From ALLtech medical provider Regence BlueShield
As the COVID-19 pandemic approaches the three-year milestone, it’s become hard to remember what life was like before we were all living under a public health emergency (PHE). For residents of Washington state, that is changing.
According to Covid Act Now, community risk for COVID-19 throughout most of Washington is low. The state’s vaccination rates are among the highest in the United States, and the Centers for Disease Control and Prevention (CDC) reports Washington as having the fifth-lowest death rate among all states.
Washington state’s public health leaders still emphasize the importance of staying up to date on vaccinations and continued mask wearing. And with full confidence in those and other tools proven to mitigate COVID-19’s impact, Gov. Jay Inslee officially called an end to the PHE, effective Oct. 31, 2022.
What Washington state ending the PHE means for access to health care
With Washington’s PHE ending, some state-specific PHE provisions have expired. Here’s a summary of what’s changed in Washington.
- Out-of-network treatment may cost patients more. The Washington PHE temporarily required private health insurers like Regence to cover many members’ COVID-19 treatment at in-network (INN) cost shares. That meant many Washingtonians with employer-sponsored or Individual/family health insurance could access treatment at any provider in the state and pay the typically lower in-network rate, regardless of whether the provider was in the insurer’s network. With the rule’s expiration, these health plan members will want to be careful to seek COVID-19 treatment from in-network (INN) providers to avoid paying higher OON cost shares. For Medicare members, federal PHE considerations may be different.
- Vaccination counseling may cost more. To encourage vaccination uptake, the Washington PHE temporarily required private health insurers to cover vaccination counseling, in which patients review and discuss the risks and benefits of specific vaccines with their provider, at no cost to the patient. Beginning Nov. 1, insurers are allowed to cover vaccination counseling for most patients at regular health plan cost shares. Check with your health plan to see whether vaccine counseling services will cost you anything out-of-pocket.
What’s not changing in Washington state
The following rules included in the Washington PHE will remain in effect as long as the federal PHE is in place:
- COVID-19 testing and related provider visits are still covered with $0 out-of-pocket cost to patients when the testing is conducted at an FDA-approved lab.
- Patients are protected from receiving “surprise bills” for lab fees related to medically necessary diagnostic testing for COVID-19.
Some self-funded employers added customized benefit enhancements to their health plans that may supersede the expiring Washington state and remaining federal PHE rules. In most of these cases, benefit enhancements will remain in place for employees (and their covered dependents) through the end of their employer’s health plan year.
Regence members – including those enrolled in ALLtech – looking to better understand their COVID-19 vaccination, testing and treatment coverage can sign in to their account on regence.com to learn more or call the Customer Service phone number on the back of their member ID card. Members who don’t have an account can create one by visiting regence.com/member/registration.