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.
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.
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.
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.
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.