Prepare Plans for Pandemic’s End
April 28, 2023
Anticipated Pandemic End:
May 11, 2023
Summary:
The Centers for Medicare and Medicaid Services (CMS) issued a fact sheet with considerations for individuals respecting their health insurance (Medicare, Medicaid, and Private Insurance) as relates to the cessation of the COVID-19 public health emergency (PHE). The fact sheet addresses:
- COVID-19 vaccines, testing, and treatments
- Telehealth services
- Health care access
- Continuing flexibilities for health care professionals; and
- Inpatient hospital care at home.
Employer Application
Education to employees will be essential in supporting a smooth transition as deadlines expire. Consider sharing the CMS Fact Sheet as the target audience is plan participants.
The Department of Health and Human Services (HHS) created a Road Map webpage for additional details on what will and will not be affected by the pandemic’s end date.
Two notes on private insurance
- Most plans will continue coverage of COVID-19 vaccines without cost sharing for in-network providers. For non-grandfathered plans, this must continue due to Affordable Care Act (ACA) preventive service coverage.
- Coverage for telehealth & remote care varies by plan and will continue after the PHE. This may include cost-sharing or prior authorization.
