Health insurers in Massachusetts will cover the full cost of testing, counseling, treatment, and vaccination for the novel coronavirus, under new instructions from the state’s division of insurance.
That means there will be no co-payments for these services, and deductibles will not be applied to them. But the insurers can check to make sure they are paying only for medically necessary services. A vaccine has not been developed but this directive will apply when one becomes available.
“Coronavirus may impose unique risks to our insurance market that Massachusetts has not faced for at least a generation,” Insurance Commissioner Gary Anderson wrote in his directive to insurers, issued Friday.
The state expects, he said, that insurers will “take all necessary steps to enable their covered members to obtain medically necessary and appropriate testing and treatment that will help fight the spread of this disease.”
The insurance division is also requiring insurers to provide dedicated help lines to answer questions about the virus, promote and fully pay for telehealth services so people won’t need to visit medical offices, “relax” requirements to obtain approval in advance for coronavirus-related services, and ease out-of-network requirements when testing or treatment is unavailable from in-network providers.
Blue Cross Blue Shield of Massachusetts, the state’s largest insurer, issued a press release Friday saying it would do everything in the insurance division’s directive, plus a little more.
Blue Cross’s help line will go beyond the state’s requirement, said spokeswoman Amy McHugh. It will operate around the clock seven days a week, with a live practitioner providing help with care and testing decisions.
Blue Cross will also give members access to early refills of 30-day prescription maintenance medications, so people can meet the public health recommendation to have enough medications on hand in case they are quarantined or other disruptions occur.
And the company has launched an online information source that includes advice on how to stay safe, a downloadable tip sheet for employers, and other resources.
“We want our members to know that we support them at this critical time,” Andrew Dreyfus, Blue Cross’s president and CEO, said in a statement. “Our members should face no barriers in getting the care they need as we face the ongoing challenge of the coronavirus.”
Lora Pellegrini, president and CEO of the Massachusetts Association of Health Plans — which represents the other health insurers in the state — said health plans were already developing voluntary measures similar to those in the insurance division’s directive.
“We think this is right for our members at this moment in time,” she said in a phone interview Saturday. “It seems like a good approach so people can get whatever they need in terms of testing.”
However, access to testing is currently very limited, and tests are offered only to those who meet certain criteria set by the state Department of Public Health. The state laboratory, the only place in Massachusetts equipped to run the tests, can do 40 to 50 a day. But private laboratories are expected to begin offering the tests eventually.
Public health officials are urging people who have symptoms to stay home and contact their doctors by phone, rather than showing up at a medical facility asking to be tested.
Pellegrini said that she doesn’t know what the tests will cost or what the financial effects of the directive will be. But if it gets expensive, the health plans can dip into their reserves.
“That’s why we have reserves,” she said.