While insurance companies in some states no longer pay for COVID treatment without co-payment for customers, Vermont still requires companies to pay for treatment and testing at no cost.
An article published in the Washington Post on September 18 said many insurers are reinstating co-payments and deductibles that were canceled in 2020.
âIf you’re lucky enough to live in Vermont or New Mexico, for example, state warrants require insurance companies to cover 100% of the treatment. But most Americans with COVID are now exposed to the uncertainty, confusion, and expense of standard medical billing and insurance practices – reaching out to people with cancer, diabetes and other serious illnesses and expensive, âthe article says.
Michael Pieciak, commissioner for the Vermont Department of Financial Regulation, said that in any matter where the state has the ability to regulate, Vermont always requires COVID-19 treatment to be provided without any outlay.
“If we didn’t and someone hadn’t hit their deductible or had no healthcare-related expenses that year, then they might be forced to pay no matter how much. its frankness, âhe said.
Pieciak pointed out that it is increasingly common for health care plans to have a high deductible.
âWhat we wanted to do was eliminate any financial burden or financial deterrent for Vermonters to go for treatment if they suspected or had a positive test for COVID-19. If you get it, get treatment sooner, âhe said. âOur theory, and I think it holds true in other situations, is that your course of care is a better progression, your health is better and because they are able to intervene earlier, it is it is also less expensive. It makes sense from a health policy perspective and we think it makes sense from a financial perspective as well. “
Testing coverage in Vermont also includes other respiratory tests such as the flu.
Pieciak said that in March 2020, after Governor Phil Scott declared a state of emergency due to the pandemic, the administration was able to set up free tests that were seen as a way to contain the spread. virus. People who knew they had COVID could quarantine and share their contacts to track the virus.
But Pieciak said the legislature was a “great partner” in establishing the requirement from April 2020 that insurers cover the cost of treatment. The coverage policy for treatment with no co-pay or deductible extends until March, but Pieciak said it would be possible to extend that time frame, if necessary.
The Washington Post article notes that insurers still routinely cover the costs of tests and vaccinations.
Nissa James, director of health care for the Department of Vermont Health Access, said Vermont Medicaid was able to quickly eliminate two of its rare services that required user fees, inpatient outpatient services and pharmacy drugs, this which eliminated user fees on drugs that could be used to treat COVID.
âTogether, these changes ensured that no co-payments would apply to COVID-19 testing, diagnostic or treatment services for Vermont Medicaid members,â she said.
James said one of the reasons this was important was because state and federal health officials recognize the importance of COVID testing in mitigating the spread of the virus. For some who rely on Vermont Medicaid, co-payment for testing could be a barrier, James said.
âIt was important to reassure Vermont Medicaid members that Vermont Medicaid is required to cover testing for SARS-CoV-2, which is the virus that causes COVID-19, and diagnostic testing for COVID-19 and it was inclusive. of all in vitro diagnostic tests that have received emergency use authorization, âshe said.
Devon Green, vice president of government relations for the Vermont Association of Hospitals and Health Systems, said she considers it “truly admirable” that Vermont maintains a policy that COVID treatment is covered “especially when this is does not occur in other states “.
Green said the policy provides support to hospitals in Vermont because when a patient is unable to pay, the financial burden usually falls on the hospital.
“This both provides the extra coverage which is useful for hospitals, especially at a time of uncertain resources, and also prompts people to seek treatment, to treat this sooner rather than procrastinating problems. money or affordability, âshe said. .
Pieciak said state officials believed the requirement was fair because insurance companies had saved money during the pandemic when hospitals couldn’t perform non-essential procedures and, therefore, they had less spending to cover patients who postponed health care to comply with hospital restrictions or because they were reluctant to leave home.
âWe were one of the first states to walk out the door on all of these issues. We thought it was really essential to financially support Vermonters so that they are not financially overburdened, âhe said.
patrick.mcardle @ rutlandherald.com