California continues to take urgent and necessary steps to fight the public health emergency created by COVID-19. Late last week, California announced new measures to provide emergency coverage for COVID-19 testing and treatment for the uninsured and some underinsured. Under this new “presumptive eligibility” guidance by the Department of Health Care Services (DHCS), uninsured and some underinsured Californians will be able to get covered under emergency Medi-Cal for COVID-19 testing and treatment.
This builds on earlier guidance from DHCS that clarified that Medi-Cal coverage for COVID-19 testing and treatment for those in restricted-scope Medi-Cal whether the emergency care takes place in inpatient or outpatient services, including hospitals or a community clinic.
This new Medi-Cal aid code will reach beyond the 13 million Californians currently enrolled in the program, to include uninsured patients who are above 138% of the poverty level and currently not eligible for the program.
It will also cover Californians who have private coverage that does not include COVID-19 emergency related treatment, although virtually all plans should. California has a waiver request to have the federal government participate in the funding, but is moving ahead regardless of the outcome of that request.
All together this means that treatment for emergencies related to COVID-19 will be covered by Medi-Cal, whether you are in the program, in “restricted scope”, uninsured, or the treatment is not covered by your current health insurance.
As millions of Californians have lost their jobs and hundreds of thousands suddenly lost their employer-based health coverage, this important step means that Californians will be able to get care they need in the midst of a global pandemic.
If we want to contain the coronavirus and emerge from this crisis, all Californians, regardless of income, insurance, or immigration status, need to be able to get tested and treated without a cost barrier. This emergency coverage will literally save a family finances if they face the hospital bills of tens of thousands of dollars for being in an ICU for a week.
The state’s emergency efforts don’t replace the need for Californians to explore their options for comprehensive, ongoing coverage. Californians need a usual source of care to discuss symptoms and preventive care before they get sick, and to address follow-up care for lung damage, and other conditions exacerbated after having this coronavirus.
We ultimately need to extend comprehensive coverage, whether to those who need more affordability assistance to buy a Covered California plan or those excluded from Medi-Cal due to immigration status, to ensure Californians are financially protected for care, providers are paid, and the public health advanced in the long-term.
Learn more about Californians’ coverage options and protections here: https://health-access.org/covid-19-resources-and-information/
Additional Resources
For additional COVID-19 information and resources, we encourage you to review the following resources:
• DHCS COVID-19 Response
• Latest news from California Department of Public Health (CDPH) about COVID19 | En Español
• Centers for Disease Control and Prevention (CDC) COVID-19 response | En
Español | 中文