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  • Writer's pictureClayton Wood

What You Need to Know: COVID-19 Emergency Declaration Expires May 11, 2023

Updated: May 10, 2023

The Biden Administration has announced that the Public Health Emergency and National Emergency declarations related to the COVID-19 pandemic will expire on May 11, 2023. This will affect group health plans as they will no longer be required to comply with certain mandates related to COVID-19 testing and vaccines.

After the expiration, group health plans will revert to how they would otherwise cover these services. Additionally, the National Emergency declaration allowed the suspension of certain deadlines for health plan coverage and liabilities during the Outbreak Period.

With the National Emergency set to end on May 11, 2023, the Outbreak Period will end on July 10, 2023, and the suspended timeframes will expire based on a one-year rule or 60-days from the end of the National Emergency.

As the COVID-19 emergency winds down, many employees may be wondering how their health insurance coverage will be impacted. While May 11th is not necessarily a hard and fast end date for the pandemic, it is a significant milestone in many areas as emergency orders and restrictions are lifted. Here are some possible changes employees may expect to see related to their health insurance coverage:

  1. Telehealth coverage may become more limited: During the pandemic, many health insurance plans expanded coverage for telehealth visits to help patients access medical care without leaving their homes. As the emergency winds down, some insurers may start to scale back this coverage, meaning employees may need to start paying out-of-pocket for telehealth visits again or return to in-person visits.

  2. Reduced cost-sharing for COVID-19 treatment: Many insurers waived cost-sharing for COVID-19 treatment during the pandemic, meaning that employees did not have to pay out-of-pocket for treatment related to COVID-19. As the pandemic winds down, some insurers may reinstate cost-sharing for COVID-19 treatment, which could result in higher out-of-pocket costs for employees.

  3. Changes to prescription drug coverage: During the pandemic, many health insurers relaxed restrictions on prescription drug coverage, such as waiving prior authorization requirements or allowing early refills. As the emergency ends, some insurers may reinstate these restrictions, meaning that employees may need to go through additional steps to get the medications they need.

  4. Changes to provider networks: During the pandemic, some health insurers expanded their provider networks to include out-of-network providers to help patients access medical care. As the emergency winds down, some insurers may reduce their provider networks back to pre-pandemic levels, meaning that employees may need to find new providers or pay more for out-of-network care.

It's important to note that not all insurers will make these changes, and some changes may not be immediate. Additionally, some changes may be temporary or may only affect certain policyholders. Employees should review their health insurance policies and talk to their HR representative or insurer to understand how their coverage may be impacted as the COVID-19 emergency ends.

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