Wednesday, May 18, 2022

Colorado requires some insurers to waive virus test fees

by The Associated Press
| March 9, 2020 6:37 PM

DENVER (AP) — Gov. Jared Polis announced Monday that Colorado will require health insurance companies it regulates to fully cover testing, under certain conditions, for the new coronavirus.

Colorado’s Division of Insurance will order those insurers to waive copays, deductibles and coinsurance payments for insured citizens seeking testing for the virus.

The waivers apply only to covered people who have been in close contact with others who have tested positive for the virus and have shown symptoms of lower respiratory illness.

Also eligible are covered people with symptoms who have traveled to areas where infection rates are high and patients hospitalized with severe respiratory illnesses that have not been linked to the new virus.

The new regulations do not apply to self-funded employer health insurance plans, which are regulated by the federal government.

Polis’ action came as Colorado announced new positive tests for the coronavirus, bringing the in-state total to at least 11.

They include an Eagle County woman in her 70s with a recent history of U.S. travel; a Larimer County woman in her 50s diagnosed with pneumonia, whose case remains under investigation; and a Denver County woman in her 30s with no known contact with an infected person and no recent travel history.

Officials are awaiting further test results for a Denver County woman in her 70s with a recent U.S. travel history.

The flu-like viral illness causes only mild or moderate symptoms for most people. But like the flu, it also can cause pneumonia.

Insurance Commissioner Michael Conway is working with insurers on implementing the new rules, which are expected by next week, said division spokesman Vincent Plywell.

Included are individual market plans sold on and off Colorado’s health insurance exchange, as well as small and large group employer plans regulated by the division.

The new rules are designed to ensure that covered people seeking testing at doctors' offices, urgent care centers or emergency rooms are not responsible for additional co-pays, deductibles or coinsurance.

If in-network providers cannot do the testing, insurance companies must cover testing by out-of-network providers, Plymell said.

The rules also mandate no excessive fees for consumers seeking one-time refills of non-opioid prescription medications if they are isolated or quarantined.