The economic downturn caused by the COVID-19 pandemic has placed families in financial hardship.
Connecticut Insurance Department Commissioner Andrew N. Mais reminds insureds that all out-of-pocket cost for testing of COVID-19 has been removed for all fully insured and self-funded plans.* UPDATE: Treatment for COVID-19 is covered under all fully insured plans, including high deductible plans, and also covered under most self-funded employer-sponsored plans. Members in an employer-sponsored plan should verify with the carrier or employer specifics of their coverage for COVID-19 treatment.
“Our insurance industry here in Connecticut has answered the call and protected those most affected by our current crisis by waiving out-of-pocket expenses for COVID-19 testing and treatment for all fully insured plans,” said Commissioner Mais. “Thanks to recent changes in federal law, employer-based plan sponsors are required to follow suit and remove all cost-sharing for testing for their workers and their families. I urge all employer-based plan sponsors to follow suit and also remove financial barriers to treatment for their workers and their families.”
Department of Social Services Commissioner Deidre S. Gifford also praised the state’s insurance carriers and noted that public health coverage is also available to Connecticut residents who qualify.
“In the regular Medicaid and the Children’s Health Insurance Program, together known as HUSKY Health in Connecticut, we are fully covering COVID-19 testing and treatment without any cost-sharing,” said Commissioner Gifford.
”In addition, HUSKY Health is now covering COVID-19 testing for uninsured Connecticut residents who are U.S. citizens or have qualifying immigration status, regardless of income; and covering COVID-19 testing for residents without a qualifying immigration status if they meet HUSKY income requirements and have COVID-19 symptoms,” said Commissioner Gifford.
For more information, the public can visit www.ct.gov/husky
and www
.
The Connecticut Insurance Department regulates fully insured health insurance plans, including those with high-deductible health plans, issued in the State of Connecticut only.
Consumers should take note that there are some differences among plans and policyholders should contact their insurer or employer to provide additional information on important details.
Some employers, especially large ones, sponsor self-funded health plans that are regulated by the U.S. Department of Labor under ERISA. Those plans are now required to cover COVID-19 testing with no out-of-pocket costs due to recent changes in federal law.
The Federal Families First Coronavirus Response Act (FFCRA) and the CARES Act
The FFCRA was enacted on March 18, 2020
Group health plans and health insurance issuers offering group or individual health insurance coverage to provide benefits for certain items and services related to diagnostic testing for the detection of SARS-CoV-2 or the diagnosis of COVID-19 when those items or services are furnished on or after March 18, 2020, and during the applicable emergency period. Under the FFCRA, plans and issuers must provide this coverage without imposing any cost-sharing requirements (including deductibles, copayments, and coinsurance) or prior authorization or other medical management requirements. Plans and issuers must cover items and services furnished to an individual during visits that result in an order of, or administration of, a COVID-19 diagnostic test, but only to the extent that the items or services related to the furnishing or administration of the test or to the evaluation of such individual for purposes of determining the need of the individual for the product, as determined by the individual’s attending healthcare provider.
The CARES Act was enacted on March 27, 2020
Section 6001 of the FFCRA includes a broader range of diagnostic items and services that plans and issuers must cover without any cost-sharing requirements or prior authorization or other medical management requirements.
*Coverage for testing is for all health plans; including fully insured, and self-funded, individual, and group health plan under these Acts. It also includes private employment-based group health plans (ERISA plans), non-federal governmental plans (such as plans sponsored by states and local governments), and church plans. Consumers and policyholders should contact their insurer or employer for information on the out of pocket costs for COVID-19 treatment if any.
Consumers, insurers, and brokers with questions can contact the department directly by email at insurance@ct.gov, online, or by calling the Department at 800-203-3447 or 860-297-3900.
For the most up-to-date information from the State of Connecticut on COVID-19, including guidance and other resources, visit ct.gov/coronavirus
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