Last updated on March 18th, 2020 at 12:31 pm
Insurers in Wisconsin are waiving out-of-pocket costs associated with coronavirus testing for their members.
Twelve community-based health plans recently announced they will cover, without cost-sharing or prior authorization, diagnostic laboratory testing for the virus when recommended by a provider.
The insurers, all members of the Wisconsin Association of Health Plans, include Brookfield-based Common Ground Healthcare Cooperative, Milwaukee-based Trilogy, Madison-based Care Wisconsin, Madison-based Dean Health Plan, Group Health Cooperative of Eau Claire and of South Central Wisconsin, Madison-based Health Tradition Health Plan, Janesville-based MercyCare Health Plans, Menasha-based Network Health, Sauk City-based Quartz Health Solutions, Marshfield-based Security Health Plan and Madison-based WEA Trust.
Last week, the Wisconsin Office of the Commissioner of Insurance urged health insurers to take such action to remove barriers to testing and treatment of the virus.
In addition to testing costs, Common Ground said it will cover copays, deductibles and coinsurance for in-network provider and urgent care visits that are related to testing for COVID-19.
“This is consistent with our members-first philosophy,” said Cathy Mahaffey, chief executive officer of CGHC “Besides, health insurance is supposed to take care of people when they are sick.”
CGHC is the largest issuer of ACA-compliant individual market policies in Wisconsin, with many members qualifying for tax credits so they can afford their health insurance coverage. Mahaffey said she is worried about people who are too afraid of high costs to get the help they need.
“In a situation like this, we all have to do our part to take care of one another,” she said. “These members are like our family, and we take care of family.”
Molina Healthcare of Wisconsin also is waiving costs associated with testing for the coronavirus, along with subsequent physician, urgent care or emergency department visits.
“We are diligently tracking developments concerning potential coronavirus cases in Wisconsin,” said Scott Johnson, president of Molina Healthcare of Wisconsin. “Molina is committed to ensuring our members’ tests and treatments occur as quickly as possible. We have also made the appropriate preparations to safeguard Molina members, employees, providers and partners during this time.”
UnitedHealthcare has also waived all member cost sharing, including copays, coinsurance and deductibles, for COVID-19 diagnostic testing at approved locations.
Currently, the state does not have capacity to test everyone who is worried about COVID-19. State Department of Health Services officials said Monday that individuals with mild common cold symptoms generally don’t require testing but should self-isolate. However, testing is encouraged for those with influenza symptoms.
One barrier to expanding testing capacity is simple test kits – like those used for influenza or strep throat – have not yet been approved by the Food and Drug Administration for COVID-19, so testing has been limited to certified “high complexity” labs. Current testing sites include the Wisconsin State Laboratory of Hygiene, which has ramped up its operations to test as many as 400 specimens a day, and the city of Milwaukee’s public health lab, along with a growing number of hospitals and commercial labs.
“But we’re optimistic that because of the public health emergency, those processes are being expedited and within the coming months those things will be available,” Dr. Ryan Westergaard, chief medical officer of the Bureau of Communicable Diseases for DHS, said Monday of the testing kits.
Health providers are urging people who have COVID-19 symptoms or concerns to call their provider before visiting a health care facility.