Claims Management News

Most Payers Cover Member Costs for COVID-19 Testing, Treatment

A majority of health payers are fully covering COVID-19 testing and treatment for their members, according to a new report from Insights by Xtelligent Healthcare Media.

payers cover majority of COVID-19 claims

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By Emily Sokol, MPH

- Health payers recognize the importance of COVID-19 testing and treatment to keep their members healthy and fight the pandemic. That is why a majority are covering the costs of testing and treatment fully, revealed a recent survey from Insights by Xtelligent Healthcare Media.  

For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.

Separate research has shown that out-of-pocket expenses can deter patients from seeking necessary care for a variety of diseases. But patients should not be expected to choose between seeking life-saving care and potential bankruptcy.

Coronavirus testing is critical to understand the number of patients infected, identify hotspot areas, and eventually relax stay-at-home orders.

There is no proven cure for COVID-19 yet, but treatment could be as severe as a hospitalization and use of ventilators.

It is clear that increased testing and effective treatment are essential to ending the pandemic. And many payers understand the importance of covering testing and treatment to help not only their members but also their communities at large.

Eighty percent of payers reported fully covering coronavirus testing for their members, according to the Xtelligent survey. No payers said they would not be covering coronavirus testing for their members.

Additionally, 69 percent were fully covering coronavirus treatment for their members. Only eight percent of payers have no plans to cover COVID-19 treatment for their members.

Payers appear to universally understand the importance of covering coronavirus-related care for their members. Many also felt confident about the organizational response to the pandemic.

As the goal of the survey was to understand how stakeholders across the healthcare industry were responding to the pandemic, the results highlight how these leaders were overcoming common challenges including personal protective equipment shortages, increased patient flow, increased demand for testing, the worried well, and reimbursement.

Respondents across the continuum reported being at least moderately prepared for the outbreak. Part of this has to do with an organization’s ability to roll out a disaster recovery plan. Many had the resources and a plan to flip a switch on a protocol when the coronavirus emerged. This helped build confidence among their employees in the response strategy. 

In fact, only nine percent of all respondents said their organization was not prepared for the pandemic. As protocols and best practice recommendations continue to evolve daily, it is critical that employees have trust in organization preparedness and feel they and their members are safe.

Data from the pandemic is continuing to evolve. Payers will soon be able to analyze claims data and better understand the health and financial impact of covering testing and treatment for their members.  

As this information becomes available, the healthcare industry will only gain further insight into the factors that have truly led to a successful response. But for now, industry leaders should feel assured they can implement an emergency preparedness plan their employees and members feel confident in.

Despite news coverage, many in the industry feel positively about their organization’s response to the coronavirus outbreak. A large part of that is likely driven by quick decisions from payers to cover testing and treatment for the virus.

Worried patients can access testing without concern about their ability to pay for the test. And patients with COVID-19 can focus solely on getting better instead of costly medical bills waiting for them after they recover. 

As the industry continues to battle this novel virus, it is critical payers share best practices and effective strategies to support their members. Learning from one another means that payers can unite in their response so proper care is not determined based on an individual’s insurance plan.

The Healthcare Industry's Response to COVID-19 report also highlights payer and provider preparedness for the COVID-19 outbreak, strategies for overcoming common challenges of the COVID-19 pandemic, and stakeholder opinions on the stimulus relief package. The full report can be found here