California directs some health insurers to waive co-pays, deductibles for coronavirus tests

Sophia Bollag, Wes Venteicher

Gov. Gavin Newsom’s administration and California’s top insurance official issued orders Thursday making coronavirus tests free for about 24 million Californians if doctors decide they are medically necessary, according to a news release.

The departments of Insurance and Managed Health Care directed commercial and Medi-Cal plans to waive co-pays and deductibles for medically necessary tests for COVID-19, the illness caused by the coronavirus spreading through the state.

California Insurance Commissioner Ricardo Lara on Thursday also directed insurers regulated by his office to waive testing fees.

The new insurance rules come a day after Newsom declared a state of emergency over the coronavirus and the first person in California died after testing positive for the virus. Sixty people had tested positive for the virus in California as of Thursday morning and about 9,400 people in the state were being monitored for signs of the disease after traveling internationally, according to state health officials.

The Department of Public Health estimates the insurance change will apply to about 24 million Californians.

Newsom expressed concern earlier this week that high prices associated with the test, in some cases reaching thousands of dollars, would deter potentially sick people from getting tested.

Health insurers in California will comply with the new directives from the Newsom administration, said Mary Ellen Grant, spokeswoman for the California Association of Health Plans.

“It is consistent with actions that many plans were already taking at the state and federal level,” she said in a written statement. “It is crucial that those who are identified as needing testing and treatment are able to access those services.”

The directives do not apply to people who work at large companies and get their insurance through work under “self-insured” health plans, according to a news release from the department.

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“Californians shouldn’t have to fear a big medical bill just because they took a test for COVID-19,” Newsom said in a written statement. “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.”

The orders also make clear that insurers can’t send “surprise,” or “balance” bills to patients related to coronavirus treatment. Insurers sometimes send the surprise bills to patients who get treatment from a doctor who isn’t in the insurance plan’s network.

The person who died Thursday had traveled on a cruise ship, the Grand Princess, which is currently being held offshore near San Francisco as officials work to determine whether any of the 2,500 people aboard have the virus.

The Department of Public Health flew coronavirus test kits to the ship Thursday.