In January 2020, a public health emergency (PHE) was declared by the Secretary of the Department of Health and Human Services in response to the COVID-19 pandemic. Since that time, the PHE has been renewed several times, but it is now scheduled to expire on May 11, 2023.
Here is some information and resources to help understand how the end of the PHE may impact your health plan coverage.
Many coverage provisions were broadened, relaxed, or impacted in other ways during the COVID-19 pandemic to provide greater access to certain services. With a return to pre-pandemic healthcare practices, it’s important for healthcare consumers to stay informed about regulations and policies that may impact their access to and coverage of services. As always, it is always best to understand and/or verify coverage and benefit limitations BEFORE receiving services.
The COVID-19 National Emergency (different from the Public Health Emergency) included a regulatory tolling period for individuals to report or file for HIPAA special enrollments, COBRA events, and claims/appeals. A tolling period is, essentially, a period of time in which days or time is not counted, meaning time limits for these activities or events were extended or relaxed during the National Emergency. The National Emergency ended on April 10, 2023; however, the Department of Labor has informally determined that the tolling periods will continue up to, and including, July 10, 2023. After that time, these provisions and qualifications revert back to what they were pre-COVID.”
Coverage for the COVID-19 vaccine will move under your preventive benefit. This means that you would have zero out-of-pocket costs for the COVID vaccine, when administered by a provider in your network. If the vaccine was received at an out-of-network location, out-of-network charges would apply.
Testing and treatment for COVID-19 will be covered under the terms of your benefit plan. You will now have to pay your plan’s cost share for these services, and you will also have to see a provider in your network for these services to be paid at in-network rates.
During the pandemic, PHP waived fees related to using our telehealth service, Parkview OnDemand. We will continue to offer Parkview OnDemand to members at no cost share for members.
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