Will your insurance company cover coronavirus related medical costs?

What's covered and what's not?
Posted at 10:59 AM, May 07, 2020

TAMPA, Fla. — Event planner Penny Zarcadoolas of Palm Beach County is convinced that she had the coronavirus in February.

"I had this persistence cough for five weeks and then they gave me all sorts of medication," she said recently. "It wasn't helping. I signed up (for testing) right away because I wanted to know if that's what it was."

But before she could get the test which would let her know if she had been a carrier of the illness, Zarcadoolas was charged $75 for a telehealth screening.

"They asked you a bunch of questions, where you've been and if you've traveled out of the country, if I was symptomatic," she said. "Basically, they wanted to know why you feel you had to have the antibody test."

Then came the test, which cost her another $150 out-of-pocket.

"I thought that was expensive," she said.

She's right. In total, Penny's COVID-19 antibody testing cost her far more than a penny and it shouldn't have.

According to the federal stimulus package known as the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed by Congress in March, all comprehensive health insurance companies must cover 100% of coronavirus testing and treatment, including the new but controversial antibody tests which experts have said is not always accurate.

An additional $2 billion is being funded by the Health Resources & Services Administration (HRSA) to help cover testing and treatment costs for the uninsured.

"They're saying yes, we will cover you on anything with COVID," said Tampa-based insurance broker Bob McKnight, who also acknowledged several unknowns once the money runs out. "I've been doing this 20 years and I can't even guess what’s going to happen."

For now, comprehensive insurance carriers will also cover hospitalizations related to the COVID-19 virus and coronavirus-related telemedicine services which have skyrocketed during the COVID crisis. But McKnight expects some consumers will still find themselves being billed once medical bills from earlier this year go out in the next month or so. Typical billing timeframes are one to three months.

"I'm guessing there will be issues there like, 'Oh, that was COVID, but it wasn't coded the right way,' things like that," he said.

McKnight advises consumers to pay attention to their explanation of benefits summary which break down costs associated with any kind of medical treatment. If consumers notice issues, they should contact their insurance company and speak with a supervisor right away.

"This is new, not only to us, but for the insurance companies, so I'm sure there's a learning curve," he said.

For Penny Zarcadoolas, after spending $250 on her antibody testing and telemedicine screening, her antibody test came back positive. But a few weeks later, when she took another one as part of the process to donate her plasma, a second antibody test came back negative.

"Now that I have a negative antibody test, I don't know if that one is wrong or the first one is wrong," she said. "So now I have to do it again and pay another $225. It's crazy. I think it's crazy."