Around the PIA Western Alliance States – Week of May 15, 2023

Oregon — To All Entities Transacting Health Insurance in Oregon; All Insurance Producers Selling Health Benefit Plan Policies: The Oregon Division of Financial Regulation has issued a bulletin regarding the end of the federal COVID-19 public health emergency.

Purpose

This bulletin: 

 Clarifies the division’s expectations regarding coverage of COVID-19 vaccines, testing, treatment, and telehealth.

 Provides information about the end of the Oregon Health Plan’s continuous Medicaid enrollment period.

 Clarifies the division’s expectations regarding Medicare Supplement Insurance Guaranteed Issue protections for people whose Medicaid is terminated due to the end of the Medicaid continuous coverage requirement.

Washington — Learn what’s covered after the COVID-19 emergency ends: The COVID-19 public health emergency ends today. This change may impact your health insurance coverage and what COVID-19-related services you need to pay for.

Vaccines

COVID-19 vaccines are considered a preventive service under the Affordable Care Act and are free, as long as supplies last. However, you must see a health provider or pharmacy in your health plan’s network.

COVID-19 tests

Most health insurers are no longer providing free at-home COVID-19 tests, but you can still get four free tests from the federal government.

You can also buy tests at a pharmacy or other retail location without a prescription. If you have Apple Health (Medicaid), at-home tests will be available for free through September 2024.

Rapid or PCR tests will be covered but you may have a copay and need to meet your deductible. Your health plan may also require you see an in-network provider. If you have traditional Medicare, tests will be free but you could be charged for the office visit. Tests will be free through September 2024 for anyone on Apple Health.

Treatment

Any prescription drug used to treat COVID-19 (Paxlovid) bought by the federal government is still free. Once the federal supply of these drugs ends, you may have copayments for any drugs used to treat COVID-19.

Telemedicine

Health insurers must still cover telemedicine the same as in-person visits for all type of care, but the ways you get telehealth may change. The federal government allowed medical providers to use additional communication tools to provider telehealth during the pandemic. Now they need to use methods that meet federal privacy standards. Ask you health plan about how you can access telehealth.

About PIA Western Alliance

The Professional Insurance Agents Western Alliance is a membership organization promoting and enhancing the success of independent agencies seeking to grow, learn and be heard within the industry.


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