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Pandemic Prep: Understanding your insurance benefits during COVID

March 19, 2020

Here's how you and your employees can sift through the jargon to figure out what care is available to you, and how your insurance covers COVID-related services.

If you're a startup founder or a small business owner, you're probably wondering how to protect yourself and your employees in the face of coronavirus. Knowing your benefits and where to get care ahead of time can keep you calm in an emergency. Once you have an insurance plan, here's how you and your employees can sort through the jargon to figure out what care is available to you.

Many carriers are currently being flexible with coverage start dates due to coronavirus. Even if you miss the mid-month enrollment deadline, you may still be able to get coverage quickly. If you're considering covering yourself and your employees, Savvy can help. It only takes 5 minutes for employers unlike signing up for most group health plans, and you can even provide some coverage for part time employees.

Understanding your insurance plan

1. Telemedicine services

Many insurance plans give you access to virtual doctors. Call your insurance help line to see which services and providers they cover, how to access them, and how much it costs. Even if you didn't see telemedicine mentioned when you signed up for your health plan, you may still have access to telemedicine services. Some insurance companies have their own telemedicine service (like Oscar) and others contract with a third party, so it's a good idea to find out where to go before you need it.

2. Free testing

Most insurers are offering to fully cover COVID testing if you think you may be sick. You should call your insurance help line and find out in advance how much it will cost. Also, ask them where you can get tests performed "in-network". If a doctor's office or medical facility is in-network, you will pay less for services there, if anything at all.

3. Where to get treatment

Call your primary care doctor to ask if and how they're treating coronavirus. Some primary care doctors are not equipped to handle these cases, and if your doctor is not treating or testing for coronavirus, head directly to urgent care or a hospital if you suspect you are infected.

4. Price of treatment

Unfortunately, insurers are not yet waiving fee on treatments. To see how much treatment could cost you, check your plan documents, specifically the Summary of Benefits and Coverage. (Tip: SBCs have to be online, so you can google your plan name and SBC and they'll usually come up! Otherwise, they'll be in your online account). Here are the key things to look for:

• "Deductible" - this is how much you pay out of pocket for services before your insurance kicks in.

• "If you need immediate medical attention" - this section tells you the prices for emergency room stays, ambulance transportation, and urgent care.

• "If you have a hospital stay" - this section tells you how much you'll pay per night (facility fee), and how much doctors will charge (physician fees).

Understanding your insurance benefits and knowing where to go ahead of time can keep you ready and prevent missteps that could happen if you or a loved one suspect you have coronavirus.

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