How Does the Ending of the COVID-19 Public Emergency Affect Group Medical Insurance Plans?

The COVID-19 pandemic led to a National Emergency period, or NE declaration, in March 2020. Along with that came the Public Health Emergency, or PHE. The NE gave the federal government the ability to take blanket measures to prop up the healthcare system, federal healthcare plans, and the welfare system in the face of the outbreak. Now, just over three years later, President Biden has called an end to the Public Health Emergency, effective May 11, 2023. When the national crisis expires, so will the emergency legislative actions associated with the pandemic, including those affecting private medical insurance.

The Impact of the Pandemic on Medical Insurance

After the proclamation took effect in 2020, Congress implemented numerous legislative measures to deal with the economic and health impacts caused by COVID-19. How did the pandemic affect group medical insurance plans? The most notable effect was in provisions for covering vaccines, testing, and treatments, including:

• Testing: The cost of COVID-19 tests and any services related to providing testing. Insurance companies could not require prior authorization or cost sharing.
• Home testing: When home tests became available in 2022, insurers had to pay for up to eight over-the-counter tests for free each month to each person covered under medical insurance plans. They could not require prior authorization for prescriptions.
• Out-of-network testing: Medical insurance companies had to reimburse out-of-network providers for giving a covered individual a COVID-19 test and for any services related to the testing.
• Vaccinations: The emergency declaration required insurers to cover vaccination administration for free, with no cost-sharing stipulation. When a covered individual received a vaccination from an out-of-network provider, the insurance company had to reimburse the provider for administering the vaccine. The Medicare reimbursement rate was the minimum reimbursement amount required.
• COBRA: The other impact on group medical insurance providers was mandated extensions for enrollment deadlines in a medical insurance plan or COBRA continuation. The emergency declaration also required extensions in claims filing deadlines.
• Telehealth:  Rules around telehealth were relaxed during the COVID pandemic, like who providers can see under what circumstances, whether you can see new patients or patients who are out of state, what platforms you can use for telehealth, etc. In the absence of a PHE, the rules governing telehealth before the pandemic will go back into effect. Your healthcare provider may continue offering telehealth appointments but may restrict them to only certain kinds of circumstances.  

The bottom line is the costs that were being borne by the federal government during the PHE are now going to be borne by insurance companies and you. The prices charged for vaccination, testing, and treatment will go up. The end of the National Emergency/Public Health Emergency will impact everybody. 

If you have questions about how your medical insurance plan will change after May 11, 2023, check with your plan administrator or call the customer service line for your insurance carrier. 

Even though the threat from COVID-19 may have lessened to some extent, protecting yourself against COVID-19 infection remains as important as ever.  

About Rooney Insurance Agency

Rooney Insurance Agency, established in Tulsa, Oklahoma in 1960, has provided customized business and personal insurance and employee benefits solutions to individuals and businesses in the state of Oklahoma and throughout the United States. We work to ensure that each client’s insurance coverage fits their specific needs, addresses their key risks, and protects their valuable assets. For more information on how we can help you today, contact us at (918) 582-0565.

---