A: Yes, Gov. Burgum issued an executive order on March 20 that ordered insurance companies to expand telehealth services to consumers. Insurance carriers must start or continue to provide covered services via telehealth. Click here to read the bulletin issued by Commissioner Godfread.
If you have a health benefit plan regulated by the State of North Dakota, you should not have to pay for the test. A health benefit plan is generally defined as an individual (including family), small group, large group, or short-term limited duration plan. The Department recommends that you contact your health benefit plan at the number listed on your identification card to see if your specific plan is regulated by North Dakota and is not self-funded.
Pursuant to Bulletin 2020-1 issued by Insurance Commissioner Jon Godfread, health carriers have been asked to waive any cost-sharing, including co-pays, deductibles, and coinsurance for Centers for Disease Control and Prevention (CDC) recommended laboratory testing of COVID-19. In addition, health carriers have also been asked to waive cost-sharing for an in-network provider office visit, urgent care center visit, or an emergency room visit when testing for COVID-19. This includes short-term limited duration policies but does not include health sharing ministries as those plans are generally not subject to any regulation.
Health benefit plans cover medically necessary treatment for disease but the treatment may be subject to deductibles, copayments and coinsurance. You will need to pay those amounts, even if the care is covered. If you have a short-term limited benefit plan, there may be additional limits on what is covered.
Pursuant to Bulletin 2020-1, in the event an immunization becomes available for COVID-19, the Department has requested that health carriers immediately cover the immunization at no cost sharing for all covered members.
Health insurance may not be canceled based on a new diagnosis. If you have a short-term medical plan, your claims may be reviewed to see if you had a pre-existing condition.
During the standard open enrollment period, or if you have a special enrollment period for a health benefit plan, you cannot be denied coverage that qualifies as a health benefit plan under the Affordable Care Act. Being diagnosed with COVID-19 would not qualify for a special enrollment period. If you are applying for a short-term medical plan, hospital indemnity plan or other health insurance that is not a health benefit plan under the Affordable Care Act, the insurer can refuse to sell you insurance if you do not meet their underwriting guidelines.
Medicare Part B covers many preventive services, such as screenings, vaccines and counseling. If you meet the eligibility requirements and guidelines for a preventive service, you must be allowed to receive the service. This is true for Medicare and Medicare Advantage plans, however, your plan’s coverage rules may apply.
If you have questions or concerns about your Medicare insurance coverage, contact the State Health Insurance Counseling (SHIC) program by phone at (701) 328-2440 or (800) 247-0560 or via email at email@example.com.
A short-term medical plan is a temporary health insurance policy typically offering “bare-bones” coverage designed for use during unexpected coverage gaps. An individual can only hold a short-term medical plan for a short period of time, less than one year. These plans are nonrenewable. Furthermore, they do not meet the coverage requirements of the Affordable Care Act (ACA), meaning an individual may have to pay a monetary penalty for not carrying acceptable health insurance coverage.
With the regulations established by the ACA, short-term medical, limited benefit and discount medical plans have become increasingly popular. However, consumers must be aware of what they are purchasing before replacing their comprehensive major medical coverage with one of these options. Remember, if it sounds too good to be true, it probably is.