What Does The End Of The Pandemic Public Health Emergency Mean For You

© JESSICA GRIFFIN/The Philadelphia Inquirer/TNS Charlotte Schwartz (left) is examined by Eric's RX Shoppe co-owner Mark Ost (right) for their fourth Covid vaccine at Eric's RX Shoppe Vaccine Clinic in Horsham, PA. Wednesday February 2, 2022

President Joe Biden announced on Monday that the COVID-19 national and public health emergency would end on May 11, nearly three years after the pandemic began.

The public health emergency began in January 2020 and has been extended ten times by the Department of Health and Human Services, most recently in January. Then, in March 2020, President Donald Trump declared a public health emergency.

The Declaration of Emergency gave millions of people access to Medicaid, a state and federal government funded health care program for low-income families and individuals. The Urban Institute, a Washington-based think tank, estimated in a December report that 18 million people will lose their Medicaid coverage within 14 months of the proclamation ending, including 3.2 million children who will be transferred to health plans for children. Another 3.8 million people will lose insurance altogether.

The state of emergency also allows the government to provide free vaccines, tests, and some COVID treatments to all Americans. This will change after the declaration is complete.

Here's what you need to know.

medical help

Thousands of Pennsylvania and New Jersey residents have recently become eligible for Medicaid.

Typically, Medicaid users must renew their insurance each year to demonstrate that they still meet the income requirements. The state has suspended the plan update process during the pandemic, but will resume in April.

Over the next year, people who enrolled in Medicaid during the pandemic will receive an update packet in the mail with instructions on how to ensure their coverage continues if they are still income-eligible. Those whose renewal applications have been denied because they now make too much money to qualify can sign up for private health insurance through the Obamacare marketplace;

vaccination

Vaccines are free to every American and have been during the pandemic. This will change.

Pfizer and Moderna have previously said they will start charging for vaccines after the public health emergency ends. Pfizer estimates the price per dose will be between $110 and $130. Uninsured people usually have to pay for vaccinations.

Private insurers will continue to cover the cost of COVID vaccines, even if people in their network must be vaccinated to avoid out-of-pocket costs.

Those with Medicaid or Medicare should continue to get free vaccinations. The Affordable Care Act requires these plans to cover recommended vaccines without copays.

examination

The government is sending out free COVID tests for now. A family can order a four-pack of vaccines from COVIDTests.gov.

People on Medicare can get eight free test kits a month, and the White House is also asking private insurance companies to reimburse participants for the same number of kits. State Medicaid and CHIP also cover the cost of testing for COVID-19.

Without a health emergency being declared, people covered by Medicaid and CHIP will need a doctor's order to get a free test, according to the Kaiser Family Foundation, a nonprofit dedicated to health policy. People who are privately insured may have to pay the cost of the test out of pocket.

Those without insurance must pay for the test.

Treatment

The federal government still has millions of doses of Paxlovid, a first-line treatment for people with COVID, that will continue to be free while supplies last, White House COVID Response Coordinator Ashish Jha said in a tweet Tuesday.

"Over time, we will move from buying vaccines and treatments from the US government to a conventional healthcare market," he said.

Drugs like Paxlovid and Lagevrio, another oral treatment for COVID, haven't received full approval from the Food and Drug Administration, but the agency has made them available through an Emergency Use Authorization (EUA). That won't affect their access after the state of emergency ends, said Matthew Cortland, a senior fellow who leads the disability portfolio at Data for Progress, a national survey organization and think tank. The EEA is a separate declaration of a national and public health emergency and will be in effect following its conclusion.

The treatment will only be available on the commercial market when government supplies run out. Medicare will cover oral care, including those available through the EUA, although Part D, which governs the reimbursement of prescriptions, likely requires a co-pay depending on the member's plan, Kaiser says.

Medicaid and CHIP will provide access to free care through mid-2024 under the American Rescue Program Act.

Private insurance companies should also cover the cost of the treatment, although participants will likely be billed as well.

Individuals who do not receive insurance or other social protection programs are responsible for the full cost of COVID-19 treatment.

remote treatment

Virtual appointments have played a vital role in keeping people in touch with their doctors during the pandemic.

Medicare and Medicaid have agreed to temporarily cover these visits, like in-person appointments. Once the public health emergency is over, Medicare recipients will be able to use telehealth for behavioral and mental health on an ongoing basis, according to the Department of Health and Human Services. They can also use telehealth for other health services through the end of 2024 if they don't live in a rural area, KFF reports.

According to the Kaiser Family Foundation, most states plan to permanently introduce or plan to introduce expanded remote drug access for Medicaid recipients.

Doctors and patients want telehealth to resume, said Jonathan Stalkamp, ​​chief medical officer at Main Line Health, but it's unclear which private insurance companies will cover it after the emergency is over.

"I think most vendors will be willing to continue providing it as long as they are reasonably paid for it," he said.

During the COVID disease

Philadelphia continues to require employers to provide employees with COVID-19-related paid sick time, in addition to paid sick time already offered. This should be completed by the end of this year, regardless of the declaration of a state of emergency.

Staff reporter Sara Ganz contributed to this article.

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