For the past three years, grabbing an over-the-counter or laboratory COVID-19 test has been easy, relatively quick and entirely free. But soon, some Rhode Islanders will have to start paying out of pocket for their tests.
That’s because after three years in a state of emergency, both the Rhode Island and the federal COVID-19 health emergencies are set to end on May 11, paving the way for the post-COVID reality – at least, from a legal point of view.
And while health leaders remind the public that COVID-19 will not disappear with the end of the state of emergency, the milestone will not go unnoticed. Since its adoption in March 2020, the emergency has ensured that state and private health insurers covered all costs related to the virus, from testing and treatments to vaccines.
Some of this is bound to change. Insurers in the state are choosing how to handle the end of the emergencies, and it’s bound to create some confusion.
But officials are clear: these changes will not affect vaccines or treatments.
“Vaccines are still widely accessible through the state and the state has no plans to decrease the amount of vaccines,” said Dr. Philip Chan, consultant medical director at the R.I. Department of Health, infectious disease doctor at Rhode Island Hospital and The Miriam Hospital, and professor at Brown University. “Vaccines are also widely available through pharmacies.”
Similarly, the COVID-19 treatment will continue to be accessible to the public at no cost, thanks to the federally purchased doses, said Kristine Campagna, director of community health and equity at the R.I. Department of Health, at Providence Business News’ latest Health Care Summit on April 6.
The one place people might see some changes is COVID-19 testing, which Campagna said will get “complicated.”
Complicated indeed.
Private insurers in the state will soon be able to choose whether to continue offering COVID-19 testing – both laboratory and over the counter – at no cost, or whether to start sharing costs with its members.
Blue Cross & Blue Shield of Rhode Island said its coverage of COVID-19-related costs will vary based on the plan. On top of this, employers will be able to opt out of certain benefits when giving insurance to their employees, adding another layer of uncertainty.
Starting May 12, Blue Cross will only cover the cost of over-the-counter, at-home and laboratory COVID-19 tests if they are medically necessary and prescribed by a health care provider. Similarly, coverage of COVID-19 treatments will revert to a plan’s standard benefits on May 12.
Blue Cross is the state’s largest health insurer by membership. It covers about 383,074 people and has 17,346 people directly insured, according to the Providence Business News 2023 Book of Lists.
“All Rhode Islanders should have access to high-quality, affordable health care no matter who they are or where they live, and whether or not a pandemic is ongoing,” Richard Salit, public relations manager for Blue Cross, said in a statement via email. “BCBSRI is committed to ensuring Rhode Islanders continue to have access to the coverage and care they need when the PHE [public health emergency] ends on May 11.”
Neighborhood Health Plan of Rhode Island, which covers about 220,830 people in the state, will continue to offer full coverage for in-network testing, treatment and vaccines to all of its members regardless of plan, even after the end of the federal public health emergency, said Elizabeth McClaine, vice president for commercial and Medicaid product management.
This choice was made to avoid any “potential confusion for members and administrative burden for providers.” McClaine said that Neighborhood may evaluate possible changes when it prepares for its annual enrollment cycle at the end of the year.
Tufts Health Plan, a Point32Health Services Inc. company, said it will no longer cover over-the-counter COVID-19 tests for its commercial members. It will continue to cover COVID-19 tests, treatments and services ordered by a provider, but commercial plan members will start sharing costs for these services after the end of the state-declared public health emergency.
UnitedHealthCare of New England Inc., which insures about 180,000 people in Rhode Island, could not be reached for comment.
Private insurers in the state are regulated by the R.I. Office of the Health Insurance Commissioner. Cory King, acting health insurance commissioner, said his office has been in touch with insurance carriers to coordinate the transition.
“We are instructing them concerning their ongoing obligations and our expectations that any changes to the companies’ policies and procedures, including those related to coverage, payment, billing, referral and prior authorization, are communicated to providers and consumers clearly and efficiently,” King said.
One thing that will not change is the availability of telemedicine, which has risen to popularity during the pandemic. King confirmed that insurers are required to continue providing coverage for “medically necessary and clinically appropriate services delivered via telephone-audio-only communications.” This means that services offered via telemedicine will be charged at the same – or lower – rates as the services provided in person.
Many of these changes will not apply to people insured through Medicaid. The state confirmed that they will continue to have access to tests, both over the counter and with a provider, through Sept. 30, 2024. This is due to a federal regulation by the Center for Medicare & Medicaid Services, which is requiring states to continue covering COVID-19 testing and treatment for Medicaid members through September 2024.
The R.I. Department of Health has posted some guidelines on its website to help people navigate the upcoming changes. According to RIDOH, people who are experiencing COVID-19 symptoms or who have been exposed can still get a free test at a Centers for Disease Control and Prevention Increasing Community Access to Testing site, where insurance is not required. People will also be able to continue requesting free at-home COVID-19 tests from the federal government while supplies last.
