Leeann Medina-Martinez, LCSW, is a bilingual Spanish oncology social worker and the Disparities Program Coordinator at CancerCare. She provides supportive counseling and resources to patients, caregivers, loved ones, and people who have experienced the loss of a loved one.
The Public Health Emergency (PHE) was declared by the U.S. Department of Health and Human Services in January 2020 as a response to the COVID-19 pandemic. The PHE was put in place so more people could have access to medical care during a period of emergency. The PHE has allowed for increased access to certain health care services, such as telemedicine, and has allowed some changes to the requirements for certain government health insurance programs, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.
The PHE is set to expire on May 11, 2023, and millions of people could lose their health insurance coverage as a result. Here, learn what the end of the PHE may mean for you and how to keep your coverage or get new coverage once the PHE expires.
How has the PHE impacted health insurance coverage?
The PHE has allowed people who need to be enrolled into Medicaid to do so without waiting for an open enrollment period. So if a person who did not have medical coverage was suddenly in need of coverage, they would be able to apply and enroll into Medicaid without waiting. The PHE also extends eligibility for programs like Medicaid, Medicare, and CHIP to people who might not have been eligible previously. In addition, those who are enrolled in one of these programs receive coverage for COVID-19 testing, vaccinations, and treatment services under the PHE, as do those who are uninsured.
People with cancer, in particular, have seen benefits from the PHE. Access to telehealth is covered by the PHE, which allows people with cancer to limit their exposure to COVID-19 and other diseases by having telephone or video visits with their doctors. Telehealth has also allowed for out-of-state coverage and consultations with doctors without the need to travel. Finally, the PHE allows greater access to obtaining medications and other long-term services.
What does the expiration of the PHE mean for people enrolled in Medicaid, Medicare, or CHIP?
People who were covered under these programs could lose their coverage or the cost of coverage could go up. The financial impacts of cancer could become a large concern, as a lot of the services that were covered under their insurance plans might no longer be covered. The expiration of the PHE could also mean the end of telemedicine appointments in certain states with certain types of coverage. Medicare recipients will be allowed to have telemedicine through December 31, 2024, even if they do not live in rural areas. For Medicaid recipients, it will vary depending on the state. People with cancer may also have to spend more on transportation as in-person appointments become the only way to receive cancer care in some areas.
What can people with cancer do to keep their existing coverage once the PHE expires?
People who have cancer and are looking to keep their existing coverage once the PHE expires will have to see if they are eligible for Medicaid and CHIP programs under the non-emergency requirements. Applying for Medicare is also an option if a person meets the eligibility requirements for that program. If a person is not eligible, then the next option would be to search the U.S. federal government’s Marketplace website for coverage.
What should people know if they plan to switch to a Marketplace plan instead?
Switching to a Marketplace plan can be complex because of the application and enrollment process. Choosing a plan can be challenging, which leads some people to give up on the process out of frustration. However, remember that there are resources available to help. The U.S. government offers a toll-free call center about Marketplace guidance at 800-318-2596. And, organizations like CancerCare have free resource navigation services available to help connect you to resources on a national level. Call CancerCare’s toll-free Hopeline at 800-813-HOPE (4673) to connect with an oncology social worker for assistance navigating the practical challenges that arise from cancer. You can also talk with a financial counselor or social worker at your care center for assistance.
While switching to a Marketplace plan will provide you with medical insurance, it is important to note that there might be changes in your coverage and certain expenses may change, such as co-pays. Also, there is a possibility that your current provider will not accept the new insurance, so always check with your medical provider before choosing a new insurance plan.
If you are concerned about what the end of the PHE means for you and your health insurance coverage, be sure to talk with your health care team. They can help you determine what the end of the PHE means for you and can assist you with keeping your coverage or finding new coverage. Learn more about health insurance coverage during cancer.
The author has no relationships relevant to this content to disclose.