[NFBOH-Cleveland] How will COVID-19 testing, vaccines, and treatment be affected when the PHE ends May 11th?

Thu Apr 20 14:06:31 UTC 2023

How will COVID-19 testing, vaccines, and treatment be affected when the PHE
ends May 11th?

President Joe Biden signed legislation April 10th to end the National
Emergency for COVID-19. This move does not affect the end of the separate
Public

Health Emergency (PHE) scheduled for May 11th.

The Public Health Emergency (PHE) enabled the government to provide COVID-19
tests, treatments and vaccines at no charge, as well as offer enhanced
social

safety net benefits, to help the nation cope with the pandemic and minimize
its impact.

So, what does it mean for COVID-19 tests, vaccines, and treatment when the
PHE ends May 11th?

2 Covid-19 rapid antigen tests on blue background. Image by chandlervid85 on
Freepik.

COVID-19 tests

Medicaid: Free tests through September 2024. After that, coverage will
likely vary by state.

Medicare: At-home tests will no longer be free after May 11th.  With
traditional Medicare, COVID-19 PCR and antigen tests will have with no cost
sharing

when the test is ordered by a health care provider and performed by a
laboratory. Medicare Advantage (MA) plan enrollees can continue to receive
COVID-19

PCR and antigen tests when the test is covered by Medicare, but their
cost-sharing may change when the PHE ends.

Private insurers: During the PHE, private insurers were required to provide
at-home and lab tests for COVID-19 with no cost-sharing. That requirement
ends

May 11th, but some plans may choose to continue the benefit.

Services for independent living (SIL) has COVID-19 self-tests available for
your household's use, at no-cost Contact 

Sunceraye 

at 

216-731-1529,

if you like a box of two COVID-19 self-tests for use in your household.

There's also still time to get free tests before the May 11th through the 

U.S. Postal Service

to households that haven't already received 2 shipments. 

Medicare beneficiaries are still entitled to obtain eight free tests over
the counter every 30 days until May 11th.

For old, unused tests, the expiration date on the package may have been
extended by the Food and Drug Administration (FDA). Check their 

website.

Doctor Vaccinating Patient. Image by Freepik.

COVID-19 vaccines

Medicaid: Medicaid will cover all COVID-19 vaccinations through September
2024.

Medicare: COVID-19 vaccinations will continue to be covered under Medicare
Part B without cost sharing.

Private Insurers: Because COVID-19 shots are a recommended vaccination, your
plan likely will cover the shots without a copay or other cost-sharing.
However,

this may by state and insurance company.

Blue pills on white background. Image by Racool_studio on Freepik

COVID-19 treatment

Medicaid: COVID-19 treatments, including the oral antiviral Paxlovid, will
be covered with no cost sharing through September 2024. After that, coverage

and cost will likely vary by state.

Medicare:  There should no change in Medicare coverage of treatments once
the PHE ends. In cases where cost sharing and deductibles apply now, they
will

continue to apply.

The good news is that the antiviral treatment Paxlovid will most likely
continue to be free for some time after the public health emergency expires.
"As

long as there's federal supply that the government purchased and
distributed, that will be free for anybody," says Juliette Cubanski, deputy
director of

the Program on Medicare Policy at KFF, a health policy nonprofit.

Private insurers: When current inventories of Paxlovid are exhausted after
the public health emergency ends, private insurers may ask you to pay a part

of the cost, as they do with many pharmaceuticals. Pfizer likely will hike
the price from what the government has been paying, already $530 per course

of treatment. 

For the Uninsured

In 2021, more than 27 million Americans under the age of 65 had no health
insurance, according to KFF, an independent source for health policy
research,

polling, and journalism. That number is likely to rise significantly as
Medicaid reevaluates all beneficiaries' eligibility.

As of late March, an average of 2,370 people with COVID-19 were being
admitted to U.S. hospitals each day, according to the Centers for Disease
Control

and Prevention (CDC).  KFF reports the average cost of a COVID-19
hospitalization in 2020 was $41,611.  People without insurance or support
from other

safety-net programs will be responsible for the full costs of COVID testing,
vaccines and treatments.

It is vital for everyone to try to find a way to afford health insurance,
whether it's through a 

private plan,

Medicaid,

or 

Medicare.

Resources

Laughlin. (2023, January 31). What does the end of the pandemic public
health emergency mean for you. The Philadelphia Inquirer. Retrieved April
17, 2023,

from 

https://www.wcpo.com/news/national/what-happens-to-covid-testing-when-the-pu
blic-health-emergency-ends

Rodriguez. (2023, February 4). The COVID emergency declaration is ending:
What it means for tests, vaccines, treatment. USA TODAY. Retrieved April 17,

2023, from 

https://www.usatoday.com/story/news/health/2023/02/04/covid-emergency-declar
ation-ends-effects-vaccines-tests/11169642002/

Rossheim, J. (2023, April 14). The Health Emergency Is Ending. Will COVID
Costs Be Covered? SFGATE. Retrieved April 17, 2023, from 

https://www.sfgate.com/business/personalfinance/article/the-health-emergency
-is-ending-will-covid-costs-17897997.php

What happens to COVID testing when the public health emergency ends? (2023,
April 11). The Associated Press. Retrieved April 17, 2023, from 

https://www.wcpo.com/news/national/what-happens-to-covid-testing-when-the-pu
blic-health-emergency-ends

CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19
Public Health Emergency. (2023, February 27). Centers for Medicare &
Medicaid

Services. Retrieved April 18, 2023, from 

https://www.cms.gov/newsroom/fact-sheets/cms-waivers-flexibilities-and-trans
ition-forward-covid-19-public-health-emergency

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Services for Independent Living

26250 Euclid Avenue, Suite 801

Cleveland, Ohio 44132 United States

216.731.1529

info at sil-oh.org

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