Marketplace Coverage & Coronavirus

If you already have coverage through the Marketplace, the rules in your Marketplace health plan for treatment for the coronavirus disease 2019 ( COVID-19 ) emergency remain the same as any other viral infection, but your health insurance company may have added benefits .All Marketplace plans cover :Learn more about booster shots at CDC.gov .

When you get a COVID-19 vaccine, your provider can’t charge you for an office visit or other fee if the vaccine is the only medical service you get. If you get other medical services at the same time you get the COVID-19 vaccine, you may owe a copayment or deductible for those services.

If you paid a fee or got a bill for a COVID-19 vaccine, check this list to see if your provider should have charged you :If you think your provider incorrectly charged you for the COVID-19 vaccine, ask them for a refund. If you think your provider charged you for an office visit or other fee, but the only service you got was a COVID-19 vaccine, report them to the Office of the Inspector General, U.S. Department of Health and Human Services by calling 1-800 – HHS-TIPS or visiting TIPS.HHS.GOV .All Marketplace health plans cover COVID-19 diagnostic tests done at a doctor’s office or other health care provider in your plan’s network, even if you don’t have symptoms, or don’t know if you’ve been exposed to COVID-19. For example, if you want to make sure you’re COVID-19 negative before visiting a family thành viên, you pay nothing to get tested .Starting January 15, your Marketplace plan covers at-home COVID-19 tests you buy trực tuyến or at a pharmacy or store .Call your health insurance plan for more details .Call before going to the doctor. Many routine medical visits are being postponed, or done trực tuyến or by phone. Telehealth services for non-emergency and non-COVID-19-related care may be available to you .If you must visit in-person, you may be asked to do the following to lower exposure risk and protect others :

If you’re sick with COVID-19 or think you may have it, visit CDC.gov for steps to help prevent the spread. If you need emergency care, you should go to the closest hospital that can help you.

You may qualify for a Special Enrollment Period if you experience certain life changes like :

Note: If you lost coverage or had another life change more than 60 days ago, you may qualify for a Special Enrollment Period if you previously qualified for a Special Enrollment Period, but you missed the 60-day deadline to enroll because you were impacted by the COVID-19 national emergency. Voluntarily dropping coverage doesn’t qualify you for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan.

If you’re enrolled in a Marketplace plan and your household income has changed, update your application immediately. If your income goes down or you gain a household thành viên :If you plan to claim your child as a tax dependent on your federal tax return, and you currently have Marketplace savings with your coverage, you can keep your child on your Marketplace application. Read the plan’s coverage documents and review the provider network carefully so you know how the plan covers care delivered in the state your child goes to school .

Note: If you change plans or add a new household member, any out-of-pocket costs you already paid on your current 2022 Marketplace plan probably won’t count towards your new deductible, even if you stay with the same insurance company. Call your insurance company before changing plans or adding a new household member to find out if you’ll need to start over to meet your new plan’s deductible.

In some states, Medicaid may cover COVID-19 testing if you don’t have other health coverage and don’t qualify for full Medicaid or the Children’s Health Insurance Program ( CHIP ) coverage. This limited Medicaid benefit only covers COVID testing and doesn’t cover any other health care benefits and services. It doesn’t count as having qualifying health coverage .

When filling out your Marketplace application, if your only coverage ending is COVID-19 testing Medicaid coverage, don’t tell us:

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