We are experiencing unprecedented times with COVID-19, and LRJ Health Solutions is here to help you navigate these unchartered waters. For many of us, COVID-19 has caused widespread concern when it comes to our health, safety, and what the future holds.  Due to the increasing economic hardship and general uncertainty for consumers, businesses, and communities, health insurance providers have responded with emergency plans to ensure the continued health and well-being of the Americans they serve.

As health insurance brokers located in the Phoenix-area, LRJ proudly serves both California and Arizona, representing more than 120 carriers.  Obviously, Arizona has made international news over the past few months for the record number of COVID cases within the state that still continue to rise, and we understand that many of our clients are worried and have questions about their health insurance coverage during this time.  We want to make sure members of individual, medicare, and group plans understand their benefits and the protections that have been put in place to help them with any out of pocket costs for COVID-related expenses.

I’m already insured; how is my insurance provider responding to COVID?

Emergency plans vary amongst providers, but generally speaking, there are three essential areas health insurance providers have been proactively addressing: Prevention, Testing, and Treatment.  Health insurance providers are devoting their resources, insights, and abilities to work with key partners – federal, state and community leaders, clinicians, pharmacies and pharmaceutical companies, medical equipment providers, and other essential partners.  

Insurance providers are committed to doing their part in helping the health and medical community combat the spread of COVID-19, and many have taken decisive action to help prevent the spread.  Amongst providers, their emergency plans reflect the belief that out-of-pocket costs should not be a barrier to people seeking testing and treatment for COVID.  As AHIP President and CEO, Matt Eyles, said following a meeting with President Trump at the White House on March 11, 2020, “No one should hesitate to see their doctor to get tested and treated for COVID-19 because of costs. Health insurance providers across the country have taken action to remove cost barriers to care.”  For your peace of mind, many have put in place proactive measures to eliminate patient cost sharing for all COVID-19 diagnostic testing.  That means, no copays and no coinsurance. 

Furthermore, many are waiving and easing the requirements for network, referral, and prior authorizations for diagnostic tests, accelerating your access to care and appropriate treatment.  Additionally, in many cases, prescription refill limits on maintenance medications have also been waived, and there has been expanded access to telehealth hotlines.  In Arizona, increased telehealth services and expanded telemedicine programs (with waived cost-sharing) has been and continues to be an essential part of this crisis as many of our local hospitals have become overwhelmed with COVID patients.  

If you have questions about the emergency protections your specific health insurance provider has put in place, click here to search for your provider. 

I’ve lost my job and employer-sponsored insurance, what now?

As businesses across the country were forced to shut their doors or cut hours in compliance with stay-at-home orders, the COVID-19 pandemic has created historic levels of unemployment.  According to Healthcare Dive, more than 31 million Americans filed for unemployment insurance between March 1 and May 2, and the Kaiser Family Foundation (KFF) “estimates nearly 78 million people live in a family that experienced a job loss in that time, a majority of which (61%) were previously covered by employer-sponsored insurance.”

Health-policy experts stress that workers facing a loss of employer-based health insurance coverage should move quickly to evaluate coverage alternatives, and be open to pursuing options not previously considered. There are some options for Americans who have found themselves newly unemployed.  Employer-sponsored coverage can be stretched out for a period of time through COBRA.  However, according to Karen Pollitz, a senior fellow at KFF, “Most people are going to find it’s just impossible to afford [COBRA], but for some people who can swing it, it may be worth the expense.”  With COBRA, you have within 60 days of your qualifying event, so time is of the essence.  If you’re in Arizona, click here; and if you’re in California, click here to begin the application process.

Many could become eligible for Medicaid or subsidized coverage via the Affordable Care Act marketplace.  Even if you don’t think you qualify for Medicaid, it’s worth checking out.  Medicaid coverage can take retroactive effect as far back as three months, if you were eligible during that period of time, and offers free or low-cost and comprehensive benefits. Both Arizona and California have adopted Medicaid expansion under the ACA, meaning you can qualify if the current household monthly income is 138% of the federal poverty level – $1,467 a month for individuals, $1,983 for a family of two and $3,013 for a family of four.  

LRJ Health Solutions is a Health Insurance Broker Here to Help

At LRJ, keeping you and your family safe, healthy, and covered continues to be our top priority. Please don’t hesitate to contact us so we can discuss your healthcare provider’s specific emergency plans to ensure you have access to the prevention, testing, and treatment needed to help fight COVID-19.  Licensed in both California and Arizona, LRJ is proud to serve all communities in both states – we are confident that we can collectively overcome this challenge and are committed to doing our part to keeping our communities healthy and protected.  We can also be reached via phone at 480.779.8253 or via email – [email protected].  We look forward to hearing from you!