Covid tests and treatments may no longer be free for everyone after the federal government’s emergency declarations end in May. But most people still won’t have to pay for Covid vaccines, according to two reports published In the past week by KFF, a nonprofit health think tank.
The White House announced Monday that it would let national and public health emergencies related to the Covid pandemic expire on May 11. The first has been in force since March 2020 and the second since January 2020.
That will end some of the federal rules that eased consumer costs, for example, the requirement that insurance companies cover eight home Covid tests a month. However, other laws, such as the Affordable Care Act, ensure that vaccines will remain free for people with insurance.
The Department of Health and Human Services did not respond to a request for comment on how various coronavirus-related costs will change after May 11.
These are some of the expected changes, according to KFF.
Insurance will no longer have to cover home tests
Since early 2022, the Biden administration has required private insurers and state health insurance a cover up to eight home tests per month.
But once the public health emergency is over, most people with private insurance will most likely have to pay for such tests out of pocket, unless the kits come from the dwindling federal supply, the author said. of the two reports, Jennifer Kates, Senior Vice President. KFF President.
«For the most part, health plans probably won’t cover it. Some might, but most won’t,» Kates said.
People with Medicare and those without insurance will also likely be charged for home tests. However, some people with Medicare Advantage, which covers additional services, can still get covered home tests under their plans.
Under the American Rescue Plan Act, people with Medicaid can get free home tests for about a year after the public health emergency ends. After that, home testing coverage will vary by state.
The Biden administration has not indicated any plans to send more free home tests beyond those currently offered.
PCR testing costs will vary depending on the situation.
Most private insurers will continue to cover the cost of PCR, or lab tests, administered by in-network providers. But those insurers can require physician orders, limit the number of tests covered per person, charge for doctor visits or make tests subject to copays or deductibles, according to KFF.
Medicare will continue to cover PCR tests, but people with Medicare Advantage may incur costs.
People without insurance will most likely have to pay for PCR tests, unless the tests were originally purchased by the federal government or are administered free of charge through a clinic or community health center.
Paxlovid and other antiviral treatments will eventually cost money
Oral antivirals purchased by the federal government will remain free to all until the national supply runs out, regardless of when the public health emergency ends. That includes Paxlovid, the gold standard treatment for people with mild to moderate covid at high risk of severe disease.
But once the supply runs out, most people, including those with private insurance or Medicare, will probably be billed for the pills according to their plans.
People with Medicare Part D, which helps cover the cost of prescription drugs, can get Paxlovid for free through December 2024, Kates said.
Most people will continue to receive vaccines at no cost
Covid vaccines and boosters will continue to be free for people with Medicare, Medicaid and private insurance. However, depending on their plans, some people with private insurance may still be billed if they get vaccinated through out-of-network providers.
Uninsured adults won’t have to pay for federally purchased covid vaccines, because there are still doses in the federal supply. But once those doses are used up, they will most likely be charged.
«Unless it’s a federally purchased vaccine, treatment or test, people without insurance don’t have any guarantee of coverage,» Kates said.
Uninsured children will still be eligible for free Covid vaccines through the Centers for Disease Control and Prevention. Vaccines for Children Program. However, their families may be charged for office visits.
President Joe Biden’s 2023 budget includes funds to create a «Vaccines for Adults» program modeled after that for children. If completed, the program would cover the cost of all recommended immunizations for the uninsured; there is no timeline for that yet.