under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), all health plans, whether private, governmental or church plans are required to cover COVID-19 testing without cost-sharing. This applies to all types of group health plans as well, including PPO, HMO, high deductible health plans, and even minimum essential coverage plans. However, this does not extend to treatment. The testing includes FDA-approved tests, tests that are being fast-tracked by the FDA and pending approval, tests for which the manufacturer says they intend to seek FDA approval, state-developed tests from states that have notified the U.S. government that they are reviewing potential tests, and other tests approved by the federal government.
Under the CARES Act, all health plans, whether private, governmental or church plans are required to cover U.S.-government approved measures to prevent COVID-19, including vaccines, without cost sharing. This applies to all types of group health plans as well, including PPO, HMO, high deductible health plans, and even minimum essential coverage plans.

As soon as a person has been declared by their doctor that they cannot perform 2 of the 6 activities of daily living, they will be able to utilize their long term care insurance. COVID-19 does not interfere with the benefits of long term care insurance. Depending on the type of long term care insurance a person may have, it is important to understand the benefits and what will be covered in the policy. We would recommend calling the long term care insurance provider with your advisory team to learn about these benefits and any exclusions these policies might hold.

Answer provided by Lighthouse Wealth Group.

The simple answer is yes. If a person was to be diagnosed with COVID-19 and they can no longer work for a period of time, short term disability could be awarded. This is a scenario where it would be good for the person and his or her advisory team to call the insurance provider and ask these critical questions. Every insurance company has different literature written in their policies.

Answer provided by Lighthouse Wealth Group.

Every client's financial situation is different. When it comes to current cash flow and how to pay for certain expenses such as medical bills, it is always a good idea to look at the big picture before liquidating from a retirement account. In certain cases it could be beneficial to use cash, such as an emergency fund, to pay for medical bills when the market is down like it is. This helps preserve the retirement assets and a client can always replenish his or her savings when the market starts to increase again.

In other cases, retirement assets might be the only source of funds to pay for medical bills. It is important that the advisory team withholds the appropriate amount for state and federal taxes so the client is not surprised in the following year with a tax bill. It’s also crucial to understand that there could be additional penalties due to age restrictions when it comes to withdrawing from retirement accounts. These are conversations that are imperative to have with a financial advisor to make sure the person is using the right account to pay for certain expenses.

Answer provided by Lighthouse Wealth Group.

Yes, life insurance will be paid out if a person owns a policy and passes away due to COVID-19. This would be similar if a person was to pass away due to a car accident, health issues or natural causes. There is no exclusion for a person passing away due to an healthcare epidemic such as COVID-19. With that being said, all life insurance companies use different literature. It is important for clients to collaborate with their advisors and schedule a conference call with their insurance provider to review these details for peace of mind.

Answer provided by Lighthouse Wealth Group.

How do I get virtual care during the pandemic?

Telemedicine is a way for you to meet your doctor virtually using telecommunication technology. Your doctor can diagnose and treat you from a distance without you having to step foot in their office. Ask your healthcare provider if they offer this service—all you need is a smartphone or laptop. Your provider will give you specific instructions to use their telemedicine platform.

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