As Californians adjust to new public health safeguards in response to the COVID-19 pandemic, Health Access would like to make sure we share practical advice for consumers and proposals for policymakers on care and coverage options. We know things are changing fast so we will update you with information as it comes. The State of California has recently created a website with more health care information surrounding the Coronavirus which can be found here: https://www.covid19.ca.gov/healthcare
Regardless of your health insurance status, California is waiving all costs associated with the screening and testing of COVID-19. However, if you need follow-up or on-going treatment related to the virus, there are options for your coverage.
Health Access Factsheet: State and Federal Responses to COVID-19
IF YOU CURRENTLY HAVE COVERAGE
If you have health care coverage through an employer, Medi-Cal, Covered California, or Medicare, use it! The State of California has eliminated cost-sharing (co-pays, deductibles, or coinsurance) for all medically necessary screening and testing for COVID-19, including hospital and urgent care visits, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.
Employer coverage: Most health insurers have announced said they will waive patient cost-sharing — copays, coinsurance and deductibles — for testing. And some, such as Kaiser, Cigna and Humana, have gone farther by eliminating cost-sharing for all COVID-19 treatment as well. More information on what each health insurer is doing here.
Covered California: If you have coverage through Covered California and experience a change of income, you may qualify for more financial help to lower the the cost of your coverage. Consumers can report an income change by logging in to their account at CoveredCA.com.
Medi-Cal: California has also announced that if you are on Medi-Cal, all COVID-19 emergency treatment would be covered as well, whether it took place in a hospital or a community clinic.
The State is also seeking the expanded use of telehealth services to help those who may not be able to see a doctor in person.
- Department of Health Care Services (DHCS) All-County Letter: Enrollment and Redeterminations Reminders During a Public Health Crisis
- DHCS: Coverage of Emergency COVID-19 Inpatient or Outpatient Services
- Health Access Blog: New DHCS Guidance Covers Emergency COVID-19 Treatment For All Medi-Cal Enrollees
IF YOU ARE UNINSURED OR BECOME UNINSURED
Many people in the hospitality, arts and entertainment, restaurant, retail, and other sectors are finding themselves without a job or otherwise losing coverage—but there are options like Medi-Cal and Covered California that can help. Many Californians who were already uninsured are eligible but unaware they qualify for Medi-Cal, or Covered California, or for county-based programs. For those who are uninsured, our patchwork system is problematic, but it can be navigated to find a public program, county safety-net services, a community clinic, or a hospital charity care program that can help connect you with the care you need. In this public health crisis, Californians should not let their insurance status get in the way of getting needed testing or treatment.
The new Federal CARES Act may affect you income levels and eligibility for these programs if you qualify for unemployment insurance. Read more in this Health Access Blog: How the Federal CARES Act May Affect Your Health Coverage
Medi-Cal is a lifeline not just for the currently 13 million Californians with low or no income, but for those who may lose income and coverage in the coming months. Medi-Cal enrollment is open year-round and we encourage those eligible to sign-up as soon as possible.
Covered California has extended it’s enrollment season to through June 2020. For Californians not eligible for Medi-Cal with its income limits, Covered California can provide many options for affordable coverage. The costs may be lower than you thought as new state subsidies are now available to reduce premiums for Californians who make up $75,000 per year, or up to $150,000 per year for a family of four. Additional affordability assistance proposed this year would help bring more people into care with less out-of-pocket costs, prioritizing prevention in the midst of this pandemic.
IF YOU OR A FAMILY MEMBER ARE UNDOCUMENTED
Public programs should not exclude any group, including immigrants, from primary and preventive care, particularly in a public health situation like this. We will not successfully combat coronavirus if our immigrant communities are concerned about seeking needed care, getting tested, and getting a bill afterward.
If you are one of the 1 million undocumented Californians currently enrolled in “restricted scope” Medi-Cal, DHCS has announced that all COVID-19 testing and emergency related treatment will be covered for this population as well. While this is a step in the right direction, this does not replace the need for on-going, comprehensive coverage.
Currently, our Medi-Cal program covers all income-eligible children and young adults up to age 26 regardless of immigration status. In January’s state budget, Governor Newsom recommended that income-eligible seniors be included in Medi-Cal regardless of immigration status. We should accelerate that expansion to take care of our seniors, who are a high risk group that will absolutely need care and coverage at this time, for themselves and the hospitals that are serving them. Our health care system is stronger when everyone is included, getting screened, tested, and treated, as soon as possible. Learn more about our work towards #Health4All.
- California Immigrant Guide + Listos California : COVID-19 – Guidance for Immigrant Californians
- California Immigrant Policy Center (CIPC): COVID-19 Resource Guide for Immigrants in California
- California Department of Public Health (CDPH): Guidance for Immigrant Communities
- California Immigrant Youth Justice Alliance: COVID-19 resources for undocumented Californians
- Para obtener información en español, visite nuestra página de el Coronavirus 2019 (COVID-19).
Directing health plans to have zero cost sharing for screening and testing is a good first step. We hope that federally-regulated plans, including self-insured employers, follows the lead of the Department of Managed Health Care in putting patient protections in place.
California has sought to stop surprise medical bills, ensure access to medically necessary treatments in a timely manner, and more. California’s consumer protections efforts are critical, but we will need additional action at the state and federal level to ensure people have the rights to get the care they need without an unexpected bill.
This pandemic will hit certain California communities hardest. Those who are disadvantaged due to chronic health conditions, housing insecurity, age, income, immigration status, and more will need to be of greater focus in our outreach and prevention efforts. The state’s response must address health equity concerns by making sure that public health messaging includes information about affected groups and communities in languages and contexts they understand, directing additional funding to community health centers that serve disproportionately impacted communities and partnering with trusted messengers to share information.
- California LGBTQ Health and Human Services Network: COVID-19 information for the LGBTQ community
- Korean Community Center (collaborated with two other Korean American non-profits to provide limited-English proficient communities with wrap-around health and social services) Here is their Response to COVID-19
- Roots Community Health Center became a COVID-19 testing site and provides mental health, food distribution and housing services for its clients. Follow: COVID-19 for more information
- Black Women for Wellness located in Los Angeles, CA developed wellness guide for the community
PRIORITIZING PEOPLE NOW AND PREPARING FOR THE NEXT PANDEMIC
Ultimately, to prepare for the next pandemic we need a universal health system focused on prevention and public health, rather than profit. Until then:
- Congress needs to continue to act to provide the resources to both slow the spread of the coronavirus and provide the social safety net supports for those dislocated by it through both health and economic impacts.
- The Trump Administration needs to stop its legal and administrative attacks on our health system in general. The current lawsuit to invalidate the Affordable Care Act threatens to throw the health system into further chaos. Cutting or capping Medicaid, or otherwise discouraging people from getting care or coverage because of their work or immigration status, is entirely counterproductive to the public health goals of stopping the spread of this pandemic.
- California needs to continue its path to expand coverage and affordability assistance, and take other steps administratively and legislatively to ensure the access, affordability, and sustainability of our health system. Setting up systems now, from a new health payments database to new Office of Health Care Affordability, will help California have a sustainable system for the future.
It’s inspirational to see so many communities and institutions respond to this public health situation. Perhaps at no other time have so many Americans thought so much about health system capacity, as we take significant action to “flatten the curve” so our hospitals and respirators are not overwhelmed at once. As we finally start thinking of health care as a system–rather than a commodity–we should take the steps needed to strengthen that system by making it universal, sustainable, accessible, accountable, and ready for the next pandemic.