Who pays for COVID-19 diagnostic testing/treatment if needed?
Medical Assistance (MA) and Managed Care Organizations (MCOs)
Lab Testing: For Medical Assistance (MA) and MCOs, all lab tests, including tests for COVID-19, are covered without copayments or prior authorization
Treatment coverage includes:
- X-rays and diagnostic testing (no prior authorization required)
- Hospital care (inpatient and outpatient)
- Emergency Ambulance Transportation
- Non-emergency transportation to MA covered appointments
- Home health services
- Nursing facility care
- Prescription drugs (early refills and extended supplies now available)
- Any medically necessary service for people under the age of 21
Telemedicine Coverage - Medical Assistance: Telemedicine preferred when patient is quarantined or self-isolating. Patient can receive services provided through telemedicine at home. Hospital clinics, outpatient clinics, CRNPs, physicians, physician's assistants, certified nurse midwives, and early intervention therapists can provide services through telemedicine. Service must be rendered in the same way it would have been in-person.
Audio-visual connectivity is strongly preferred, but telephone-only may be used if A/V is not available. Services paid the same as if they were rendered face-to-face for both behavioral and physical health
Telemedicine Coverage - MCOs: MCOs must offer coverage for services through telemedicine that meets or exceeds coverage under fee-for-service. Many MCOs offer more expansive coverage and have specific apps that they offer to patients. MCOs have been instructed to make network providers and enrollees aware of their telehealth options.
For specific coverage information, please contact the Medical Assistance fee-for-service program if you only have an ACCESS card, or your managed care organization if you have another insurance card in addition to your ACCESS card.
Services paid the same as if they were rendered face-to-face for both behavioral and physical health.