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Out-Of-Network Insurance Coverage COVID-19 Checklist

COVID-19 Checklist for Out-Of-Network Insurance Coverage

Protecting Against COVID-19

Ohio Department of Health Director Amy Acton, M.D., MPH, strongly recommends that Ohioans are aware of the following information provided by the Ohio Department of Insurance regarding out-of-network insurance coverage specific to COVID-19 testing and treatment.

  • Effective March 20, 2020, the Ohio Department of Insurance issued a bulletin defining COVID-19 testing and treatment as emergency services. The bulletin is available at:
    https://iop-odi-content.s3.amazonaws.com/static/Legal/Bulletins/Documents/2020-05.pdf
     
  • Health insurance corporations (HICs) and health maintenance organizations (HMOs) are required to pay for COVID-19 testing and treatment at both in-network and out-of-network hospitals, with no balance bill.
     
  • Other plans that are subject to the Ohio Department of Insurance’s jurisdiction are also required to pay for COVID-19 testing and treatment at both in-network and out-of-network hospitals.
  1. In the case of an out-of-network hospital for these types of plans, the health plan is required to pay what they would typically pay an in-network provider or out-of-network provider, or the Medicare rate – whichever is the greatest.
     
  2. As a result, the hospital will be receiving either a market rate or the Medicare rate – whichever is higher. However, the consumer may receive an out-of-network bill that the insurer is not required to pay.
  • If consumers receive bills for testing and treatment of COVID-19, they should reach out to the Ohio Department of Insurance at Consumer.Complaint@insurance.ohio.gov to ensure claims are being processed according to the Ohio Department of Insurance guidance.
     
  • The Ohio Department of Insurance does not have regulatory authority over a significant number of health plans in Ohio. As a result, the Ohio Department of Insurance’s order does not apply to Medicare, Medicaid, or self-insured employer plans.


For answers to your COVID-19 questions, call 1-833-4-ASK-ODH (1-833-427-5634).


If you or a loved one are experiencing anxiety related to the coronavirus pandemic, help is available. Call the Disaster Distress Helpline at 1-800-985-5990 (1-800-846-8517 TTY); connect with a trained counselor through the Ohio Crisis Text Line by texting the keyword “4HOPE” to 741 741; or call the Ohio Department of Mental Health and Addiction Services help line at 1-877-275-6364 to find resources in your community. 


Prevention Infographic


Protect yourself and others from COVID-19 by taking these precautions.

  • Stay home 
  • Practice Social Distancing
  • Get adequate sleep and eat well-balanced meals
  • Wash hands often with water and soap (20 seconds or longer)
  • Dry hands with a clean towel or air dry your hands
  • Cover your mouth with a tissue or sleeve when coughing or sneezing
  • Avoid touching your eyes, nose, mouth with unwashed hands or after touching surfaces
  • Clean and disinfect "High-Touch" surfaces often
  • Call before visiting your doctor
  • Practice good hygiene habits 


If you have questions regarding Coronavirus/COVID-19 please call 1-833-4-ASK-ODH (1-833-427-5634)


CLEAN ALL "HIGH-TOUCH" SURFACES EVERY DAY

High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.



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