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Surprise! But not the good kind

Many New York patients are getting unexpected COVID-19 testing bills, despite the state saying they have it covered. While patients are surprised, we’re not that shocked.

You got your COVID-19 vaccine. You get your COVID-19 tests as necessary. Due diligence has been served, right? Well, don’t look behind you—here come the COVID-19 testing bills (and collection agencies).

Per a Modern Healthcare article, New Yorkers are receiving surprise medical bills. And this isn’t petty change—some of these bills are as high as a few hundred dollars for COVID-19 tests. And we get it, lab tests cost money, but New Yorkers are upset (and rightly so) because they feel misled after state and federal regulations stated that they would cover the cost of COVID-19 care.

How is this happening? Particularly at a time when testing and vaccinations are pretty much our only solution for ever getting out of this pandemic? Insurers just aren’t listening, despite how clear the rules are: NY’s Department of Financial Services says insurers may not impose copayments, coinsurance and annual deductibles for in-network diagnostic COVID-19 testing and visits to diagnose COVID-19 at an in-network provider, such as an urgent care center.

The article shares, “Aetna does not require a physician’s referral to cover COVID-19 testing. Empire Blue Cross Blue Shield, which covers 4 million New Yorkers, does, said spokeswoman Alessandra Simkin. She said a clinician must deem the test medically appropriate based on an individualized clinical assessment, even though the federal government says health plans “generally must assume” that a patient seeking a COVID-19 test reflects such an assessment.”

The NY Attorney General’s Office says they’re looking into the situation—and we’re hoping they figure it out soon, because similar trends are cropping up elsewhere. As we’ve previously reported, two large Michigan insurers are also pulling back coverage for COVID-19-related care.

Can’t say we’re surprised by any of this, but at every stage, health plans continue to astound us with their total disregard for public health and safety during this pandemic…or before it, for that matter.

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