Sacramento–Today, under the direction of Governor Gavin Newsom, the Department of Managed Health Care directed all commercial and Medi-Cal health plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the COVID-19.
This includes waiving cost-sharing for emergency room, urgent care or provider office visits when the purpose of the visit is to be screened and tested for COVID-19. The need for COVID-19 testing is based on medical necessity, a clinical determination made on a case by case basis by medical professionals.
“Californians shouldn’t have to fear a big medical bill just because they took a test for COVID-19,” said Governor Newsom. “This action means that Californians who fit the testing requirements can receive the test at no cost. We’re all in this together, and I’m grateful to those health providers who have already stepped up and heeded our call.”
Today the California Department of Insurance issued similar direction providing cost free medically necessary testing for an additional 2 million Californians. Combined these announcements ensure that 24 million more Californians are eligible to receive testing, should their health care provider deem it medically necessary.
The Department of Managed Health Care also directed health plans to increase capacity to screen and treat COVID-19 as needed to minimize further transmission by encouraging health plans to expand telehealth services and to take steps to ensure patients receive medically necessary medication if there is a shortage of a particular drug.
These orders from the Department of Managed Health Care and the Department of Insurance do not apply to individuals in self-insured health coverage products.
Also today, the California Employee Development Department announced support services to individuals affected by COVID-19 in California. Individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) can file a Disability Insurance (DI) claim.
Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) can file a Paid Family Leave (PFL) claim.
