March 11, 2020
Governor Tom Wolf today announced that the state’s Medicaid program, Medical Assistance (MA) and Children’s Health Insurance Program (CHIP), will cover COVID-19 testing and treatment for recipients and is lifting some prior authorization requirements to ease access to necessary testing and treatment. There are no MA or CHIP copayments for laboratory tests for COVID-19. For those services that do have copayments, MA providers may not deny services if a beneficiary is unable to pay the copayment.
“We are prepared to mitigate COVID-19 throughout the commonwealth, and part of this mitigation includes ensuring that anyone who needs to be tested for COVID-19 can access the test,” said Governor Tom Wolf. “No Pennsylvanian should forego testing for any reason, if deemed medically necessary, including fear of what it might cost.”
The MA and CHIP programs will pay for COVID-19 testing when a health care practitioner determines it is needed, and prior authorization is not required. While there is no specific antiviral treatment for COVID-19, the MA and CHIP programs cover a broad range of services that help relieve symptoms.
The Department of Human Services reminds Pennsylvanians that Medicaid enrollment is year-round and if anyone is currently uninsured, they should go to compass.state.pa.us to see if they qualify for Medicaid.
“We are pleased to make this announcement today and thankful to our partners at the Centers for Medicare for Medicaid Services and our managed care organizations for working with us to ensure that anybody who needs to be tested for COVID-19 will have no barriers to the test,” said DHS Secretary Teresa Miller.
Providers and patients can consult the Medicaid FAQ and CHIP FAQ for more information and answers to common questions related to medical assistance coverage and COVID-19 and information on who to contact if consumers need more information.
The Wolf Administration recently released guidance through the Pennsylvania Insurance Department outlining resources available and coverage for COVID-19 testing through commercial health insurers. Read more on common questions related to commercial insurance coverage and COVID-19 here.
Visit the PA Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19.