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Governor Newsom and Commissioner Lara Waive Consumer Cost-Sharing for COVID-19 Testing

News: 2020 Press Release

For Release: March 5, 2020
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Governor Newsom and Commissioner Lara Waive Consumer Cost-Sharing for COVID-19 Testing
Direct health insurance companies to eliminate patient cost-sharing and surprise bills

SACRAMENTO, Calif. — As Governor Gavin Newsom announced emergency steps to respond to the spread of COVID-19, Insurance Commissioner Ricardo Lara joined him in directing health insurance companies to waive costs for screening and testing of the disease to protect the public from the growing threat. The Department of Insurance has issued a bulletin to health insurance companies to encourage the public to obtain medical help if they become exposed to the illness.

“We want all Californians to know that the cost of health care should never be an obstacle to testing and treatment of COVID-19,” said Commissioner Lara. “Today, Governor Newsom and I direct health insurance companies to immediately eliminate cost-sharing on patients for medically necessary tests and associated clinic and emergency care visits without prior authorization to help us slow the spread of this disease and save lives.”

The actions announced today by both the Department of Insurance and the Department of Managed Health Care — the chief regulators of California’s commercial health coverage — include:

  • Immediately eliminating cost-sharing, including but not limited to co-pays, deductibles, and coinsurance, for medically necessary screening and testing for COVID-19 and associated hospital, emergency department, urgent care, and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19
  • Educating providers and the public that cost-sharing is waived for medically necessary COVID-19 screening and testing, and for the associated office, urgent care, or ER visits for such screening or testing
  • Reminding plans that California law requires emergency care without prior authorization, whether it is at an in-network or out-of-network hospital
  • Protecting policyholders from unlawful “balance bills” from providers related to the testing of COVID-19
  • Ensuring adequate provider networks to handle an increase in health care services, as more COVID-19 cases develop in California

Consumers with concerns or complaints about accessing care for COVID‑19 under their health insurance policy may also contact the Department’s Consumer Hotline at 1-800-927-4357 or visit Commissioner Lara and the Department of Insurance will continue to monitor the situation closely and take further actions as appropriate to ensure California’s consumers have timely access to necessary screening, testing and care.

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Media notes:

Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state’s consumers by fairly regulating the insurance industry. Under the Commissioner’s direction, the Department uses its authority to protect Californians from insurance rates that are excessive, inadequate, or unfairly discriminatory, oversee insurer solvency to pay claims, set standards for agents and broker licensing, perform market conduct reviews of insurance companies, resolve consumer complaints, and investigate and prosecute insurance fraud. Consumers are urged to call 1-800-927-4357 with any questions or contact us at via webform or online chat. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.

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