The COVID-19 Public Health Emergency Act (PHE) ended on May 11. President Biden allowed the act to expire as planned by the Department of Health and Human Services (HHS). Now that the COVID-19 emergency act has come to a close you may wonder how it affects you.
Restructuring
The end of the COVID-19 PHE declarations changes how the federal government treats COVID-19. Instead of classifying COVID-19 as a pandemic, the federal government has classified it as an endemic (prevalent or limited in a specific region or locality).
Services That Are Affected
The end of the COVID-19 PHE will change how various agencies and private insurance companies provide access to care. For example, the Department of Veterans Affairs (VA) is returning to its requirement for in-home visits to determine eligibility for caregiver assistance. The Department of Housing and Urban Development (HUD) is ending its COVID-19 mortgage forbearance program at the end of May 2023.
Medicare and Medicaid Waivers
A combination of emergency authority waivers, regulations, and sub-regulatory guidance were installed to ensure health care providers had the flexibility necessary to provide services to people. The waivers were integrated into patient care and providers systems ensuring care and payments were protected and expanded to address the increase in demand caused by the symptoms of COVID-19.
Vaccines
Throughout the COVID-19 pandemic the federal government provided vaccines and boosters at no cost to people. The government remains dedicated to providing free vaccines and boosters as a preventative benefit. However, it is unknown how long this commitment will last. The U.S. government has a stockpile of vaccines and boosters that it can distribute. As the stockpile dwindles the federal government may not replenish its stockpile. If the federal government chooses not to continue ordering vaccines and boosters, private insurance companies will become the providers of vaccines and boosters.
Your insurance company may begin to charge you for vaccines and boosters. Why? The federal government paid approximately $20.69 per dose. Private insurance companies may pay $110 to $130 per dose. These companies may begin to charge an out-of-pocket fee to their enrollees to help them with the added cost.
Yet, even after the stockpile is gone, people in certain Medicare programs and most private insurance companies may still be able to receive vaccines and boosters at no cost. Check with your medical insurance provider to see if you qualify for no cost vaccines and boosters. Medicaid recipients will have their vaccines and boosters provided at no cost until September 30, 2024.
Treatments
Oral antibiotics and other medications approved by the U.S. Food and Drug Administration (FDA) to treat COVID-19 that were purchased by the government are still free even after the PHE ends on May 11, 2023. Like the vaccines, once the federal government runs out of its stockpile, individual insurance companies will set the out-of-pocket price for these medications.
Medicaid programs will maintain their coverage of treatments to people who are enrolled until September 30, 2024. Once the deadline passes, coverage will vary by state. Those with Medicare plans that include prescription drug coverage will not see a change; their COVID-19 medication remains at no cost.
Testing
Private insurance companies are no longer required to cover at-home or lab COVID-19 tests. The fees for testing will vary depending on your insurance provider and your plan. However, testing may be treated like preventative screening tests (blood sugar, cholesterol) because preventative screening tests are considered medically necessary.
Medicare recipients will need to check their plan to determine if they must pay for at-home tests. Doctor-ordered laboratory tests will remain free. Those who receive Medicaid will continue to receive tests at no cost until September 30,2024. After the deadline expires your state can determine if it wants to continue providing testing for free.
Telehealth
Even before the COVID-19 pandemic, telehealth was available. During the pandemic, the availability of telehealth services was expanded. Telehealth services increased access to healthcare services especially among vulnerable populations. Some services like occupational and speech therapy will return to in-person care.
To remain up to date on COVID-19 reporting or information you can visit the Centers for Disease Control and Prevention’s (CDC) website.
Christina Sisti, DPS, MPH, MS is a bioethicist and health care policy advocate. She works to create awareness and improve health care policy for those with long-term health issues.
