Billing and the End of COVID Public Health Emergency – Important Information
The Department of Health and Human Services has ended the federal Public Health Emergency (PHE) for COVID-19 effective May 11, 2023. The Public Health Emergency provided waivers which helped hospitals to focus on providing necessary patient care in a timely manner, including COVID-19 testing, treatment and vaccination during the health crisis. Now that the PHE has ended, we wanted to share changes that may impact your health care effective May 12, 2023.
COVID-19 Vaccines
Most private health insurers will continue to cover the cost of COVID-19 vaccines. There may be a co-pay for your vaccine. People with Medicare coverage will continue to have access to COVID-19 vaccinations without cost-sharing after the end of the PHE.
States must provide Medicaid and Childrens Health Insurance Program (CHIP) coverage without cost-sharing for COVID-19 vaccinations, and this coverage requirement will end on September 30, 2024. After that date, many Medicaid and CHIP enrollees will continue to have coverage for COVID-19 vaccinations.
COVID-19 Testing
Effective May 12, 2023, mandatory coverage for COVID-19 testing has ended. Coverage will vary depending on the health plan, and cost-sharing may apply.
Medicare patients can continue to receive COVID-19 tests with no cost-sharing when the test is ordered by a physician or certain other health care providers, such as physician assistants and certain registered nurses, and performed by a laboratory. People enrolled in Medicare Advantage (MA) plans can continue to receive COVID-19 tests when the test is covered by Medicare, but their cost-sharing may change. By law, Medicare does not generally cover over-the-counter services and tests. Access to free over the counter COVID-19 tests ended with the end of the PHE, however, some Medicare Advantage plans may continue to provide coverage as a supplemental benefit.
States must provide Medicaid and CHIP coverage without cost-sharing for COVID-19 testing. This coverage requirement will end on September 30, 2024.
The U.S. Department of Health and Human Services can help you find Community-Based Testing Sites for COVID-19.
COVID-19 Treatments
For patients with private health insurance the transition forward from the PHE will not change how treatments are covered. Cost-sharing and deductibles will apply.
There is no change in Medicare coverage of treatments for those exposed to COVID-19, and in cases where cost-sharing and deductibles apply now, they will continue to apply.
States must provide Medicaid and CHIP coverage without cost sharing for COVID-19 treatments through the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE, and this coverage requirement will end on September 30, 2024.
Uninsured Patients
If you do not have health insurance, you will need to pay out of pocket for COVID-19 vaccines, tests, and treatment. If you are unable to pay your bill in full, you may be eligible for free or low-cost health insurance through a public assistance program and/or the state's Health Safety Net program. If you wish to speak with a Patient Financial Counselor, please ask your nurse or doctor, or contact our Financial Counselors directly at 508-334-9300.
Patient Financial Counseling is open Monday through Friday, 8 am to 4:30 pm or by email. No interest payment plans are also available. Please contact our Customer Service Department at 1-800-225-8885.
Please visit UMass Memorial Health's COVID-19 Information and Resources page for more information.