Advice in this article is subject to change. We will make updates as needed.
As the number of COVID-19 cases rise, we know that you will field more and more calls from existing and potential clients.
Here’s some guidance on what you can do for your clients and your community:
Walk them through how their plan will cover COVID-19
HHS declared COVID-19 testing an essential health benefit [1], so the cost-sharing rules for COVID-19 will be the same as any other viral infection for Marketplace health plans [2].
Many health plans have pledged to waive any cost-sharing (including co-pays) that would apply to the test, as well as certain co-pays for treatment. America’s Health Insurance Plans is maintaining this list of how health insurers are responding to COVID-19.
There’s a link to view plan details from each client’s page, and you can walk through how much services related to getting a COVID-19 test might cost. This includes labs, diagnostic tests, hospital services, and emergency room visits.
Many health systems are changing in-person appointments to remote ones, wherever possible. Be sure to highlight the cost-sharing rules for virtual appointments, and warn your clients that non-urgent procedures may be postponed.
Offer advice in case of layoffs or reduced hours
According to a NPR/PBS NewsHour/Marist poll released on March 14th, 1 in 5 households have already experienced a layoff or reduction in hours due to COVID-19.
Reach out to your clients and offer to do some proactive contingency planning. For example:
- If a client knows their wages will decrease, make sure they know that they need to keep their income up-to-date because it may lower their premium payments.
- If someone in the client’s household knows they will lose their job-based coverage, they can take advantage of an SEP 60 days in the future.
- Let your clients know that you can easily help them apply for Medicaid if their income changes. Our quoter will flag if they are Medicaid eligible and your client can complete their Medicaid application through our site.
Consider reaching out to a client’s employer if your client is getting laid off. Chances are many of his colleagues are in the same boat. You may be able to support other employees and help them assess their options.
Review Form 1095-A with clients that have yet to file taxes
Reach out to clients that might still need help with their taxes and let them know you can retrieve their Form 1095-A. We put together an article here about how you can do this for your clients, even if they enrolled in their 2019 Marketplace coverage without your help.
Also, check that your clients know the deadlines. On March 20th, Treasury Secretary Steven Mnuchin announced that the IRS’ tax filing deadline will be extended to July 15th. For now, this only applies to federal taxes. However, this postponement only applies to federal taxes. The American Institute of CPA’s is maintaining a list of state tax filing guidance here.
This list is in no way exhaustive. If you have any suggestions of what can be added to this article, please share in the comments section below, or fill out this form to let us know what resources would be helpful.
[2] https://www.healthcare.gov/blog/coronavirus-marketplace-coverage/