Is Coronavirus Testing Covered by My High Deductible Health Plan?
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30 sec brief
Discover how COVID-19 testing and treatment are covered by your HDHP.
Since the United States’ first case of COVID-19 on January 20, 2020, there has been speculation as to whether testing and the cost of treatment for COVID-19 would be covered by health insurance. Specifically, would High Deductible Health Plans (HDHPs) cover COVID-19 testing and treatment pre-deductible?
We have gathered the latest updates that may impact Health Savings Account (HSA) account holders here and will continue to keep this post updated with any related IRS or legislative updates (last updated: March 11, 2020).
What is COVID-19 (Novel Coronavirus)?
According to the Centers for Disease Control and Prevention (CDC), “a novel (new) coronavirus was first detected in China and is now detected in more than 100 locations internationally, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”). As of March 11, 2020, the World Health Organization (WHO) has characterized it as a pandemic. Read the Coronavirus Disease 2019 (COVID-19) Situation Summary.
How Can I Get Tested?
According to the CDC, current symptoms reported for patients with COVID-19 include mild to severe respiratory illness, accompanied by a fever, cough, and difficulty breathing between two and 14 days after exposure. Learn more about the COVID-19 symptoms from the CDC.
If you think that you have COVID-19 and would like to be tested, first, contact your healthcare provider by phone. They will provide the best next steps, which may include testing for COVID-19. If your healthcare provider thinks you may have COVID-19, they will contact the CDC or the local health department with instructions on testing. This may include visiting a special lab for the test since only select labs are allowed to administer COVID-19 testing.
What is the COVID-19 Test?
Most commonly, the COVID-19 is tested via a swab test of the nose and throat, but there are other methods. Here are the ways that COVID-19 testing is currently being administered:
- Swab sample: from the nose and throat
- Nasal aspirate: A saline solution injected into the nose, then gently suctioned
- Tracheal aspirate: Sample from the lungs via a tube down your mouth
- Sputum test: Cough up sputum into a testing cup or swabbed from the nose
- Blood sample
Is it Covered by My Insurance?
With increased COVID-19 testing and confirmed cases growing, Americans with High-Deductible Health Plans (HDHPs) are worried they’ll face high out-of-pocket costs from deductibles, copays, or coinsurance as a result of the virus. Effective March 11th, IRS Notice 2020-15 has clarified this, as it relates to HDHPs.
The notice sets out to “(remove) barriers to testing for and treatment of COVID-19” and “(provide) flexibility to HDHPs to provide health benefits for testing and treatment of COVID-19 without application of a deductible or cost-sharing.”
Under the revised IRS provision, HDHPs otherwise qualified as HSA-eligible plans will not lose their status as HSA-eligible by adding coverage of testing and treatment of COVID-19:
“Internal Revenue Code (Code) will not fail to be an HDHP under section 223(c)(2)(A) merely because the health plan provides health benefits associated with testing for and treatment of COVID-19 without a deductible, or with a deductible below the minimum deductible (self-only or family) for an HDHP. Therefore, an individual covered by the HDHP will not be disqualified from being an eligible individual under section 223(c)(1) who may make tax-favored contributions to a health savings account (HSA).”
Therefore, HDHPs can cover COVID-19 testing and treatment pre-deductible.
What can I pay for with my HSA?
The testing and treatment of COVID-19 are considered eligible medical expenses per IRS Notice 2020-15. Therefore, you can use your tax-preferred Health Savings Account (HSA) funds to pay for expenses incurred for these purposes.
The actual cost of the testing and treatment is determined by your health plan, including the amount and format (e.g. co-payment, one-time fee, free). Be sure to consult your health plan carrier for accurate cost information. The costs, if any, to the member may count towards reaching your deductible maximum. Similarly, if you have not yet reached your out-of-pocket maximum, these costs may count towards reaching your out-of-pocket maximum.
See the full list of qualified expenses you can pay for with your HSA.
Where should I go If I have more questions about COVID-19?
The CDC is constantly providing the public with up-to-date information about the COVID-19 situation as it evolves. Stay current with the CDC’s updates regarding COVID-19.
If you’re looking for more information about whether or not your health plan covers any COVID-19 testing or treatment, contact your health plan provider directly.
Additional Resources on COVID-19
Header Image Source: CDC Tests for COVID-19
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