For Consumers

COVID-19 and health coverage

The federal public health emergency ended May 11, 2023. People with private health insurance may have increased out-of-pocket costs for COVID-19-related services. If you’re on Apple Health (Medicaid), the state will notify you by mail if you need to reapply for benefits or if you're no longer eligible.

Here’s what you need to know about paying for COVID-19 tests, vaccines and treatment.

Vaccines

The federal government is still providing free COVID-19 vaccines, as long as supplies last. 

Vaccines are covered for free under the preventive services benefit of the Affordable Care Act, but you must see a health provider that is in your health plan’s network.  

At-home COVID-19 tests

Most health insurance companies will no longer provide free COVID-19 at-home tests. Contact your health plan for more information. At-home tests will be available to buy at pharmacies and other retail locations without a prescription. 

PCR and rapid tests from a medical provider

Insurance companies will cover polymerase chain reaction (PCR) and rapid tests done in a clinic or medical provider’s office, but you could have a copay and need to meet your deductible. Your health plan also may require you to see an in-network provider. This applies to anyone with private insurance, including Medicare Advantage plans. 

  • If you have traditional Medicare, tests will still be free, but you could be charged for the office visit. 
  • If you have Apple Health (Medicaid), tests will be free through September 2024.

COVID-19 treatment

Any prescription drug used to treat COVID-19 (Paxlovid) that is purchased by the federal government is still free, regardless of your insurance coverage. Once the federal supply of these drugs ends, people with insurance will likely have copayments for any drugs they need. Cost-sharing for hospitalizations and outpatient visits related to COVID-19 treatment will continue.

Telemedicine

Health insurance companies must still cover telemedicine the same as in-person visits for all types of care. However, the ways you can get telehealth may change. The federal government allowed medical providers to use additional communication tools to provide telehealth during the pandemic. After the emergency declaration ends, they must use methods that meet federal privacy standards. 

  • Also after May 11, 2023, you’ll need an in-person visit to get a prescription for controlled-substances.
  • People on Medicare will have expanded telehealth benefits through Dec. 31, 2024. 
  • Apple Health (Medicaid) will continue to cover telehealth.